Date Submitted
7-31-2026
Faculty Advisor
Jennifer Fugate
Abstract
Schizophrenia is a chronic and pervasive psychiatric disorder characterized by cognitive, perceptual, social, and occupation deficits, with symptoms that often persist throughout adulthood. Although antipsychotic medications are effective for managing positive symptoms, negative symptoms – such as diminished emotional expression, avolition, apathy, and asociality – are often treatment resistant. Negative symptoms are associated with poorer prognosis; these symptoms often worsen over time and severely impact one’s functioning and recovery. Emotional granularity (EG), the ability to identify, differentiate, and describe emotional states, is associated with emotional regulation, psychological well-being, and social functioning. High EG correlates with positive mental health outcomes, whereas low EG corresponds to impaired emotion regulation and psychopathology. Clinical insight – one’s ability to recognize symptoms and attribute them to a diagnosis – is essential for treatment adherence and positive outcomes; however, many individuals with schizophrenia lack insight, leading to treatment noncompliance and poorer outcomes. Current literature on EG is limited for individuals with schizophrenia. Likewise, research on effective therapeutic interventions designed to improve EG and insight is minimal. The purpose of this study was to examine the relationships between EG, clinical insight, and schizophrenia symptoms, as well as to assess the feasibility and potential effectiveness of a group therapy intervention focused on emotion language development in an inpatient setting. Specifically, this study was designed to examine whether patients with more severe negative symptoms and diminished clinical insight demonstrated lower EG at baseline. It would also explore whether receiving a word-learning intervention additional to treatment as usual (TAU), was associated with reductions in number and severity of negative symptoms and increased clinical insight compared to TAU alone. A total of nine individuals diagnosed with schizophrenia participated in this study. Challenges with participant recruitment resulted in a much smaller sample size than anticipated. As such, the planned inferential statistics could not be completed. Instead, descriptive statistics and qualitative observations were used to summarize participant characteristics, behaviors and engagement, and notable trends or changes to study variable. Overall, participants who received the intervention demonstrated descriptive reductions in severity of negative symptoms and improvements in clinical insight, whereas changes in EG were generally mixed across measures. Although these findings are preliminary and cannot determine treatment effectiveness, they are consistent with the theoretical rationale that increasing emotional awareness and vocabulary may support overall functioning for individuals with schizophrenia.
