Humor recognition and appreciation deficits in early psychosis

Abstract

Humor recognition and appreciation are important aspects to enhance psychological well-being and enrich social relationships and interactions. The present study hypothesized that first-episode psychosis (FEP) patients with adult onset in the Chinese society have deficits in humor recognition and appreciation compared with healthy controls. It also predicted FEP patients with a diminished ability in recalling humorous stimuli. Moreover, this study sought to explore the potential associations of humor recognition and appreciation deficits with measures of clinical symptoms, psychosocial and neurocognitive functioning, and self-perception towards hope and recovery among FEP patients.

Thirty FEP patients with a DSM-IV diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder or delusional disorder were compared with 30 healthy controls matched for gender, age and education years on a humor task comprising six comedy video clips. Humor recognition was measured by the detection of total ‘standard humorous moments’ in the comedy clips. Humor appreciation was measured by self-report Visual Analogue Scale (VAS) funniness ratings. Percentage of recalled ‘standard humorous moments’ was also measured. Changes in positive and negative mood states were measured using Positive and Negative Affect Schedule (PANAS). Patients were assessed for clinical symptoms, psychosocial functioning, self-perception towards recovery and hope, and a battery of neuropsychological tests measuring executive function, working memory, intelligence quotient, semantic and visuospatial memory, and selective attention.

FEP patients had a lower number in detection of total ‘standard humorous moments’, in total VAS funniness rating, and in percentage of recalled ‘standard humorous moments’ compared with healthy controls. Patients and healthy controls did not differ in positive and negative mood changes induced by the comedy clips. In patients, humor recognition had significant negative correlation with negative symptoms and significant positive correlation with self-perception towards hope. Recall of ‘standard humorous moments’ had significant negative correlation with negative symptoms and significant positive correlation with immediate and delayed recall using working memory. Both humor recognition and appreciation had no correlation with psychosocial and neurocognitive functioning.

FEP patients had impaired humor recognition, appreciation and recall compared with healthy controls. The degree of humor recognition and recall deficits may be, respectively, associated with the extent of negative symptoms and attributed to impairments in the neurocognitive domain of working memory. Potentials of humorous stimuli in inducing a positive impact on mood for the patient population were found, providing insight for the introduction of humor therapy as a new form of intervention that could further improve psychological well-being.