Ambivalence Predicts Schizotypic Symptoms and Impairment in Daily Life: An Experience Sampling Methodology Study

Pathological ambivalence, which refers to the simultaneous experience of opposing and contradictory thoughts or emotions, is a relatively understudied construct despite its integral role in early formulations of schizophrenia and schizotypy. The Schizotypal Ambivalence Scale (SAS) was developed to measure this synchronic ambivalence characteristic of schizophrenia-spectrum psychopathology. Interview, questionnaire, and ambulatory assessment studies have demonstrated the SAS is associated with multidimensional schizotypy. The present study examined the expression of ambivalence, as measured by the SAS, in daily life using experience sampling methodology (ESM) in 227 young adults. We also examined ambivalence as a predictor of reactivity, variability, and instability affective dynamics. Participants were prompted by a smartphone application eight times per day for one week to complete ESM questionnaires that assessed affect, social functioning, situation appraisals, and schizotypic experiences in daily life. Overall, SAS scores were associated with daily life experiences of positive, negative, and disorganized schizotypic experiences, emotional dysregulation, and social impairment. SAS scores also predicted time-dependent affective dynamics. Specifically, ambivalence predicted reactivity and variability of negative affect, as well as variability of appraising the current situation as positive. The study also includes an exploratory examination of the effects of ambivalence over-and-above neuroticism measure by the NEO-FFI-3. The present study supports results from interview and questionnaire studies that pathological ambivalence is a cross-cutting component of multidimensional schizotypy and provides further support for the construct validity of the SAS.