Subjective emotional experiences in clinical high-risk youth: Insights from a dyadic interaction paradigm

Alterations in emotional functioning are a characteristic symptom of psychotic disorders. The clinical high-risk (CHR) period provides an important time for investigating early mechanisms, and their relation to psychosis vulnerability. However, our understanding of subjective emotional experiences in this critical population, particularly contextualized within social interactions, is limited. To address this gap, the present study aimed to evaluate subjective emotional experiences in CHR youth (12-30) using an experimental dyadic interaction paradigm. The sample included 148 individuals, 36 CHR-Partner dyads and 41 Control-Partner dyads, who engaged in three 10-min dyadic interactions (i.e., neutral, conflict, and pleasant). Following each conversation, participants reported the intensity of their positive and negative emotional experiences. Participants also completed a series of structured clinical interviews. CHR youth reported greater negative emotional experiences following pleasant conversations than control youth (U(74) = 533.5, p = 0.035). In CHR youth, greater negative emotional experiences following neutral conversations were associated with greater positive (r_s = 0.37,p_corr = 0.046) and negative (r_s = 0.44, p_corr = 0.038) psychosis-risk symptoms. Significant differences between CHR and control dyads were found for youth-partner discrepancies in positive emotional experiences following neutral (U(72) = 883, p_corr = 0.014) and conflict (t(72) = 3.28, p < 0.005) conversations as well as negative emotional experiences following neutral (U(72) = 914, p < 0.005) and pleasant (U(71) = 855.5, p = 0.043) conversations. Greater discrepancies in negative emotional experiences between CHR youth and partners following the neutral conversation were associated with greater negative symptoms (r_s = -0.42, p < 0.05). These results provide understanding into mechanisms driving socioemotional functioning in CHR individuals and can inform interventions that target close relationships to improve outcomes.