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Chan RCK, Wang LL, Huang J, Wang Y, Lui SSY. Anhedonia Across and Beyond the Schizophrenia Spectrum. Schizophr Bull 2024:sbae165. [PMID: 39326030 DOI: 10.1093/schbul/sbae165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Abstract
Anhedonia refers to the diminished ability to experience pleasure, and is a core feature of schizophrenia (SCZ). The neurocognitive and neural correlates of anhedonia remain elusive. Based on several influential theoretical models for negative symptoms, this selective review proposed four important neurocognitive domains, which may unveil the neurobiological mechanisms of anhedonia. The authors critically reviewed the current evidence regarding value representation of reward, prospection, emotion-behavior decoupling, and belief updating in the Chinese setting, covering both behavioral and neuroimaging research. We observed a limited application of the transdiagnostic approach in previous studies on the four domains, and the lack of adequate measures to tap into the expressivity deficit in SCZ. Despite many behavioral paradigms for these four domains utilized both social and non-social stimuli, previous studies seldom focused on the social-versus-non-social differentiation. We further advocated several important directions for future research.
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Affiliation(s)
- Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ling-Ling Wang
- School of Psychology, Shanghai Normal University, Shanghai, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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2
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Shao YX, Wang LL, Zhou HY, Yi ZH, Liu S, Yan C. Dampened motivation in schizophrenia: evidence from a novel effort-based decision-making task in social scenarios. Eur Arch Psychiatry Clin Neurosci 2024; 274:1447-1459. [PMID: 38413455 DOI: 10.1007/s00406-024-01761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/13/2024] [Indexed: 02/29/2024]
Abstract
Apathy represents a significant manifestation of negative symptoms within individuals diagnosed with schizophrenia (SCZ) and exerts a profound impact on their social relationships. However, the specific implications of this motivational deficit in social scenarios have yet to be fully elucidated. The present study aimed to examine effort-based decision-making in social scenarios and its relation to apathy symptoms in SCZ patients. We initially recruited a group of 50 healthy participants (16 males) to assess the validity of the paradigm. Subsequently, we recruited 45 individuals diagnosed with SCZ (24 males) and 49 demographically-matched healthy controls (HC, 25 males) for the main study. The Mock Job Interview Task was developed to measure effort-based decision-making in social scenarios. The proportion of hard-task choice and a range of subjective ratings were obtained to examine potential between-group differences. SCZ patients were less likely than HC to choose the hard task with strict interviewers, and this group difference was significant when the hard-task reward value was medium and high. More severe apathy symptoms were significantly correlated with an overall reduced likelihood of making a hard-task choice. When dividing the jobs into two categories based on the levels of social engagement needed, SCZ patients were less willing to expend effort to pursue a potential offer for jobs requiring higher social engagement. Our findings indicated impaired effort-based decision-making in SCZ can be generalized from the monetary/nonsocial to a more ecologically social dimension. Our findings affirm the critical role of aberrant effort allocation on negative symptoms, and may facilitate the development of targeted clinical interventions.
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Affiliation(s)
- Yu-Xin Shao
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Room 413, Building Junxiu, 3663 North Zhongshan Road, Shanghai, 200062, China
- Shanghai Changning Mental Health Center, Shanghai, China
- Leshan Hi-Tech Zone Jiaxiang Foreign Languages School, Sichuan, China
| | - Ling-Ling Wang
- School of Psychology, Shanghai Normal University, Shanghai, China
| | - Han-Yu Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Zheng-Hui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuai Liu
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Room 413, Building Junxiu, 3663 North Zhongshan Road, Shanghai, 200062, China
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Room 413, Building Junxiu, 3663 North Zhongshan Road, Shanghai, 200062, China.
- Shanghai Changning Mental Health Center, Shanghai, China.
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3
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Morales I, Berridge KC. Optogenetic hedonic hotspots in orbitofrontal cortex and insula: causing enhancement of sweetness 'liking'. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.31.606067. [PMID: 39211252 PMCID: PMC11361101 DOI: 10.1101/2024.07.31.606067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Hedonic hotspots are brain subregions that causally amplify the hedonic impact of palatable tastes, measured as increases in affective orofacial 'liking' reactions to sweetness. Previously, two cortical hedonic hotspots in orbitofrontal cortex and insula were identified by neurochemical stimulation using opioid or orexin microinjections. Here we used optogenetic stimulation in rats as an independent neurobiological technique for activating cortical hedonic hotspots to identify hedonic functions and map boundaries. We report that channelrhodopsin stimulations within rostral orbitofrontal and caudal insula hotspots doubled the number of hedonic 'liking' reactions elicited by sucrose taste. This independently confirms their robust functional identity as causal amplifiers of hedonic 'liking' and confirms their anatomical boundaries. Additionally, we confirmed an intervening suppressive hedonic coldstrip, to stretching from caudal orbitofrontal cortex to rostral insula. By contrast to localized hedonic hotspots for 'liking' enhancement, motivational 'wanting' for reward, measured as laser self-stimulation, was mediated by more widely distributed anatomical sites.
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Isıklı S, Bektaş AB, Tamer Ş, Atabay M, Arkalı BD, Bağcı B, Bayrakcı A, Sebold M, Zorlu N. Effort-cost decision-making associated with negative symptoms in schizophrenia and bipolar disorder. Behav Brain Res 2024; 467:114996. [PMID: 38609021 DOI: 10.1016/j.bbr.2024.114996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
Motivational deficits and reduced goal-directed behavior for external rewards have long been considered an important features of negative symptoms in patients with schizophrenia (SCZ). Negative symptoms have also a high prevalence in bipolar disorder (BP). We used a transdiagnostic approach in order to examine association between negative symptoms and effort allocation for monetary rewards. 41 patients with SCZ and 34 patients with BP were enrolled in the study along with 41 healthy controls (HC). Effort-Expenditure for Rewards Task (EEfRT) was used to measure subjects' effort allocation for monetary rewards. Generalized estimating equation models were used to analyze EEfRT choice behavior. Negative symptoms were assessed using the Brief Negative Symptom Scale (BNSS). SCZ and BP groups expended lower effort to obtain a monetary rewards compared to HC. Severity of negative symptoms was negatively correlated with EEfRT performance in both diagnostic groups. Each diagnostic group showed lower effort allocation for monetary rewards compared to HC suggesting reduced motivation for monetary rewards. In addition, our results suggest that abnormal effort-based decision-making might be a transdiagnostic factor underlying negative symptoms.
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Affiliation(s)
- Serhan Isıklı
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Aslıhan Bilge Bektaş
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Şule Tamer
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Murat Atabay
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Bilgesu Deniz Arkalı
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Başak Bağcı
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Adem Bayrakcı
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Miriam Sebold
- Department of Business and Law, Aschaffenburg University of Applied Sciences, Aschaffenburg, Germany
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
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5
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Yan YJ, Hu HX, Zhang YJ, Wang LL, Pan YM, Lui SSY, Huang J, Chan RCK. Reward motivation adaptation in people with negative schizotypal features: development of a novel behavioural paradigm and identifying its neural correlates using resting-state functional connectivity analysis. Eur Arch Psychiatry Clin Neurosci 2024; 274:941-953. [PMID: 37395812 DOI: 10.1007/s00406-023-01640-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
Reward motivation in individuals with high levels of negative schizotypal traits (NS) has been found to be lower than that in their counterparts. But it is unclear that whether their reward motivation adaptively changes with external effort-reward ratio, and what resting-state functional connectivity (rsFC) is associated with this change. Thirty-five individuals with high levels of NS and 44 individuals with low levels of NS were recruited. A 3T resting-state functional brain scan and a novel reward motivation adaptation behavioural task were administrated in all participants. The behavioural task was manipulated with three conditions (effort > reward condition vs. effort < reward condition vs. effort = reward condition). Under each condition were rated 'wanting' and 'liking' for rewards. The seed-based voxel-wise rsFC analysis was conducted to explore the rsFCs associated with the 'wanting' and 'liking' ratings in individuals with high levels of NS. 'Wanting' and 'liking' ratings of individuals with high levels of NS significantly declined in the effort > reward condition but did not rebound as high as their counterparts in the effort < reward condition. The rsFCs in NS group associated with these ratings were altered. The altered rsFCs in NS group involved regions in the prefrontal lobe, dopaminergic brain regions (ventral tegmental area, substantia nigra), hippocampus, thalamus and cerebellum. Individuals with high levels of NS manifested their reward motivation adaptation impairment as a failure of adjustment adaptively during effort-reward imbalance condition and altered rsFCs in prefrontal, dopaminergic and other brain regions.
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Affiliation(s)
- Yong-Jie Yan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, People's Republic of China
- Sino-Danish Centre for Education and Research, Beijing, People's Republic of China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Yi-Ming Pan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region , People's Republic of China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China.
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, People's Republic of China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China.
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6
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Wen H, Wu M, Wang Z, Gao B, Zheng Y. Aberrant effort-based reward dynamics in anhedonia. Cereb Cortex 2024; 34:bhae193. [PMID: 38741268 DOI: 10.1093/cercor/bhae193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 05/16/2024] Open
Abstract
Anhedonia is a transdiagnostic symptom and associated with a spectrum of reward deficits among which the motivational dysfunction is poorly understood. Previous studies have established the abnormal cost-benefit trade-off as a contributor to motivational deficits in anhedonia and its relevant psychiatric diseases. However, it remains elusive how the anhedonic neural dynamics underlying reward processing are modulated by effort expenditure. Using an effort-based monetary incentive delay task, the current event-related potential study examined the neural dynamics underlying the effort-reward interplay in anhedonia using a nonclinical sample who scored high or low on an anhedonia questionnaire. We found that effort prospectively decreased reward effect on the contingent variation negativity and the target-P3 but retrospectively enhanced outcome effect on the feedback-P3 following effort expenditure. Compared to the low-anhedonia group, the high-anhedonia group displayed a diminished effort effect on the target-P3 during effort expenditure and an increased effort-enhancement effect for neutral trials during the feedback-P3 period following effort expenditure. Our findings suggest that anhedonia is associated with an inefficient control and motivation allocation along the efforted-based reward dynamics from effort preparation to effort production.
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Affiliation(s)
- Hailing Wen
- Department of Psychology, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian 116044, China
| | - Menglin Wu
- Department of Psychology, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian 116044, China
| | - Zhao Wang
- Department of Psychology, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian 116044, China
| | - Bo Gao
- Department of Psychology, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian 116044, China
| | - Ya Zheng
- Department of Psychology, Guangzhou University, 230 Wai Huan Xi Road, Guangzhou Higher Education Mega Center, Guangzhou 510006, China
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7
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Fernandes HDB, Oliveira BDS, Machado CA, Carvalho BC, de Brito Toscano EC, da Silva MCM, Vieira ÉLM, de Oliveira ACP, Teixeira AL, de Miranda AS, da Silva AM. Behavioral, neurochemical and neuroimmune features of RasGEF1b deficient mice. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110908. [PMID: 38048936 DOI: 10.1016/j.pnpbp.2023.110908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/02/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
The factor RasGEF1b is a Ras guanine exchange factor involved in immune responses. Studies have also implicated RasGEF1b in the CNS development. It is still limited the understanding of the role of RasGEF1b in CNS functioning. Using RasGEF1b deficient mice (RasGEF1b-cKO), we investigated the impact of this gene deletion in behavior, cognition, brain neurochemistry and microglia morphology. We showed that RasGEF1b-cKO mice display spontaneous hyperlocomotion and anhedonia. RasGEF1b-cKO mice also exhibited compulsive-like behavior that was restored after acute treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine (5 mg/kg). A down-regulation of mRNA of dopamine receptor (Drd1, Drd2, Drd4 and Drd5) and serotonin receptor genes (5Htr1a, 5Htr1b and 5Htr1d) was observed in hippocampus of RasGEF1b-cKO mice. These mice also had reduction of Drd1 and Drd2 in prefrontal cortex and 5Htr1d in striatum. In addition, morphological alterations were observed in RasGEF1b deficient microglia along with decreased levels of hippocampal BDNF. We provided original evidence that the deletion of RasGEF1b leads to unique behavioral features, implicating this factor in CNS functioning.
