Emotional context processing in severe mental illness: scale development and preliminary construct validity.

There is growing recognition that emotional context may play an important role in emotion perception and severe mental illness (SMI). Limited instruments directly assess and adequately account for emotional context processing. To measure this construct in schizophrenia research, this study aimed to develop and validate the Emotional Context Processing Scale (ECOS) using cartoon portrayals originally developed by Masuda et al. (2008). In Study 1, we piloted the measure with 99 college students and selected 20 cartoon portrayals (4 simple emotions only+16 simple emotions with contextual emotions). In Study 2, we confirmed the emotion-specificity and factor structure of the measure by administering it to 73 individuals with SMI. Item response theory (IRT) modeling confirmed a 4-factor structure of the ECOS, providing evidence that emotional context processing is specific to particular emotions. Internal consistency of the ECOS subscales ranged from 0.61 to 0.83. In Study 3, we examined the convergent and divergent validity of the ECOS in a separate sample of 36 individuals with SMI. Even after controlling for facial affect perception, the ECOS is uniquely related to multi-modal emotion perception and executive functioning measures.