What is emotional intelligence in schizophrenia?

Emotional intelligence in schizophrenia refers to the capacity to perceive, use, understand and manage emotions—based on Mayer and Salovey’s four-branch model—applied to people with schizophrenia and evaluated for deficits affecting social cognition and functioning.

What are the four branches of emotional intelligence in schizophrenia?

The four branches are emotional perception, emotional facilitation, emotional understanding and emotional management, organized into experiential (perception, facilitation) and strategic (understanding, management) areas.

How is emotional intelligence in schizophrenia assessed with the MSCEIT?

The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) uses 141 items across eight tasks to yield seven scores measuring experiential and strategic areas plus each branch; validated adaptations include a Spanish version.

What emotional intelligence deficits occur in schizophrenia?

Deficits include reduced facial expressivity, alexithymia (difficulty identifying and verbalizing emotions), impaired recognition of others' emotions (especially negative), and emotion regulation problems, often with preserved capacity to experience emotions.

How do emotional intelligence deficits in schizophrenia affect psychosocial functioning?

Emotional intelligence deficits negatively impact social and occupational functioning, reducing interpersonal skills, adaptive behavior, and overall psychosocial outcomes in individuals with schizophrenia.

Are there neurostructural correlates of emotional intelligence in schizophrenia?

Dysfunction in facilitation, understanding and management correlates with reduced gray matter in the left parahippocampal gyrus and right posterior cingulate gyrus in early-course schizophrenia.

Emotional intelligence in schizophrenia: Deficits in schizophrenia

Doctor of Psychology Carlos Rebolleda explains what emotional intelligence in schizophrenia is, its assessment, and the deficits in schizophrenia.

Emotional intelligence in schizophrenia: definition

The four-branch model of emotional intelligence proposed by researchers J.D. Mayer and P. Salovey in 1997 defines it as a type of intelligence different from others, composed of four abilities or “branches” specifically called emotional perception, emotional facilitation, emotional understanding and emotional management which, in turn, are organized into two areas called experiential and strategic.

As Mayer, Salovey and Caruso (2002) indicate, the experiential area refers to the individual’s capacity to perceive, respond to and manipulate emotional information without this necessarily implying comprehension. It indicates the accuracy with which the subject can “read” and express emotions and whether they can compare emotional information with other types of emotional experiences (for example, colors and sounds). This shows how the individual functions under the influence of different emotions. This area is made up of the perception and emotional facilitation branches.

1. Emotional perception

Emotional perception refers to the ability to recognize how an individual feels and those around them. This branch implies the ability to perceive and express feelings, as well as to pay attention to and accurately decode emotional signals from facial expressions, voice tone and artistic expressions (Mayer et al., 2002).

2. Emotional facilitation

Emotional facilitation focuses on how emotions affect cognition and can be used to reason, solve problems or make decisions (Mayer et al., 2002). It is known that some emotions, such as fear, can negatively affect cognition but, as multiple studies have shown, they can also enhance cognitive abilities, for example, by helping the individual prioritize what is most relevant when paying attention or by improving concentration when facing a task.

The so-called strategic area would be the individual’s capacity to understand and manage emotions without necessarily perceiving or experiencing them correctly. It indicates the accuracy with which the person is able to comprehend the meaning of emotions and the skill to handle both their own emotions and those of others. The understanding and emotional management branches make up this area (Mayer et al., 2002).

3. Emotional understanding

As Mayer et al. (2002) point out, the emotional understanding branch refers to the individual’s ability to label emotions, that is, to recognize that there are groups of related terms for them. The ability to understand how different emotions arise, how they combine or change over time, are fundamental components of emotional intelligence, as well as important aspects for relating with other people or improving self-knowledge.

4. Emotional management

Finally, the emotional management branch refers to the individual’s ability to, at appropriate times, not repress their emotions but rather work with them reflectively and use them to make better decisions. A term historically associated with this branch is emotional regulation, which has usually been understood as the repression or rationalization of emotions; however, this term actually refers to the involvement of emotions in thinking, not to their minimization or elimination (Mayer et al., 2002).

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Emotional intelligence in schizophrenia: Assessment

Emotional intelligence is considered an important component of social cognition (Matthews, Zeidner and Roberts, 2007; Mayer and Salovey, 1997) and since the MATRICS committee recommended in 2003 the management branch of the MSCEIT (Mayer et al., 2002) as the sole tool to measure social cognition in schizophrenia, several studies have attempted to explore the psychometric characteristics of the test, especially in populations diagnosed with schizophrenia.

Emotional intelligence in schizophrenia: test

The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT; Mayer et al., 2002) is based on the four-branch model and, through 141 items divided into eight tasks, yields a total of seven scores: an overall score, two for the experiential and strategic areas, and four for each of the branches that compose the model. The names of these tests are as follows:

Emotional perception: Composed of the tasks called Drawings and Faces,
emotional facilitation: Comprised of the subtests Facilitation and Sensations,
emotional understanding: Composed of Changes and Combinations,
Emotional management: Comprised of Emotional Management and Emotional Relations.