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Affiliation(s)
- Heliana de Barros Fernandes
- Laboratório de Genes Inflamatórios, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil; Laboratório de Neurobiologia, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil.
| | - Bruna da Silva Oliveira
- Laboratório de Neurobiologia, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Caroline Amaral Machado
- Laboratório de Neurobiologia, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Brener Cunha Carvalho
- Laboratório de Genes Inflamatórios, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Eliana Cristina de Brito Toscano
- Laboratório Integrado de Pesquisas em Patologia, Departamento de Patologia, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Av. Eugênio do Nascimento, s/n°, Dom Bosco, CEP: 36038-330, Juiz de Fora, MG, Brazil
| | - Maria Carolina M da Silva
- Laboratório de Neurofarmacologia, Departamento de Fisiologia e Farmacologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Érica Leandro Marciano Vieira
- Campbell Family Mental Health Research Institute, Center of Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Antônio Carlos Pinheiro de Oliveira
- Laboratório de Neurofarmacologia, Departamento de Fisiologia e Farmacologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Antônio Lúcio Teixeira
- Departament of Psychiatry and Behavioral Science McGovern School, Behavioral and Biomedical Sciences Building (BBSB), The University of Texas Health Science Center, 941 East Road, Houston, TX 77054, United States of America
| | - Aline Silva de Miranda
- Laboratório de Neurobiologia, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Aristóbolo Mendes da Silva
- Laboratório de Genes Inflamatórios, Departamento de Morfologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
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8
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Wang LL, Lui SSY, So JWL, Hu HX, Chu MY, Cheng KM, Li SB, Le BL, Lv QY, Yi ZH, Chan RCK. Range adaptive value representations in schizophrenia and major depression. Asian J Psychiatr 2024; 92:103880. [PMID: 38157714 DOI: 10.1016/j.ajp.2023.103880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
Anhedonia and amotivation are core symptoms of schizophrenia (SCZ) and major depressive disorder (MDD). Reward processing involves constructing and contrasting the representations for expected value (EV) and outcome value (OV) of a given stimulus, a phenomenon termed range adaptation. Impaired range adaptation can lead to anhedonia and amotivation. This study aimed to examine range adaptation in SCZ patients and MDD patients. Fifty SCZ, 46 MDD patients and 56 controls completed the Effort-based Pleasure Experience Task to measure EV and OV adaptation. SCZ and MDD patients showed altered range adaptation, albeit in different patterns. SCZ patients exhibited over-adaptation to OV and reduced adaptation to EV. By contrast, MDD patients exhibited diminished OV adaptation but intact EV adaptation. Both OV and EV adaptation were correlated with anhedonia and amotivation in SCZ and MDD. Taken together, our findings suggest that range adaptation is altered in both SCZ and MDD patients. Associations of OV and EV adaptation with anhedonia and amotivation were consistently found in SCZ and MDD patients. Impaired range adaptation in SCZ and MDD patients may be putative neural mechanisms and potential intervention targets for anhedonia and amotivation.
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Affiliation(s)
- Ling-Ling Wang
- Neuropsychology and applied cognitive neuroscience laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; School of Psychology, Shanghai Normal University, Shanghai, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Jane W L So
- Castle Peak Hospital, Hong Kong Special Administrative Region of China
| | - Hui-Xin Hu
- Neuropsychology and applied cognitive neuroscience laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Min-Yi Chu
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Koi-Man Cheng
- Castle Peak Hospital, Hong Kong Special Administrative Region of China
| | - Shuai-Biao Li
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bei-Lin Le
- Neuropsychology and applied cognitive neuroscience laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qin-Yu Lv
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, China
| | - Zheng-Hui Yi
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Mental Health, Fudan University, Shanghai, China
| | - Raymond C K Chan
- Neuropsychology and applied cognitive neuroscience laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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9
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Luther L, Westbrook A, Ayawvi G, Ruiz I, Raugh IM, Chu AOK, Chang WC, Strauss GP. The role of defeatist performance beliefs on cognitive effort-cost decision-making in schizophrenia. Schizophr Res 2023; 261:216-224. [PMID: 37801740 DOI: 10.1016/j.schres.2023.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/01/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
Impairments in effort-cost decision-making have been consistently observed in people with schizophrenia (SZ) and may be an important mechanism of negative symptoms. However, the processes that give rise to impairments in effort-cost decision-making are unclear, leading to limited progress in identifying the most relevant treatment targets. Drawing from cognitive models of negative symptoms and goal-directed behavior, this study aimed to examine how and under what type of task conditions defeatist performance beliefs contribute to these decision-making processes. Outpatients with SZ (n = 30) and healthy controls (CN; n = 28) completed a cognitive effort allocation task, the Cognitive Effort-Discounting (COGED) task, which assesses participants' willingness to exert cognitive effort for monetary rewards based on parametrically varied working memory demands (completing N-back levels). Results showed that although participants with SZ demonstrated reduced willingness to work for rewards across N-back levels compared to CN participants, they showed less choice modulation across different N-back conditions. However, among SZ participants with greater defeatist performance beliefs, there was a reduced willingness to choose the high effort option at higher N-back levels (N-back levels 3, 4, and 5 versus 2-back). Results suggest that compared to CN, the SZ group's subjective willingness to expend effort largely did not dynamically adjust as cognitive load increased. However, defeatist beliefs may undermine willingness to expend cognitive effort, especially when cognitive task demands are high. These beliefs may be a viable treatment target to improve effort-cost decision-making impairments in people with SZ.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA.
| | | | - Gifty Ayawvi
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ivan Ruiz
- Department of Psychology, University of Georgia, Athens, GA, USA; Department of Psychiatry, University of California, Los Angeles, USA
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Angel On Ki Chu
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong; Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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10
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Blouzard E, Pouchon A, Polosan M, Bastin J, Dondé C. Effort-Cost Decision-making Among Individuals With Schizophrenia: A Systematic Review and Meta-analysis. JAMA Psychiatry 2023; 80:548-557. [PMID: 37043223 PMCID: PMC10099175 DOI: 10.1001/jamapsychiatry.2023.0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/31/2023] [Indexed: 04/13/2023]
Abstract
Importance Motivational impairments in schizophrenia are by definition associated with poor outcome. It is postulated that the reduction of goal-directed behavior arises from abnormal trade-offs between rewards and efforts. Objective To examine whether schizophrenia is associated with impairments in effort-cost decision-making. Data Sources For this systematic review and meta-analysis, the PubMed, ScienceDirect, PsycINFO, Embase, and ClinicalTrials.gov databases were searched from inception to July 2022 for studies that investigated effort-cost decision-making in schizophrenia. Search terms included effort, cost, and schizophrenia. Study Selection Consensual criteria for inclusion were peer-reviewed studies published in English that used a computerized effort-cost decision-making behavioral paradigm and compared individuals with schizophrenia with control individuals. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was used for abstracting data. Data were extracted independently by 2 authors and then pooled using random-effects sizes and bayesian approaches. Main Outcomes and Measures The main outcomes were performance on effort-cost decision-making tasks requiring an effort-reward trade-off, measured by Hedges g effect size. Effects of moderators were tested with meta-regressions and subgroup analyses. Results Twenty studies involving 1503 participants were included: 837 individuals with schizophrenia (541 [64.6%] male; mean [SD] age, 35.89 [6.70] years) and 666 control individuals without schizophrenia (360 [54.1%] male; mean [SD] age, 34.16 [5.92] years). Participants with schizophrenia had significantly reduced willingness to expend effort for rewards compared with controls (k = 20; effect size, 0.43; 95% CI, 0.30-0.56; P < .001; I2 = 33.1%; Q test P = .08). The magnitude of the deficit was significantly greater for high-reward trials. The severity of negative symptoms was negatively associated with effort-cost decision-making (k = 8; effect size, -0.33; 95% CI, -0.50 to -0.15; P < .001), while participants with a high number of negative symptoms had a significantly larger impairment in effort-cost decision-making (k = 5; effect size, 0.47; 95% CI, 0.10-0.84; P = .01). Conclusions and Relevance In this systematic review and meta-analysis, schizophrenia was associated with deficits in effort allocation as indexed by effort-cost decision-making tasks. Understanding the cognitive and neurobiological mechanisms driving effort allocation impairments may assist in developing novel interventions.
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Affiliation(s)
- Elodie Blouzard
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
| | - Arnaud Pouchon
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Mircea Polosan
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Julien Bastin
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
| | - Clément Dondé
- University Grenoble Alpes, Inserm, Grenoble Institut Neurosciences, Grenoble, France
- Adult Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
- Adult Psychiatry Department, Centre Hospitalier Alpes-Isère, Saint-Egrève, France
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11
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Lui SSY, Wang LL, Lau WYS, Shing E, Yeung HKH, Tsang KCM, Zhan EN, Cheung ESL, Ho KKY, Hung KSY, Cheung EFC, Chan RCK. Emotion-behaviour decoupling and experiential pleasure deficits predict negative symptoms and functional outcome in first-episode schizophrenia patients. Asian J Psychiatr 2023; 81:103467. [PMID: 36669292 DOI: 10.1016/j.ajp.2023.103467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/29/2022] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Emotion-behaviour decoupling refers to the failure to translate emotion into motivated behaviour, and is a putative marker for schizophrenia. The heterogeneity of experiential pleasure and emotion expressivity deficits has been reported in schizophrenia patients. These three constructs are believed to contribute to negative symptoms, but very few studies have examined their predictive ability for clinical and functional outcome of schizophrenia. This study aimed to clarify whether these three constructs influence clinical and functional outcome of schizophrenia. METHOD At baseline, 127 first-episode schizophrenia patients completed a behavioural paradigm for emotion-behaviour decoupling, and self-report scales for experiential pleasure and emotion expressivity deficits. Cluster-analysis was applied to characterize schizophrenia subgroups based on these three constructs. At end-point (mean follow-up = 5.37 years, SD = 1.03 years), 85 schizophrenia patients were reassessed using the Clinical Assessment Interview for Negative Symptoms (CAINS) and a clinician-rated social functioning scale. RESULTS Cluster 1 (n = 74) did not show emotion-behaviour decoupling, and had intact experiential pleasure and emotion expressivity. Cluster 2 (n = 29) showed emotion-behaviour decoupling and experiential pleasure deficits. Cluster 3 (n = 24) showed emotion expressivity deficits. At endpoint, the three clusters differed significantly in CAINS MAP factor (p = 0.016) and social functioning (p = 0.019), but not CAINS EXP factor. Specifically, Cluster 2 (n = 18) showed more severe negative symptoms of CAINS MAP factor (p = 0.046) and poorer social functioning (p = 0.022) than Cluster 1 (n = 49). Cluster 3 (n = 18) did not differ from Cluster 1 and Cluster 2 in negative symptoms and social functioning. DISCUSSION Emotion-behaviour decoupling and experiential pleasure deficits predicted clinical and functional outcome of schizophrenia.
