Expert Witness Journal Issue 64 December 2025 - Flipbook - Page 7
The Role of Emotion in Psychosis Onset
by King’s College London
New research from the Institute of Psychiatry,
Psychology & Neuroscience (IoPPN) at King’s
College London has highlighted the important role
that emotions play in the onset and persistence of
psychosis.
and maintenance of their psychosis symptoms.
Therefore, psychological interventions that explicitly
target emotions and emotional coping in psychosis
could help prevent relapse and maintain recovery.”
- Dr Anna Georgiades,
a Lecturer in Early Intervention in Psychosis
at King’s IoPPN and the study’s senior author
The research, published in Early Intervention
in Psychiatry1, advocates for the development of
emotion-focused interventions that seek to prevent
a person’s relapse in their health as well as maintain
their recovery.
The researchers also wanted to explore how
individuals at CHR and those with schizophrenia
employed coping mechanisms to manage emotional
situations. They found that, while the healthy
controls were more likely to adopt “Adaptive
Coping Strategies”, in which individuals seek to
manage stress and di昀케cult situations in healthy and
constructive ways, people with psychosis were more
likely to employ maladaptive techniques that were
associated with an increase in their symptoms and
increased depression.
Psychosis is a symptom of mental illness typi昀椀ed
by hallucinations, delusional thoughts and
disorganized thinking. While previous research has
implicated emotion in the onset and continuation
of psychosis, there has not yet been a universally
acknowledged theory to account for the in昀氀uence
that emotions can have on it.
Researchers in this study conducted a systematic
review of 78 studies comparing the experiences of
healthy controls with individuals at Clinical High
Risk (CHR), a diagnosis of schizophrenia (SZ), and
those experiencing their First Episode of Psychosis
(FEP). Researchers wanted to better understand
both the role of emotions, as well as emotional
coping strategies, in their experiences.
Dr Anna Georgiades, a Lecturer in Early Intervention
in Psychosis at King’s IoPPN and the study’s senior
author said,
This systematic review found that SZ and CHR
individuals demonstrated signi昀椀cant impairments
in their emotional awareness, their understanding
of self and others, and their ability to regulate
their emotions when compared to healthy controls.
They also demonstrated a heightened emotional
reactivity.
The researchers found that individuals with
schizophrenia reported high levels of “Negative
A昀昀ect” - a reduction or absence of normal emotional
expression – which was a strong predictor of
paranoia.
“
Experiencing emotions is a natural part of everyday
life. However, our study highlights that people with
psychosis experience emotions with more intensity,
which can signi昀椀cantly contribute to the emergence
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“
“
There are two ways in which a person might manage
an emotionally stressful situation; either by removing
the stressor, or by seeking to manage the stress that is
being caused.
“
By reducing unhelpful emotional coping and by
increasing more helpful emotional coping ( i.e. by
increasing active problem solving and the skill in
changing one’s view of a situation), we could prevent
relapse and maintain recovery. This therefore has
important implications for the psychological treatment
of psychosis.”
From the studies we reviewed, we consistently found
that people with psychosis used more unhelpful
emotional coping such as avoidance and suppression
rather than helpful emotional coping such as problem
solving or changing the way they think about the
situation.
1
The Role of Emotion in Psychosis Onset and Symptom
Persistence: A Systematic Review (DOI.org/10.1111/eip.70096)
(R. Gurnani, A. Georgiades) was published in Early Intervention
in Psychiatry.
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DECEMBER/JANUARY 2025-2026
