Altered top-down modulation of electrodermal responses to sudden auditory stimuli in individuals at clinical high risk for psychosis

Emotional disruptions are a key component of psychotic disorders. In particular, disruptions in emotion regulation form a cornerstone to impaired social functioning and clinical symptoms. Although several paradigms have been leveraged to characterize the components of emotion in psychosis, how their regulation relates to psychosis-risk symptoms, and whether it is impacted by secondary psychopathology, is less well-understood. We began to bridge these findings by investigating intentional regulation of electrodermal responding to a sudden auditory stimulus in individuals with psychosis risk symptoms. A total of 70 participants completed a paradigm examining electrodermal responding during unwarned, spontaneous regulation (with 20-second countdown), and instructed regulation (with explicit instruction to downregulate and a 20-second countdown) delivery of a sudden auditory stimulus. The relationships between electrodermal responding, psychosis risk symptoms, and subjective emotional judgements were explored. Participants downregulated their electrodermal responses, as indicated by both reduced rate of non-specific skin conductance responses (W > 3034, p_corr < 0.005) and reduced skin conductance response amplitude (W > 3015, p_corr < 0.005) throughout the task. More severe psychosis risk symptoms were related to higher baseline arousal (r_s = 0.30, p = 0.020) and larger skin conductance responses (r_s = 0.28, p = 0.030) on spontaneous regulation trials, and related to altered physiology-emotion relationships (β < -19, p < 0.01). Relationships with depressive and anxiety symptoms were present, but differed from those observed with psychosis risk symptoms. These findings suggest that spontaneous regulation of electrodermal responding and reduced physiology-emotion coherence may be specific to psychosis risk symptoms, and that top-down regulation of autonomic arousal may be a target of interest for intervention in those at-risk for psychosis.