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Affiliation(s)
- Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wilson Y S Lau
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Eunice Shing
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hera K H Yeung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Kirby C M Tsang
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Emma N Zhan
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ezmond S L Cheung
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Karen K Y Ho
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Karen S Y Hung
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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12
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Strauss GP, Bartolomeo LA, Luther L. Reduced willingness to expend effort for rewards is associated with risk for conversion and negative symptom severity in youth at clinical high-risk for psychosis. Psychol Med 2023; 53:714-721. [PMID: 34120660 DOI: 10.1017/s003329172100204x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and predictive of conversion to illness. Mechanisms underlying negative symptoms are unclear in the CHR population. METHODS The current study evaluated whether CHR participants demonstrated deficits in the willingness to expend effort for rewards and whether these impairments are associated with negative symptoms and greater risk for conversion. Participants included 44 CHR participants and 32 healthy controls (CN) who completed the Effort Expenditure for Reward Task (EEfRT). RESULTS Compared to CN, CHR participants displayed reduced likelihood of exerting high effort for high probability and magnitude rewards. Among CHR participants, reduced effort expenditure was associated with greater negative symptom severity and greater probability of conversion to a psychotic disorder on a cross-sectional risk calculator. CONCLUSIONS Findings suggest that effort-cost computation is a marker of illness liability and a transphasic mechanism underlying negative symptoms in the SZ spectrum.
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Affiliation(s)
| | | | - Lauren Luther
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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13
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Berkovitch L, Gaillard R, Abdel-Ahad P, Smadja S, Gauthier C, Attali D, Beaucamps H, Plaze M, Pessiglione M, Vinckier F. Preserved Unconscious Processing in Schizophrenia: The Case of Motivation. Schizophr Bull 2022; 48:1094-1103. [PMID: 35751516 PMCID: PMC9434445 DOI: 10.1093/schbul/sbac076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND HYPOTHESIS Motivation deficit is a hallmark of schizophrenia that has a strong impact on their daily life. An alteration of reward processing has been repeatedly highlighted in schizophrenia, but to what extent it involves a deficient amplification of reward representation through conscious processing remains unclear. Indeed, patients with schizophrenia exhibit a disruption of conscious processing, whereas unconscious processing appears to be largely preserved. STUDY DESIGN To further explore the nature of motivational deficit in schizophrenia and the implication of consciousness disruption in this symptom, we used a masking paradigm testing motivation both under conscious and unconscious conditions in patients with schizophrenia (n = 31) and healthy controls (n = 32). Participants were exposed to conscious or subliminal coin pictures representing money at stake and were subsequently asked to perform an effort-task by squeezing a handgrip as hard as possible to win this reward. STUDY RESULTS We observed a preserved effect of unconscious monetary rewards on force production in both groups, without any significant difference between them. By contrast, in the conscious condition, patients with schizophrenia were less sensitive to rewards than controls. Our results confirm that unconscious incentives have effects on exerted forces in the general population, and demonstrate that patients with schizophrenia exhibit a dissociation between an impaired conscious motivation and a preserved unconscious motivation. CONCLUSIONS These findings suggest the existence of several steps in motivational processes that can be differentially affected and might have implication for patient care.
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Affiliation(s)
- Lucie Berkovitch
- To whom correspondence should be addressed; Service Hospitalo-Universitaire, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Centre Hospitalier Sainte Anne, 1 rue Cabanis, 75014 Paris, France; tel: 0033145658867, fax: 0033145657689, e-mail:
| | - Raphaël Gaillard
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Pierre Abdel-Ahad
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Sarah Smadja
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Claire Gauthier
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - David Attali
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Hadrien Beaucamps
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Marion Plaze
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France
| | - Mathias Pessiglione
- Motivation, Brain and Behavior (MBB) Lab, Paris Brain Institute (ICM), Hôpital Pitié-Salpêtrière, F-75013 Paris, France,Sorbonne University, Inserm, CNRS, Paris, France
| | - Fabien Vinckier
- Université Paris Cité, F-75006 Paris, France,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie and Neurosciences, F-75014 Paris, France,Motivation, Brain and Behavior (MBB) Lab, Paris Brain Institute (ICM), Hôpital Pitié-Salpêtrière, F-75013 Paris, France
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14
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Donnelly NA, Perry BI, Jones HJ, Khandaker GM. Childhood immuno-metabolic markers and risk of depression and psychosis in adulthood: A prospective birth cohort study. Psychoneuroendocrinology 2022; 139:105707. [PMID: 35286909 DOI: 10.1016/j.psyneuen.2022.105707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metabolic and inflammatory disorders commonly co-occur with depression and psychosis, with emerging evidence implicating immuno-metabolic dysfunction in their aetiology. Previous studies have reported metabolic dysfunction and inflammation in adults with depression and psychosis. However, longitudinal studies testing the direction of association, and the effects of different dimensions of early-life immuno-metabolic dysfunction on adult psychopathology are limited. METHODS Using data from 3258 birth cohort participants we examined longitudinal associations of three metabolic hormones (leptin, adiponectin, insulin) at age 9 with risks for depression- and psychosis-spectrum outcomes at age 24. In addition, using nine immuno-metabolic biomarkers (leptin, adiponectin, insulin, interleukin-6, C-Reactive protein, low density lipoprotein, high density lipoprotein, triglycerides, and BMI), we constructed an exploratory bifactor model showing a general immuno-metabolic factor and three specific factors (adiposity, inflammation, and insulin resistance), which were also used as exposures. RESULTS Childhood leptin was associated with adult depressive episode (adjusted odds ratio (aOR)= 1.31; 95% CI, 1.02-1.71) and negative symptoms (aOR=1.15; 95% CI, 1.07-1.24), but not positive psychotic symptoms. The general immuno-metabolic factor was associated with atypical depressive symptoms (aOR=1.07; 95% CI, 1.01-1.14) and psychotic experiences (aOR=1.21; 95% CI, 1.02-1.44). The adiposity factor was associated with negative symptoms (aOR=1.07; 95% CI 1.02-1.12). Point estimates tended to be larger in women, though 95% credible intervals overlapped with those for men. In women, the inflammatory factor was associated with depressive episodes (aOR=1.27; 95% CI, 1.03-1.57). CONCLUSIONS While general immuno-metabolic dysfunction in childhood may contribute to risks for both psychotic and depressive symptoms in adulthood, childhood adiposity and inflammation appear to be particularly linked to affective (depressive and negative), but not positive psychotic symptoms.
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Affiliation(s)
- N A Donnelly
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Avon and Wiltshire Mental Health Partnership NHS Trust, UK.
| | - B I Perry
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - H J Jones
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - G M Khandaker
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Avon and Wiltshire Mental Health Partnership NHS Trust, UK; Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK; NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
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15
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Hune ND, McGovern TF. A Perspective on Neurobiological and Intersubjective Connectedness in Coexisting Schizophrenia and Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2021.1996302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nicole D. Hune
- Center for Collegiate Community Recoveries, Texas Tech University, Lubbock, TX, USA
| | - Thomas F. McGovern
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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16
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Büki A, Bohár Z, Kekesi G, Vécsei L, Horvath G. Wisket rat model of schizophrenia: Impaired motivation and, altered brain structure, but no anhedonia. Physiol Behav 2021; 244:113651. [PMID: 34800492 DOI: 10.1016/j.physbeh.2021.113651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 01/17/2023]
Abstract
It is well-known that the poor cognition in schizophrenia is strongly linked to negative symptoms, including motivational deficit, which due to, at least partially, anhedonia. The goal of this study was to explore whether the schizophrenia-like Wisket animals with impaired motivation (obtained in the reward-based hole-board test), also show decreased hedonic behavior (investigated with the sucrose preference test). While neurochemical alterations of different neurotransmitter systems have been detected in the Wisket rats, no research has been performed on structural changes. Therefore, our additional aim was to reveal potential neuroanatomical and structural alterations in different brain regions in these rats. The rats showed decreased general motor activity (locomotion, rearing and exploration) and impaired task performance in the hole-board test compared to the controls, whereas no significant difference was observed in the sucrose preference test between the groups. The Wisket rats exhibited a significant decrease in the frontal cortical thickness and the hippocampal area, and moderate increases in the lateral ventricles and cell disarray in the CA3 subfield of hippocampus. To our knowledge, this is the first study to investigate the hedonic behavior and neuroanatomical alterations in a multi-hit animal model of schizophrenia. The results obtained in the sucrose preference test suggest that anhedonic behavior might not be involved in the impaired motivation obtained in the hole-board test. The neuropathological changes agree with findings obtained in patients with schizophrenia, which refine the high face validity of the Wisket model.
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Affiliation(s)
- Alexandra Büki
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary.
| | - Zsuzsanna Bohár
- MTA-SZTE Neuroscience Research Group, Semmelweis u. 6, Szeged, H-6725, Hungary
| | - Gabriella Kekesi
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary
| | - László Vécsei
- MTA-SZTE Neuroscience Research Group, Semmelweis u. 6, Szeged, H-6725, Hungary; Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., Szeged, H-6725, Hungary; Interdisciplinary Excellence Center, Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., Szeged, H-6725 Hungary
| | - Gyongyi Horvath
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary
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17
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Wang LL, Lam CYT, Huang J, Cheung EFC, Lui SSY, Chan RCK. Range-Adaptive Value Representation in Different Stages of Schizophrenia: A Proof of Concept Study. Schizophr Bull 2021; 47:1524-1533. [PMID: 34420057 PMCID: PMC8530390 DOI: 10.1093/schbul/sbab099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Amotivation is related to value representation. A comprehensive account of amotivation requires a mechanistic understanding of how the brain exploits external information to represent value. To achieve maximal value discriminability, brain valuation system will dynamically adapt its coding sensitivity to the range of values available in any given condition, so-called range adaptive coding. We administered an experimental task to 30 patients with chronic schizophrenia (C-SCZ), 30 first-episode schizophrenia (FE-SCZ), 34 individuals with high social anhedonia (HSoA), and their paired controls to assess range adaptation ability. C-SCZ patients exhibited over-adaptation and their performances were negatively correlated with avolition symptoms and positive symptoms and positively correlated with blunted-affect symptoms and self-reported consummatory interpersonal pleasure scores, though the results were non-significant. FE-SCZ patients exhibited reduced adaptation, which was significantly and negatively correlated with avolition symptoms and positively correlated with the overall proportion of choosing to exert more effort. Although HSoA participants exhibited comparable range adaptation to controls, their performances were significantly and negatively correlated with the proportion of choosing to exert more effort under the lowest value condition. Our results suggest that different stages of schizophrenia spectrum showed distinct range adaptation patterns. Range adaptation impairments may index a possible underlying mechanism for amotivation symptoms in FE-SCZ and more complicated and pervasive effects on clinical symptoms in C-SCZ.