Reliability was 0.91 for the total score, 0.91 and 0.85 for the experiential and strategic areas respectively, while Cronbach’s alpha coefficients for the branches ranged from the lowest, yet adequate, coefficient of 0.74 in emotional facilitation to the highest of 0.89 in the case of emotional perception (Mayer et al., 2002).

Spanish adaptation of the MSCEIT: Extremera and Fernández-Berrocal (2009

Extremera and Fernández-Berrocal (2009) carried out the Spanish adaptation of the MSCEIT which, in turn, shows reliability coefficients very similar to or even higher than those found in the original test, being 0.95 for the total score, 0.93 and 0.90 for the experiential and strategic areas, 0.93 in perception, 0.76 in facilitation, 0.83 in understanding and 0.85 in emotional management. The Spanish adaptation, like other adaptations of the MSCEIT, shows adequate levels of face, predictive and content validity.

Emotional intelligence in schizophrenia: Deficits in schizophrenia

Some studies have found the existence of deficits in emotional intelligence both in patients diagnosed with psychiatric disorders (Lizzeretti, Extremera and Rodríguez, 2012), and in their direct relatives (Sanders and Szymanski, 2012).

Regarding the study of deficits in emotional intelligence in psychosis, one of the first investigations that used this concept as it is currently known was that of Aguirre, Sergi and Levy (2008), who found that people with high levels of schizotypy show deficits in emotional intelligence that, in turn, significantly affect their psychosocial functioning.

However, the study of the emotional deficits that accompany a psychotic disorder such as schizophrenia is much older; for example, the reduction these patients show in facial emotional expression has been confirmed in numerous studies (Andreasen, 1979; Borod et al., 1990; Tremeau et al., 2005; Yecker et al., 1999), a deficit that, as has been shown, is present even several years before the person develops the illness (Hafner et al., 2003; Yung and McGorry, 1996), which makes it a strong candidate to constitute an endophenotypic trait of the disorder.

These problems are not limited to facial expression; patients diagnosed with schizophrenia also show difficulties in identifying and verbalizing their own emotions (Cedro, Kokoszka, Popiel and Narkiewicz-Jodko, 2001; Stanghellini and Ricca, 2010; Van’t Wout, Aleman, Bermond and Kahn, 2007; Yu et al., 2011), a deficit known as alexithymia (Sifneos, 1973).

Added to these deficits are the problems these individuals show when recognizing emotional expressions in others, especially when those emotions are negative (Edwards et al., 2002; Kohler et al., 2003; Mandal et al., 1998; Scholten, Aleman, Montagne and Kahn, 2005).

Emotion regulation deficits have also been found in this population (Nuechterlein and Green, 2006), with emotional suppression being the self-regulation strategy these subjects commonly use (Kimhy et al., 2012; Van der Meer, Van’t Wout and Aleman, 2009). While the only emotional area in which patients diagnosed with schizophrenia appear to function similarly to the non-affected population is the capacity to experience emotions (Kring, Barrett and Gard, 2003; Kring and Earnst, 1999).

Even so, the aspect on which there is full agreement today concerns the negative influence these emotional deficits have on the individual’s psychosocial functioning (Baslet, Termini and Herberner, 2009; Kee, Green, Mintz and Brekke, 2003; Kimhy et al., 2012; Kring and Caponigro, 2010).

Research using the MSCEIT as a measure

As for studies that have used the MSCEIT as a measure, for example, Eack et al. (2010) expand on results obtained in three previous studies (Eack et al., 2009; Kee et al., 2009; Nuechterlein et al., 2008), using a sample of 64 individuals diagnosed with various psychotic disorders, including schizophrenia, to whom they applied this test.

Those authors found, first, that the scores obtained by the subjects were significantly lower than those of the non-psychosis population, although they emphasize the need to carry out rigorous studies that can yield more reliable results about the true degree to which these differences occur, since some studies claim that the most affected branch would be emotional management (Wojtalik, Eack and Keshavan, 2013), while others find that it is emotional understanding (Dawson et al., 2012; Kee et al., 2009).

Not all studies at this level find impairment in all branches that make up the test; for example, Kee et al. (2009) do not find significant differences in emotional facilitation between the group of patients diagnosed with schizophrenia and the non-diagnosed population. This reinforces the need to continue researching the actual differences and the degree to which they occur.

At the neurostructural level, Wojtalik et al. (2013) found that those patients who exhibit dysfunction in the facilitation, understanding and emotional management branches show a significant reduction of gray matter in both the left parahippocampal gyrus and the right posterior cingulate gyrus.

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