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Affiliation(s)
- Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Christina Y T Lam
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Simon S Y Lui
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
- Department of Psychiatry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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18
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Prettyman GE, Kable JW, Didier P, Shankar S, Satterthwaite TD, Davatzikos C, Bilker WB, Elliott MA, Ruparel K, Wolf DH. Relationship of ventral striatum activation during effort discounting to clinical amotivation severity in schizophrenia. NPJ SCHIZOPHRENIA 2021; 7:48. [PMID: 34625567 PMCID: PMC8501117 DOI: 10.1038/s41537-021-00178-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/17/2021] [Indexed: 12/04/2022]
Abstract
Motivational deficits play a central role in disability due to negative symptoms of schizophrenia (SZ), but limited pathophysiological understanding impedes critically needed therapeutic development. We applied an fMRI Effort Discounting Task (EDT) that quantifies motivation using a neuroeconomic decision-making approach, capturing the degree to which effort requirements produce reductions in the subjective value (SV) of monetary reward. An analyzed sample of 21 individuals with SZ and 23 group-matched controls performed the EDT during fMRI. We hypothesized that ventral striatum (VS) as well as extended brain motivation circuitry would encode SV, integrating reward and effort costs. We also hypothesized that VS hypoactivation during EDT decisions would demonstrate a dimensional relationship with clinical amotivation severity, reflecting greater suppression by effort costs. As hypothesized, VS as well as a broader cortico-limbic network were activated during the EDT and this activation correlated positively with SV. In SZ, activation to task decisions was reduced selectively in VS. Greater VS reductions correlated with more severe clinical amotivation in SZ and across all participants. However, these diagnosis and amotivation effects could not be explained by the response to parametric variation in reward, effort, or model-based SV. Our findings demonstrate that VS hypofunction in schizophrenia is manifested during effort-based decisions and reflects dimensional motivation impairment. Dysfunction of VS impacting effort-based decision-making can provide a target for biomarker development to guide novel efforts to assess and treat disabling amotivation.
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Affiliation(s)
- Greer E Prettyman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Paige Didier
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sheila Shankar
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Warren B Bilker
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mark A Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, 19104, USA
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19
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Factor structure and sex invariance of the temporal experience of pleasure scale (TEPS) in Chinese university students and clinical population. BMC Psychiatry 2021; 21:378. [PMID: 34320935 PMCID: PMC8317394 DOI: 10.1186/s12888-021-03379-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A motivation dimension of the core psychiatric symptom anhedonia additional has been suggested. The Temporal Experience of Pleasure Scale (TEPS) has been reported to assess anticipatory and consummatory pleasure separately in multiple factor-structure models. This study explored the factor structure of a Chinese version of the 18-item TEPS and further explored the measurement invariance of the TEPS across sex and clinical status (non-clinical, psychiatric). METHODS Best-fit factor structure of the TEPS was examined in a non-clinical cohort of 7410 undergraduates, randomized into sample 1 (N = 3755) for exploratory factor analysis (EFA) and sample 2 (N = 3663) for confirmatory factor analysis (CFA). Additionally, serial CFA was conducted to evaluate measurement invariance across sex and between clinical (N = 313) and non-clinical (N = 341) samples. RESULTS EFA supported a new four-factor structure with a motivation component, based on the original two-factor model (consummatory pleasure with/without motivation drive, anticipatory pleasure with/without motivation drive). CFA confirmed the four-factor model as the best-fit structure and revealed a second-order hierarchy in non-clinical and clinical samples. Full scalar invariance was observed across clinical and non-clinical samples and across sex in the clinical sample; only partial scalar invariance was observed across sex in the non-clinical sample. CONCLUSIONS A four-factor structured TEPS can assess motivation-driving dimensions of anticipatory and consummatory pleasure, consistent with the recently advanced multidimensional structure of anhedonia. CFA and measurement invariance results support application of the TEPS for assessing motivation aspects of anhedonia.
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20
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Yang X, Huang J, Harrision P, Roser ME, Tian K, Wang D, Liu G. Motivational differences in unipolar and bipolar depression, manic bipolar, acute and stable phase schizophrenia. J Affect Disord 2021; 283:254-261. [PMID: 33571794 DOI: 10.1016/j.jad.2021.01.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Motivational anhedonia has been observed in patients with a wide range of mental disorders. However, the similarity and uniqueness of this deficit across diagnostic groups has not been thoroughly investigated. METHOD The study compared motivational deficits in 37 patients with major depressive disorder (MDD), 32 with bipolar depression, 33 with manic bipolar disorder (BD), 30 with acute phase and 33 with stable phase schizophrenia, as well as 47 healthy controls. Participants were administered the Effort-Expenditure for Reward Task which measures allocation of effort between a high-effort and a low-effort task for monetary rewards at varying magnitudes and probabilities. RESULTS Compared with healthy controls, BD manic, acute and stable phase schizophrenia patients were significantly less likely to choose the high-effort task in the high reward magnitude condition. BD manic and acute phase schizophrenia patients were significantly less likely to choose the high-effort task in the high probability condition. Acute and stable phase schizophrenia patients made less effort in the high estimated value condition. Bipolar manic patients made excessive effort in low estimated value but less effort in high estimated value. Contrary to expectations, both the unipolar and bipolar depression patients did not differ significantly from healthy controls in reward magnitude, probability, and estimated value conditions. Anhedonia and negative symptoms were associated with fewer high-effort task choices in schizophrenia patients. CONCLUSION Motivation anhedonia showed distinct patterns across psychiatric patients: acute phase schizophrenia was the most severely affected, bipolar mania was similar to schizophrenia, but bipolar depression was similar to unipolar depression.
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Affiliation(s)
- Xinhua Yang
- Department of Psychology, Hunan Agricultural University, Changsha, China; Brain Research & Imaging Centre, School of Psychology, Cognition Institute, Faculty of Health & Human Sciences, Plymouth University, UK..
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Science, Beijing, China.
| | - Phillippa Harrision
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK..
| | - Matthew E Roser
- Brain Research & Imaging Centre, School of Psychology, Cognition Institute, Faculty of Health & Human Sciences, Plymouth University, UK..
| | - Kai Tian
- Department of Psychology, Hunan Agricultural University, Changsha, China.
| | - Dongfang Wang
- Department of Psychology, Hunan Agricultural University, Changsha, China.
| | - Guangya Liu
- Department of psychiatry, Brains Hospital of Hunan province, Changsha, China.
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21
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Zhang P, Zhang N, Fang S, He J, Fan L, Luo X, Zhang J, Xiong Y, Luo F, Wang X, Yao S, Wang X. Factor Structure and Measurement Invariance of the Chinese version of the Snaith-Hamilton Pleasure Scale (SHAPS) in Non-clinical and Clinical populations. J Affect Disord 2021; 281:759-766. [PMID: 33229024 DOI: 10.1016/j.jad.2020.11.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/30/2020] [Accepted: 11/08/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Anhedonia, a key symptom of depression and schizophrenia, has emerged as a potential endophenotype. The aim of this study was to evaluate the psychometric properties of a Chinese version of the Snaith-Hamilton Pleasure Scale(SHAPS), a self-report anhedonia scale, in a non-clinical sample and clinical sample inclusive of major depressive disorder (MDD), schizophrenia, or a personality disorder. METHODS A total of 4,722 undergraduate students and 352 clinical patients participated in this study. Internal consistency was assessed by calculating Cronbach's α and mean inter-item correlation (MIC) values. Test-retest reliability and convergent validity were assessed with Pearson r coefficients. The best fitting of six potential factor-structure models was determined by confirmatory factor analysis (CFA). Measurement invariance across genders and samples was determined by multi-group CFA. RESULTS Internal consistency of the Chinese version of the SHAPS was acceptable in non-clinical (Cronbach's α = 0.90) and clinical (Cronbach's α = 0.91) samples. Four-week interval test-retest reliability was 0.60. Moreover, the Spanish four-factor structure had the best fit indexes in both samples. Scalar invariance was established across genders as well as across non-clinical sample and clinical sample. SHAPS was significantly related with the Temporal Experience of Pleasure Scale (TEPS) and Beck Depression Inventory (BDI). LIMITATIONS There was a restricted scope of convergent validity and the size of clinical sample is relatively small, psychometric properties in elderly sample is also required. CONCLUSION The Chinese version of the SHAPS is a reliable, effective, simple and convenient tool for assessing and screening for anhedonia.
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Affiliation(s)
- Panwen Zhang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Na Zhang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shulin Fang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiayue He
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lejia Fan
- Institute of Mental Health, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xingwei Luo
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jianghua Zhang
- Student Affairs Department, Central South University, Changsha, Hunan, China
| | - Yan Xiong
- Student Affairs Department, Central South University, Changsha, Hunan, China
| | - Fusheng Luo
- Student Affairs Department, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Xiaosheng Wang
- Department of Human Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Shuqiao Yao
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiang Wang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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22
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Chang WC, Westbrook A, Strauss GP, Chu AOK, Chong CSY, Siu CMW, Chan SKW, Lee EHM, Hui CLM, Suen YM, Lo TL, Chen EYH. Abnormal cognitive effort allocation and its association with amotivation in first-episode psychosis. Psychol Med 2020; 50:2599-2609. [PMID: 31576787 DOI: 10.1017/s0033291719002769] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP). METHOD Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants' willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored. RESULTS Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits. CONCLUSION This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
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Affiliation(s)
- W C Chang
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - A Westbrook
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen 6525 EN, The Netherlands
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, RI02906, USA
| | - G P Strauss
- Department of Psychology, University of Georgia, Athens, GA30602, USA
| | - A O K Chu
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - C S Y Chong
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - C M W Siu
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - S K W Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - E H M Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - C L M Hui
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Y M Suen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - T L Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - E Y H Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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23
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Culbreth AJ, Moran EK, Kandala S, Westbrook A, Barch DM. Effort, avolition and motivational experience in schizophrenia: Analysis of behavioral and neuroimaging data with relationships to daily motivational experience. Clin Psychol Sci 2020; 8:555-568. [PMID: 33758684 PMCID: PMC7983405 DOI: 10.1177/2167702620901558] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent research suggests that schizophrenia is associated with reduced effort allocation. We examined willingness to expend effort, neural correlates of effort allocation, and the relationship of effort to daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 controls to perform an effort task during fMRI. Individuals with schizophrenia also completed an ecological momentary assessment (EMA) protocol. Individuals with schizophrenia with high negative symptoms were less willing to expend effort for rewards. Daily EMA assessments of motivation were positively associated with effort allocation at a trend-level. Individuals with schizophrenia and controls displayed similar increases in BOLD activation in frontal, cingulate, parietal, and insular regions during effort-based decision-making. However, negative symptoms were associated with reduced BOLD activation in bilateral ventral striatum. These results replicate previous reports of reduced effort allocation in schizophrenia patients with severe negative symptoms, and provide evidence for the role of ventral striatum in effort impairments.
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Affiliation(s)
- Adam J Culbreth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130
| | - Erin K Moran
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Sri Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Andrew Westbrook
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, RI 02906
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
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24
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Visser KF, Chapman HC, Ruiz I, Raugh IM, Strauss GP. A meta-analysis of self-reported anticipatory and consummatory pleasure in the schizophrenia-spectrum. J Psychiatr Res 2020; 121:68-81. [PMID: 31783235 PMCID: PMC6939125 DOI: 10.1016/j.jpsychires.2019.11.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/03/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Recent conceptual frameworks propose anhedonia reflects abnormalities in the temporal dynamics of positive emotion in schizophrenia, characterized by intact consummatory and impaired anticipatory pleasure. A comprehensive meta-analysis can directly test this theory using self-report data. METHOD A meta-analysis was performed on studies reporting Temporal Experience of Pleasure Scale (TEPS) data from healthy controls and schizophrenia or schizotypy groups. The TEPS was examined as it contains subscales to measure both consummatory and anticipatory pleasure separately. Statistical heterogeneity and study bias were examined. Meta-regressions evaluated moderators. RESULTS 53 studies were retrieved (7,797 participants). Results revealed small effect sizes for comparisons of combined schizophrenia/schizotypy and control groups for both consummatory and anticipatory pleasure. Within-group comparisons of pleasure conditions were nonsignificant. The percentage of male schizophrenia/schizotypy participants significantly moderated anticipatory and consummatory pleasure for the combined sample and schizotypy alone; male participants were found to report reduced pleasure. There was only minor evidence of bias; sensitivity analysis confirmed result robustness. Exploratory outlier removal for schizophrenia within-group pleasure comparisons revealed a statistically significant difference between reported anticipatory and consummatory pleasure, with consummatory pleasure reduced relative to anticipatory (i.e., in the opposite direction of the majority of experimental research findings). CONCLUSIONS These findings provided only modest support for the temporal dynamics of positive emotion conceptualization because they revealed no evidence for: 1) specific anticipatory pleasure deficits in schizophrenia-spectrum participants compared to controls; 2) significant reductions in anticipatory pleasure relative to consummatory pleasure in schizophrenia-spectrum participants.
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Affiliation(s)
| | - Hannah C Chapman
- University of Georgia, Department of Psychology, Athens, GA, USA
| | - Ivan Ruiz
- University of Georgia, Department of Psychology, Athens, GA, USA
| | - Ian M Raugh
- University of Georgia, Department of Psychology, Athens, GA, USA
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25
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Goldsmith DR, Rapaport MH. Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits. Front Psychiatry 2020; 11:46. [PMID: 32153436 PMCID: PMC7044128 DOI: 10.3389/fpsyt.2020.00046] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/20/2020] [Indexed: 01/08/2023] Open
Abstract
Negative symptoms of schizophrenia are debilitating and chronic in nature, are difficult to treat, and contribute to poor functional outcomes. Motivational deficits are a core negative symptom and may involve alterations in reward processing, which involve subcortical regions such as the basal ganglia. More specifically, dopamine-rich regions like the ventral striatum, have been implicated in these reward-processing deficits. Inflammation is one mechanism that may underlie negative symptoms, and specifically motivational deficits, via the effects of inflammatory cytokines on the basal ganglia. Previous work has demonstrated that inflammatory stimuli decrease neural activity in the ventral striatum and decrease connectivity in reward-relevant neural circuitry. The immune system has been shown to be involved in the pathophysiology of schizophrenia, and inflammatory cytokines have been shown to be altered in patients with the disorder. This paper reviews the literature on associations between inflammatory markers and negative symptoms of schizophrenia as well as the role of anti-inflammatory drugs to target negative symptoms. We also review the literature on the role of inflammation and reward processing deficits in both healthy controls and individuals with depression. We use the literature on inflammation and depression as a basis for a model that explores potential mechanisms responsible for inflammation modulating certain aspects of negative symptoms in patients with schizophrenia. This approach may offer novel targets to treat these symptoms of the disorder that are significant barriers to functional recovery and do not respond well to available antipsychotic medications.
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Affiliation(s)
- David R Goldsmith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Mark Hyman Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
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26
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Stiekema APM, van Heugten CM, de Vugt ME. Joining forces to improve psychosocial care for people with cognitive deficits across diagnoses: social health as a common framework. Aging Ment Health 2019; 23:1275-1281. [PMID: 30450949 DOI: 10.1080/13607863.2018.1498446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cognitive deficits such as memory problems have a major impact on independence in daily life and participation in society in several populations, such as people with dementia, brain injury (i.e. stroke) or a severe mental illness such as schizophrenia. Similarities in the impact on participation and well-being have resulted in the development of comparable psychosocial interventions across populations, aiming to support people to adapt to cognitive deficits or by adapting the environment. These interventions are developed separately, without using the expertise in other fields. We argue that each of the fields and the field of psychosocial care in general would benefit from closer collaboration on development and evaluation of innovative psychosocial interventions. Collaboration has been complicated by the use of different care models and theoretical frameworks, each with their own terminology. The concept of social health - the ability to participate in work or other meaningful activities and to feel healthy despite a condition - translates to the leading care models within the fields of dementia, brain injury and severe mental illness. The concept of social health provides a common language and framework. In this paper, we elaborate on strategies for collaboration using examples of interventions to improve social health.
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Affiliation(s)
- Annemarie P M Stiekema
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Caroline M van Heugten
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands.,b School for Mental Health and Neuroscience, Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University , Maastricht , The Netherlands
| | - Marjolein E de Vugt
- a School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center , Maastricht , The Netherlands
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27
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Cai XL, Weigl M, Liu BH, Cheung EFC, Ding JH, Chan RCK. Delay discounting and affective priming in individuals with negative schizotypy. Schizophr Res 2019; 210:180-187. [PMID: 30598400 DOI: 10.1016/j.schres.2018.12.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/08/2018] [Accepted: 12/20/2018] [Indexed: 12/15/2022]
Abstract
Previous studies have demonstrated that patients with schizophrenia and individuals with schizotypy experience decreased anticipatory pleasure. However, it is unclear whether this decrease is contributed by altered reward processing at the proximal or distal future. In order to investigate the preference for receiving rewards in the proximal or distal future for individuals with schizophrenia spectrum disorders, individuals with either high or low levels of negative schizotypy performed a delay discounting task under positive, neutral and negative affective priming conditions. Compared with individuals with low levels of negative schizotypy, individuals with high levels of schizotypy exhibited increased delay discounting, preferring to choose immediate but smaller rewards instead of delayed but larger rewards across all three affective priming conditions. Negative affective priming elevated discounting for both groups compared with both the positive and neutral affective conditions. After dividing delayed temporal distance into the proximal and distal future, the results showed that individuals with high levels of negative schizotypy exhibited more preference for immediate but smaller rewards in the distal instead of proximal future compared with controls. Our results suggest that individuals with high levels of negative schizotypy have altered anticipatory reward processing, which is mainly attributed to alterations in representing rewards in the distal future. These findings extend the alterations in representing reward values from schizophrenia patients to schizotypal individuals, and suggest that diminished anticipatory pleasure in schizophrenia spectrum disorders may be due to changes in processing anticipatory rewards in the distal future.
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Affiliation(s)
- Xin-Lu Cai
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100190, PR China; Sino-Danish Center for Education and Research, Beijing 100190, PR China
| | - Michael Weigl
- Experimental Neuropsychology Unit, Saarland University, Saarbrücken, Germany
| | - Bing-Hui Liu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100190, PR China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong, Special Administrative Region, PR China
| | - Jin-Hong Ding
- Department of Psychology, Capital Normal University, Beijing 100037, PR China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100190, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100190, PR China.
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28
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Chu MY, Hu HX, Ni H, Lu WH, Lui SSY, Yi ZH, Cheung EFC, Chan RCK. Impact of long-term institutionalization on experiential pleasure and motivation in patients with schizophrenia. Psych J 2019; 9:77-86. [PMID: 31328448 DOI: 10.1002/pchj.300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/12/2019] [Accepted: 05/06/2019] [Indexed: 11/11/2022]
Abstract
Anhedonia and amotivation, the hallmarks of negative symptoms in schizophrenia, are believed to be due to "emotion-behavior decoupling," a failure in translating pleasure experience into appropriate goal-directed behavior. A number of studies have reported that long-term institutionalized schizophrenia patients suffer from more severe negative symptoms than community-dwelling patients, but few studies have investigated pleasure experience and motivational behavior in schizophrenia patients who have experienced long-term institutionalization. In this study, we recruited 26 long-term institutionalized schizophrenia patients, 27 community-dwelling schizophrenia patients, and 27 healthy controls. Participants were administered two specific computer-based tasks to assess anhedonia and amotivation. The Anticipatory and Consummatory Pleasure (ACP) Task was used to measure emotion-behavior decoupling and the Effort-Expenditure for Rewards Task (EEfRT) was used to measure amotivation related to rewards. Findings from the ACP Task showed that compared with healthy controls, the coupling between emotion experience and motivated behavior was significantly weaker in both clinical groups, suggesting that emotion-behavior decoupling could be a stable trait in schizophrenia patients. In the EEfRT, compared with both community-dwelling patients and healthy controls, institutionalized patients with schizophrenia failed to expend more effort to gain potential rewards even when reward probability increased. These findings further reveal the underlying mechanism of anhedonia and amotivation and their potential relationships with long-term institutionalization in patients with schizophrenia.
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Affiliation(s)
- Min-Yi Chu
- Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui-Xin Hu
- Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Ni
- Shanghai Xuhui Mental Health Centre, Shanghai, China
| | - Wei-Hong Lu
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Zhen-Hui Yi
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Raymond C K Chan
- Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Neuropsychology and Applied Cognitive Neuroscience, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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29
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Zhang YJ, Wang J, Huang J, Chan RCK. High incentive salience promotes motivation and pleasure experience. Psych J 2019; 9:150-152. [PMID: 31290590 DOI: 10.1002/pchj.308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/29/2019] [Accepted: 05/23/2019] [Indexed: 11/06/2022]
Abstract
The present study aimed to examine the effect of incentive salience on the motivational behavior and pleasure experience of 35 healthy participants during reward pursuits. The findings suggest that high incentive salience promotes motivation in effort-expenditure decision-making, effort exertion, and pleasure experience.
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Affiliation(s)
- Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiao Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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30
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Cooper JA, Barch DM, Reddy LF, Horan WP, Green MF, Treadway MT. Effortful goal-directed behavior in schizophrenia: Computational subtypes and associations with cognition. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:710-722. [PMID: 31282687 DOI: 10.1037/abn0000443] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schizophrenia is associated with amotivation and reduced goal-directed behavior, which have been linked to poor functional outcomes. Motivational deficits in schizophrenia are often measured using effort-based decision-making (EBDM) paradigms, revealing consistent alterations in effort expenditure relative to controls. Although these results have generally been interpreted in terms of decreased motivation, the ability to use trial-by-trial changes in reward magnitude or probability of receipt to guide effort allocation may also be affected by cognitive deficits. To date, it remains unclear whether altered performance in EBDM primarily reflects deficits in motivation, cognitive functioning, or both. We applied a newly developed computational modeling approach to the analysis of EBDM data from two previously collected samples comprising 153 patients and 105 controls to determine the extent to which individuals did or did not use available information about reward and probability to guide effort allocation. Half of the participants with schizophrenia failed to incorporate information about reward and probability when making effort-expenditure decisions. The subset of patients who exhibited difficulties using reward and probability information were characterized by greater impairments across measures of cognitive functioning. Interestingly, even within the subset of patients who successfully used reward and probability information to guide effort expenditure, higher levels of negative symptoms related to motivation and avolition were associated with greater effort aversion during the task. Taken together, these data suggest that prior reports of aberrant EBDM in schizophrenia patients are related to both cognitive function and individual differences in negative symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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31
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Pessiglione M, Vinckier F, Bouret S, Daunizeau J, Le Bouc R. Why not try harder? Computational approach to motivation deficits in neuro-psychiatric diseases. Brain 2019; 141:629-650. [PMID: 29194534 DOI: 10.1093/brain/awx278] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 08/30/2017] [Indexed: 12/19/2022] Open
Abstract
Motivation deficits, such as apathy, are pervasive in both neurological and psychiatric diseases. Even when they are not the core symptom, they reduce quality of life, compromise functional outcome and increase the burden for caregivers. They are currently assessed with clinical scales that do not give any mechanistic insight susceptible to guide therapeutic intervention. Here, we present another approach that consists of phenotyping the behaviour of patients in motivation tests, using computational models. These formal models impose a precise and operational definition of motivation that is embedded in decision theory. Motivation can be defined as the function that orients and activates the behaviour according to two attributes: a content (the goal) and a quantity (the goal value). Decision theory offers a way to quantify motivation, as the cost that patients would accept to endure in order to get the benefit of achieving their goal. We then review basic and clinical studies that have investigated the trade-off between the expected cost entailed by potential actions and the expected benefit associated with potential rewards. These studies have shown that the trade-off between effort and reward involves specific cortical, subcortical and neuromodulatory systems, such that it may be shifted in particular clinical conditions, and reinstated by appropriate treatments. Finally, we emphasize the promises of computational phenotyping for clinical purposes. Ideally, there would be a one-to-one mapping between specific neural components and distinct computational variables and processes of the decision model. Thus, fitting computational models to patients' behaviour would allow inferring of the dysfunctional mechanism in both cognitive terms (e.g. hyposensitivity to reward) and neural terms (e.g. lack of dopamine). This computational approach may therefore not only give insight into the motivation deficit but also help personalize treatment.
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Affiliation(s)
- Mathias Pessiglione
- Motivation, Brain and Behaviour (MBB) Lab, Institut du Cerveau et de la Moelle (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.,Inserm U1127, CNRS U9225, Université Pierre et Marie Curie (UPMC - Paris 6), France
| | - Fabien Vinckier
- Motivation, Brain and Behaviour (MBB) Lab, Institut du Cerveau et de la Moelle (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.,Inserm U1127, CNRS U9225, Université Pierre et Marie Curie (UPMC - Paris 6), France.,Service de Psychiatrie, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Sébastien Bouret
- Motivation, Brain and Behaviour (MBB) Lab, Institut du Cerveau et de la Moelle (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.,Inserm U1127, CNRS U9225, Université Pierre et Marie Curie (UPMC - Paris 6), France
| | - Jean Daunizeau
- Motivation, Brain and Behaviour (MBB) Lab, Institut du Cerveau et de la Moelle (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.,Inserm U1127, CNRS U9225, Université Pierre et Marie Curie (UPMC - Paris 6), France
| | - Raphaël Le Bouc
- Motivation, Brain and Behaviour (MBB) Lab, Institut du Cerveau et de la Moelle (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.,Inserm U1127, CNRS U9225, Université Pierre et Marie Curie (UPMC - Paris 6), France.,Urgences cérébro-vasculaires, Hôpital de la Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France
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Chang WC, Chu AOK, Treadway MT, Strauss GP, Chan SKW, Lee EHM, Hui CLM, Suen YN, Chen EYH. Effort-based decision-making impairment in patients with clinically-stabilized first-episode psychosis and its relationship with amotivation and psychosocial functioning. Eur Neuropsychopharmacol 2019; 29:629-642. [PMID: 30879927 DOI: 10.1016/j.euroneuro.2019.03.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/06/2018] [Accepted: 03/02/2019] [Indexed: 12/14/2022]
Abstract
Effort-based decision-making has recently been proposed as a potential mechanism contributing to motivational deficits (amotivation) in psychotic disorder. Previous research has identified altered effort allocation in chronic schizophrenia, but produced mixed results regarding its relationship with amotivation. No study has investigated effort allocation in first-episode psychosis (FEP). We examined effort-based decision-making in 45 clinically-stabilized FEP patients and 45 demographically-matched controls, using Effort-Expenditure for Reward Task (EEfRT) which measures allocation of physical effort for monetary reward at varying magnitude and probability levels. Our results showed that FEP patients did not demonstrate overall reduction in effort expenditure but displayed reduced willingness to expend effort for high-value/high-probability reward as compared to controls. In particular, such selective effort-related impairment was most pronounced in patients with high levels of amotivation. Furthermore, reduced allocation of greater effort for higher probability reward was related to poorer psychosocial functioning. Decreased effort exertion was generally unrelated to other symptom dimensions, self-report anhedonia, antipsychotic dose and cognitive deficits. This study thus provides the first evidence of effort-based decision-making impairment in FEP, and indicates that first-episode patients were not generally effort-averse but exhibited inefficient effort allocation by failing to make high-effort choices to maximize reward receipt. Our findings affirm the critical role of amotivation on aberrant effort allocation, and support the link between laboratory-based effort-cost measures and real-world psychosocial functioning in medicated FEP. Further longitudinal research is required to clarify trajectory of suboptimal effort allocation and its potential utility in predicting amotivation and functional outcomes in the early course of illness.
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Affiliation(s)
- Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
| | - Angel On Ki Chu
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Michael T Treadway
- Department of Psychology, University of Emory, Atlanta, GA 30322, United States
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, Athens, GA 30602, United States
| | - Sherry Kit Wa Chan
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Christy Lai Ming Hui
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong
| | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong
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Luther L, Fischer MW, Firmin RL, Salyers MP. Clarifying the overlap between motivation and negative symptom measures in schizophrenia research: A meta-analysis. Schizophr Res 2019; 206:27-36. [PMID: 30577993 PMCID: PMC6525651 DOI: 10.1016/j.schres.2018.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
Motivation and negative symptom research has recently been hampered by a series of inconsistent findings, leading to calls for a greater consensus on the type of measures used across studies. To inform this issue, we conducted a meta-analysis that quantified the association between motivation measures (self-report, performance-based) and clinician-rated negative symptom measures as well as a series of moderator analyses to develop a greater understanding of the measurement factors impacting this relationship. Forty-seven eligible studies with people with schizophrenia-spectrum disorders were included. Using a random-effects meta-analytic model, a small but significant overall effect size emerged between motivation and clinician-rated negative symptoms (r = -0.18). Several significant moderators were identified, including the generation of negative symptom measures such that there was a significantly stronger relationship between motivation and second-generation (r = -0.38) than first-generation negative symptom measures (r = -0.17). Further, the type of performance-based measure used moderated the relationship, with effort discounting tasks most strongly related to negative symptoms (r = -0.44). The domain of motivation assessed (intrinsic, extrinsic, amotivation) also moderated the relationship. These findings help to identify sources of inconsistencies observed in prior studies and point to both second-generation and effort discounting tasks as the most promising types of measures, particularly for those interested in validating motivation measures or assessing the effectiveness of motivation treatments. Although additional research is needed, our results suggest that using these measures may help to reduce inconsistencies across studies and move the field forward.
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Affiliation(s)
- Lauren Luther
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA; University of Illinois at Chicago, Department of Psychiatry, 1747 West Roosevelt Road, 279, Chicago, IL 60608, USA.
| | - Melanie W Fischer
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA.
| | - Ruth L Firmin
- University of California Los Angeles, Semel Institute, 760 Westwood Plaza, Los Angeles, CA 90046, USA.
| | - Michelle P Salyers
- Indiana University-Purdue University Indianapolis, Department of Psychology, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA.
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Yan C, Lui SSY, Zou LQ, Wang CY, Zhou FC, Cheung EFC, Shum DHK, Chan RCK. Anticipatory pleasure for future rewards is attenuated in patients with schizophrenia but not in individuals with schizotypal traits. Schizophr Res 2019; 206:118-126. [PMID: 30545761 DOI: 10.1016/j.schres.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/11/2018] [Accepted: 12/04/2018] [Indexed: 01/02/2023]
Abstract
The anhedonia paradox is consistently observed in individuals with schizophrenia. However, the underlying mechanism of the dissociation between trait and state hedonic capacity remains unclear. In the present study, we aimed to re-examine anhedonia in patients with schizophrenia (SCZ) and individuals with high schizotypy (HS) using the Monetary Incentive Delay (MID) task to assess different dimensions of anticipatory and consummatory pleasure. We recruited 44 SCZ patients, 46 matched healthy controls (HC), 30 individuals with HS and 35 with low schizotypy (LS). The modified MID task was used to measure anticipatory and consummatory pleasure in terms of valence and arousal ratings. To measure the predictive value of anticipatory pleasure, participants were asked to predict their hedonic experience before the MID task. For SCZ patients, there was no significant Group main effect or Group × Prize interaction on consummatory pleasantness to reward received or loss avoidance. As expected, SCZ patients (particularly male patients) reported less pleasantness and arousal to future rewards in both the prediction and feeling dimensions compared with HC. Additionally, male patients reported less anticipatory and consummatory negativity than HC. Individuals with HS predicted more arousing experience to high-rewards than LS individuals. They also reported and predicted more negativity to in-the-moment and future monetary losses. Further, the negative dimension of schizotypy predicted low levels of pleasantness and arousal towards future rewards, but the positive dimension predicted increased arousing experience towards future rewards. In conclusion, the anhedonia paradox in schizophrenia could be partially accounted for by the dissociation between anticipatory and consummatory pleasure.
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Affiliation(s)
- Chao Yan
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics, Ministry of Education, East China Normal University, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | | | - Lai-Quan Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China; Centre of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, Beijing, China
| | - Fu-Chun Zhou
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China; Centre of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, Beijing, China
| | | | - David H K Shum
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
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Kim SJ, Hong YJ, Kim MW, Jung YH, Min SR, Kim JJ. Inflexible eye fixation pattern in schizophrenia affecting decision-making on daily life. Psychiatry Res 2019; 274:414-420. [PMID: 30870671 DOI: 10.1016/j.psychres.2019.02.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 02/05/2023]
Abstract
Patients with schizophrenia have difficulties in real life due to impairment in ability to make decisions. The purpose of this study was to elucidate the relationship between impaired decision-making processes with real life stimuli and abnormal eye gaze patterns in patients with schizophrenia. Each of 23 patients with schizophrenia and 23 healthy controls performed an apparel purchase decision task including the influencing factors such as preference, fit, and price, during which the eye gaze was traced. Fixation time and fixation time ratio on areas of interest, which were set for participant faces and clothing, were compared between the two groups. Compared with controls, patients made purchase decisions at a higher rate and showed significantly shorter fixation time on clothing in the preference, fit, and price phases and on faces in the purchase phase. Fixation time ratio of face over clothing did not change over purchase decisions in patients, whereas controls showed significantly higher fixation time ratio in not-to-buy decisions than in to-buy decisions. These results suggest that aberrant decision-making behaviors in patients with schizophrenia are closely related to inflexible visual information gathering patterns because they apportion the same amount of attention to objects regardless of purchase intention.
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Affiliation(s)
- Soo-Jeong Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yeon-Ju Hong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Woo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Hoon Jung
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sa-Rang Min
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Hallford DJ, Sharma MK. Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: A systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 58:357-383. [PMID: 30854671 DOI: 10.1111/bjc.12218] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/27/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Deficits in anticipating pleasure may be an important dimension of anhedonia and functioning in psychiatric disorders, particularly schizophrenia and depression; however, inconsistent findings have limited the conclusions that can be drawn. We conducted the first systemic review and meta-analysis of the extant literature for research comparing psychiatric groups to healthy control groups on anticipatory pleasure. METHODS Academic Search Complete, Science Direct, and CINAHL databases were systematically searched up to 9 June 2018 for relevant peer-reviewed articles, book chapters, and dissertations. Reference lists were also hand searched. A total of 36 studies were included in the review. RESULTS A moderate-sized deficit was observed in schizophrenia spectrum disorders (k = 32, 1,851 patients and 1,449 controls, g = -0.42 [95% CI = -0.53 to -0.31], p < .001), and a large deficit in major depression (k = 415 patients and 506 controls, g = -0.87 [95% CI = -1.23 to -0.51], p < .001), with this effect being significantly larger for depression (p < .05). Meta-regression showed that heterogeneity was partially explained in schizophrenia spectrum by longer duration of illness and lower cognitive functioning predicting larger deficits. In depression, some evidence was found that ruling out a history of psychiatric illness in controls may be related to larger effects. There was evidence for small study bias inflating estimates in schizophrenia spectrum disorders. CONCLUSIONS Deficits in anticipatory pleasure are manifest in these disorders, and significantly more so in major depression. These findings indicate a possible therapeutic target to link cognitive, affective, and behavioural factors that precipitate and maintain disorder. PRACTITIONER POINTS Anticipatory pleasure is impaired in schizophrenia spectrum and major depression. A particular focus on enhancing anticipatory pleasure may improve motivation for rewarding behaviour and psychosocial functioning. The review contained only a small number of studies for major depression. Given the heterogeneity in effects, there are likely to be more moderators of anticipatory pleasure that require examination.
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Affiliation(s)
- David J Hallford
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Manoj K Sharma
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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DeRosse P, Barber AD, Fales CL, Malhotra AK. Deconstructing Avolition: Initiation vs persistence of reward-directed effort. Psychiatry Res 2019; 273:647-652. [PMID: 31207847 PMCID: PMC7864548 DOI: 10.1016/j.psychres.2019.01.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Abstract
Avolition, a decrease in the initiation and persistence of goal-directed behavior, is a critical determinant of disability in patients with schizophrenia. Recent studies have demonstrated that avolition can be modeled using reward-based, behavioral paradigms. These studies suggest that avolition represents a motivational deficit, accounted for by a diminished ability to anticipate pleasurable experiences. Notably, although data suggest that "initiation" and "persistence" of goal-directed behavior may depend on different processes, few studies have sought to distinguish between these two components of avolitional symptoms. Such distinctions could have real consequences for the development and evaluation of interventions designed to ameliorate avolitional symptoms. Thus, the present study examined the relationship between anticipatory pleasure, a key driver of avolition, and both the initiation and persistence of reward-directed, effortful responding during the Effort Expenditures for Rewards Task in 103 healthy participants. We found that anticipatory pleasure was not significantly predictive of the initiation of effortful responding but was significantly predictive of the persistence of effortful responding; most notably when the probabilities of reward and non-reward were equivalent. These data suggest that although deficits in reward processes contribute to the likelihood of persisting in reward-driven behavior, they contribute little to the initiation of such behavior.
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Affiliation(s)
- Pamela DeRosse
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA.
| | - Anita D Barber
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
| | - Christina L Fales
- The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
| | - Anil K Malhotra
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
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Missault S, Anckaerts C, Ahmadoun S, Blockx I, Barbier M, Bielen K, Shah D, Kumar-Singh S, De Vos WH, Van der Linden A, Dedeurwaerdere S, Verhoye M. Hypersynchronicity in the default mode-like network in a neurodevelopmental animal model with relevance for schizophrenia. Behav Brain Res 2019; 364:303-316. [PMID: 30807809 DOI: 10.1016/j.bbr.2019.02.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Immune activation during pregnancy is an important risk factor for schizophrenia. Brain dysconnectivity and NMDA receptor (NMDAR) hypofunction have been postulated to be central to schizophrenia pathophysiology. The aim of this study was to investigate resting-state functional connectivity (resting-state functional MRI-rsfMRI), microstructure (diffusion tension imaging-DTI) and response to NMDAR antagonist (pharmacological fMRI-phMRI) using multimodal MRI in offspring of pregnant dams exposed to immune challenge (maternal immune activation-MIA model), and determine whether these neuroimaging readouts correlate with schizophrenia-related behaviour. METHODS Pregnant rats were injected with Poly I:C or saline on gestational day 15. The maternal weight response was assessed. Since previous research has shown behavioural deficits can differ between MIA offspring dependent on the maternal response to immune stimulus, offspring were divided into three groups: controls (saline, n = 11), offspring of dams that gained weight (Poly I:C WG, n = 12) and offspring of dams that lost weight post-MIA (Poly I:C WL, n = 16). Male adult offspring were subjected to rsfMRI, DTI, phMRI with NMDAR antagonist, behavioural testing and histological assessment. RESULTS Poly I:C WL offspring exhibited increased functional connectivity in default mode-like network (DMN). Poly I:C WG offspring showed the most pronounced attenuation in NMDAR antagonist response versus controls. DTI revealed no differences in Poly I:C offspring versus controls. Poly I:C offspring exhibited anxiety. CONCLUSIONS MIA offspring displayed a differential pathophysiology depending on the maternal response to immune challenge. While Poly I:C WL offspring displayed hypersynchronicity in the DMN, altered NMDAR antagonist response was most pronounced in Poly I:C WG offspring.
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Affiliation(s)
- Stephan Missault
- Experimental Laboratory of Translational Neuroscience and Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Cynthia Anckaerts
- Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Soumaya Ahmadoun
- Experimental Laboratory of Translational Neuroscience and Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Ines Blockx
- Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Michaël Barbier
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Kenny Bielen
- Molecular Pathology Group, Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Disha Shah
- Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Samir Kumar-Singh
- Molecular Pathology Group, Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Winnok H De Vos
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Cell Systems & Imaging, Faculty of Bioscience Engineering, University of Ghent, Coupure Links 653, 9000 Gent, Belgium
| | - Annemie Van der Linden
- Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Stefanie Dedeurwaerdere
- Experimental Laboratory of Hematology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Marleen Verhoye
- Bio-Imaging Lab, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
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Predicting Predischarge Anhedonia Among Inpatients With Schizophrenia and Schizoaffective Disorders: A Large-scale Analysis. J Nerv Ment Dis 2019; 207:12-21. [PMID: 30575703 DOI: 10.1097/nmd.0000000000000923] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study sought to evaluate predischarge anhedonia level and its predictors in 125 inpatients with schizophrenia and schizoaffective disorders. Consecutively admitted inpatients were assessed before discharge from the hospital using the Specific Loss of Interest and Pleasure Scale (SLIPS) and a battery of measures for clinical and psychosocial variables. When symptoms, distress, and social anhedonia scores were controlled, the SLIPS score inversely correlated with self-constructs, social support, quality of life, recovery, and unmet needs. Using two cutoff points of the data set of SLIPS, we identified three groups: 19 (15.2%) patients reported "no loss of pleasure"; 46 (36.8%), "some loss of pleasure"; and 60 (48.0%), "marked diminishment of pleasure." The SLIPS score is predicted by sensitivity, unmet needs, deficient interpersonal pleasure, poor quality of life, and friend support. The study underlines the importance of assessing anhedonia and related psychosocial factors in patients with serious mental illness.
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Abstract
Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.
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Affiliation(s)
- Adam J. Culbreth
- Department of Psychological and Brain Sciences, Washington University in Saint Louis
| | - Erin K. Moran
- Department of Psychiatry, Washington University in Saint Louis
| | - Deanna M. Barch
- Department of Psychological and Brain Sciences, Washington University in Saint Louis
- Department of Psychiatry, Washington University in Saint Louis
- Department of Radiology, Washington University in Saint Louis
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Effort-based decision-making paradigms as objective measures of apathy in schizophrenia? Curr Opin Behav Sci 2018. [DOI: 10.1016/j.cobeha.2018.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Xie DJ, Lui SSY, Geng FL, Yang ZY, Zou YM, Li Y, Yeung HKH, Cheung EFC, Heerey EA, Chan RCK. Dissociation between affective experience and motivated behaviour in schizophrenia patients and their unaffected first-degree relatives and schizotypal individuals. Psychol Med 2018; 48:1474-1483. [PMID: 29017618 DOI: 10.1017/s0033291717002926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The neuropsychological origins of negative syndrome of schizophrenia remain elusive. Evidence from behavioural studies, which utilised emotion-inducing pictures to elicit motivated behaviour generally reported that that schizophrenia patients experienced similar affective experience as healthy individuals but failed to translate emotional salience to motivated behaviour, a phenomenon called emotion-behaviour decoupling. However, a few studies have examined emotion-behaviour decoupling in non-psychotic high-risk populations, who are relatively unaffected by medication effects. METHODS In this study, we examined the nature and extent of emotion-behaviour decoupling in in three independent samples (65 schizophrenia patients v. 63 controls; 40 unaffected relatives v. 45 controls; and 32 individuals with social anhedonia v. 32 controls). We administered an experimental task to examine their affective experience and its coupling with behaviour, using emotion-inducing slides, and allowed participants to alter stimulus exposure using button-pressing to seek pleasure or avoid aversion. RESULTS Schizophrenia patients reported similar affective experiences as their controls, while their unaffected relatives and individuals with high levels of social anhedonia exhibited attenuated affective experiences, in particular in the arousal aspect. Compared with their respective control groups, all of the three groups showed emotion-behaviour decoupling. CONCLUSIONS Our findings support that both genetically and behaviourally high-risk groups exhibit emotion-behaviour decoupling. The familial association apparently supports its role as a putative trait marker for schizophrenia.
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Affiliation(s)
- Dong-Jie Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Fu-Lei Geng
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Zhuo-Ya Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Ying-Min Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Ying Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
| | - Hera K H Yeung
- Castle Peak Hospital,Hong Kong Special Administrative Region,China
| | - Eric F C Cheung
- Castle Peak Hospital,Hong Kong Special Administrative Region,China
| | - Erin A Heerey
- Department of Psychology,Western University,London, Ontario,Canada
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory,CAS Key Laboratory of Mental Health,Institute of Psychology,Beijing,China
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43
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Social motivation in schizophrenia: How research on basic reward processes informs and limits our understanding. Clin Psychol Rev 2018; 63:12-24. [PMID: 29870953 DOI: 10.1016/j.cpr.2018.05.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 05/18/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Limited quantity and quality of interpersonal exchanges and relationships predict worse symptomatic and hospitalization outcomes and limit functional recovery in people with schizophrenia. While deficits in social skills and social cognition contribute to much of the impairment in social functioning in schizophrenia, our focus on the current review is social motivation-the drive to connect with others and form meaningful, lasting relationships. We pay particular attention to how recent research on reward informs, and limits, our understanding of the construct. Recent findings that parse out key components of human motivation, especially the temporal nature of reward and effort, are informative for understanding some aspects of social motivation. This approach, however, fails to fully integrate the critical influence of uncertainty and punishment (e.g., avoidance, threat) in social motivation. In the current review, we argue for the importance of experimental paradigms and real-time measurement to capture the interaction between social approach and avoidance in characterizing social affiliation in schizophrenia. We end with suggestions for how researchers might move the field forward by emphasizing the ecological validity of social motivation paradigms, including dynamic, momentary assessment of social reward and punishment using mobile technology and other innovative tools.
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Culbreth AJ, Moran EK, Barch DM. Effort-cost decision-making in psychosis and depression: could a similar behavioral deficit arise from disparate psychological and neural mechanisms? Psychol Med 2018; 48:889-904. [PMID: 28889803 DOI: 10.1017/s0033291717002525] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Motivational impairment is a common feature of both depression and psychosis; however, the psychological and neural mechanisms that give rise to motivational impairment in these disorders are poorly understood. Recent research has suggested that aberrant effort-cost decision-making (ECDM) may be a potential contributor to motivational impairment in both psychosis and depression. ECDM refers to choices that individuals make regarding the amount of 'work' they are willing to expend to obtain a certain outcome or reward. Recent experimental work has suggested that those with psychosis and depression may be less willing to expend effort to obtain rewards compared with controls, and that this effort deficit is related to motivational impairment in both disorders. In the current review, we aim to summarize the current literature on ECDM in psychosis and depression, providing evidence for transdiagnostic impairment. Next, we discuss evidence for the hypothesis that a seemingly similar behavioral ECDM deficit might arise from disparate psychological and neural mechanisms. Specifically, we argue that effort deficits in psychosis might be largely driven by deficits in cognitive control and the neural correlates of cognitive control processes, while effort deficits in depression might be largely driven by reduced reward responsivity and the associated neural correlates of reward responsivity. Finally, we will provide some discussion regarding future directions, as well as interpretative challenges to consider when examining ECDM transdiagnostically.
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Affiliation(s)
- A J Culbreth
- Department of Psychological and Brain Sciences,Washington University in Saint Louis,St. Louis, MO,USA
| | - E K Moran
- Department of Psychiatry,Washington University in Saint Louis,St. Louis, MO,USA
| | - D M Barch
- Department of Psychological and Brain Sciences,Washington University in Saint Louis,St. Louis, MO,USA
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45
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Motivation deficits in individuals with social anhedonia. Psychiatry Res 2018; 261:527-534. [PMID: 29395876 DOI: 10.1016/j.psychres.2018.01.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/07/2018] [Accepted: 01/15/2018] [Indexed: 02/08/2023]
Abstract
Patients with schizophrenia have been reported to exhibit anhedonia, a reduced hedonic capacity and deficits in motivation for reward pursuit. However, it is unclear whether these deficits also exist in at-risk individuals prone to psychosis or not. The present study compared 26 individuals with social anhedonia and 28 healthy controls using a grip Effort-based Pleasure Experience Task (E-PET). The findings showed that individuals with social anhedonia did not increase their hard task choices with the elevation of reward magnitude and probability while healthy controls did. Higher reward probability and magnitude did not lead to more anticipatory pleasure in individuals with social anhedonia. The mean anticipatory pleasure experience ratings in individuals with social anhedonia were significantly lower than controls. Our results suggest that individuals with social anhedonia already exhibit motivational deficits during reward pursuit.
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46
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Assessment of Snaith-Hamilton Pleasure Scale (SHAPS): the dimension of anhedonia in Italian healthy sample. Neurol Sci 2018; 39:657-661. [PMID: 29383616 DOI: 10.1007/s10072-018-3260-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
Abstract
The Snaith-Hamilton Pleasure Scale (SHAPS) is a rapid screening battery created for assessing the presence of anhedonia, namely the inability to experience pleasure. Although, this symptom has widely been investigated in clinical settings, individual differences in anhedonia are also present in healthy population. The aim of present study was to validate the translated Italian version of this test. One thousand six hundred ninety-seven consecutive healthy subjects (55% female) of different ages (age 18-82 years) underwent SHAPS. Participants who showed mild level of anhedonia also completed the Apathy Evaluation Scale (AES), Beck Depression Inventory (BDI), Toronto Alexithymia Scale-20 (TAS), Mood Disorders Insight Scale (MDIS), and Beck Hopelessness Scale (BHS). The SHAPS showed good internal consistency and discriminant validity; moreover, the factorial analysis highlighted that SHAPS had a three-factor structure for explaining the anhedonic construct. 14.9% showed a significant reduction of hedonic tone (SHAPS ≥ 3). Finally, the degree of anhedonia was significantly correlated with BDI and BHS scores, but not with age or gender. Although anhedonia is a prominent feature of many psychiatric and neurological disorders, the presence of this symptom in the healthy population highlighted the importance to develop reliable tool. SHAPS shows good psychometric properties to assess multidimensional anhedonia symptoms also in Italian healthy population.
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47
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Campellone TR, Kring AM. Anticipated pleasure for positive and negative social interaction outcomes in schizophrenia. Psychiatry Res 2018; 259:203-209. [PMID: 29069621 PMCID: PMC5742063 DOI: 10.1016/j.psychres.2017.09.084] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 08/10/2017] [Accepted: 09/28/2017] [Indexed: 12/15/2022]
Abstract
While recent research suggests that people with schizophrenia anticipate less pleasure for non-social events, considerably less is known about anticipated pleasure for social events. In this study, we investigated whether people with and without schizophrenia differ in the amount and updating of anticipated pleasure over the course of repeated interactions as well as the influence of emotional displays. Thirty-two people with schizophrenia and 29 controls rated their anticipated pleasure over the course of repeated interactions with smiling, scowling, or neutral social partners that had either positive or negative outcomes. Compared to controls, people with schizophrenia anticipated a lower amount of pleasure during interactions with smiling, but not neutral social partners that had positive outcomes. However, the groups did not differ in the amount or updating of anticipated pleasure during interactions that had negative outcomes. Both groups anticipated more pleasure over the course of repeated interactions with smiling partners and less pleasure over the course of repeated interactions with scowling partners compared to interactions with neutral partners. We discuss how less anticipated pleasure for interactions with smiling social partners may be linked to difficulties in social engagement among people with schizophrenia.
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Affiliation(s)
- Timothy R. Campellone
- San Francisco VA Medical Center, San Francisco, CA,Department of Psychiatry, University of California, San Francisco, CA,Communications may be directed to Timothy R. Campellone, 4150 Clement Street, San Francisco, CA 94121, , Phone: 415-221-4810 x 25548
| | - Ann M. Kring
- Department of Psychology, University of California, Berkeley, CA
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48
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Serper M, Payne E, Dill C, Portillo C, Taliercio J. Allocating effort and anticipating pleasure in schizophrenia: Relationship with real world functioning. Eur Psychiatry 2017; 46:57-64. [PMID: 29031122 DOI: 10.1016/j.eurpsy.2017.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/29/2017] [Accepted: 07/13/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Poor motivation to engage in goal-oriented behavior has been recognized as a hallmark feature of schizophrenia spectrum disorders (SZ). Low drive in SZ may be related to anticipating rewards as well as to poor working memory. However, few studies to date have examined beliefs about self-efficacy and satisfaction for future rewards (anticipatory pleasure). Additionally, few studies to date have examined how these deficits may impact SZ patients' real world functioning. METHOD The present study examined SZ patients' (n=57) anticipatory pleasure, working memory, self-efficacy and real world functioning in relation to their negative symptom severity. RESULTS Results revealed that SZ patients' negative symptom severity was related to decisions in effort allocation and reward probability, working memory deficits, self-efficacy and anticipatory pleasure for future reward. Effort allocation deficits also predicted patients' daily functioning skills. CONCLUSIONS SZ patients with high levels of negative symptoms are not merely effort averse, but have more difficulty effectively allocating effort and anticipating pleasure engaging in effortful activities. It may be the case that continuously failing to achieve reinforcement from engagement and participation may lead SZ patients to form certain negative beliefs about their abilities which contributes to amotivation and cognitive deficits. Lastly, our findings provide further support for a link between SZ patients functional daily living skills their effort allocation.
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Affiliation(s)
- M Serper
- Department of Psychology, Hofstra University, New York, NY, USA; Department of Psychiatry, Ichan Mount Sinai School of Medicine, New York, NY, USA.
| | - E Payne
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - C Dill
- Department of Psychology, Hofstra University, New York, NY, USA
| | - C Portillo
- Department of Psychology, Hofstra University, New York, NY, USA
| | - J Taliercio
- Department of Psychology, Hofstra University, New York, NY, USA
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49
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Fisher M, Nahum M, Howard E, Rowlands A, Brandrett B, Kermott A, Woolley J, Vinogradov S. Supplementing intensive targeted computerized cognitive training with social cognitive exercises for people with schizophrenia: An interim report. Psychiatr Rehabil J 2017; 40:21-32. [PMID: 28368179 PMCID: PMC5380146 DOI: 10.1037/prj0000244] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Individuals with schizophrenia demonstrate cognitive, social cognitive, and motivational deficits that contribute to impairment in real-world functioning. In the current study, we investigated the effects of supplementing computerized neurocognitive training with social cognitive exercises, as compared with neurocognitive training alone. METHOD In this ongoing, double-blind, randomized controlled trial of 111 participants with psychosis, we compare the effects of supplementing intensive targeted cognitive training with social cognitive training exercises (TCT + SCT) with the effects of targeted cognitive training alone (TCT-only). Participants were assessed on cognition, symptoms, functional capacity, and functional outcomes, as well as social cognition and measures related to reward processing. RESULTS Both treatment groups showed significant improvement in multiple cognitive domains and improvement in functional capacity. However, as predicted, TCT + SCT group participants showed significant improvement in prosody identification and reward processing relative to TCT-only participants. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Our findings indicate that supplementing intensive computerized cognitive training with social cognitive exercises in people with psychosis confers greater benefits in prosody identification and reward processing relative to cognitive training alone, even though both approaches drive significant improvements in cognition and functional capacity. Impairments in both prosody identification and reward processing have been associated with greater negative symptoms and poorer functional outcomes in schizophrenia, raising the possibility that this form of treatment may lead to better long-term outcomes than traditional cognitive training approaches. Follow-up assessments will determine whether results are durable and generalize over time to improvements in symptoms and functioning. (PsycINFO Database Record
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Mor Nahum
- Posit Science Inc., San Francisco, CA, United States
| | - Elizabeth Howard
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Abby Rowlands
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Benjamin Brandrett
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Amy Kermott
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Joshua Woolley
- Department of Psychiatry, University of California, San Francisco, CA, United States
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, United States
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
- Department of Psychiatry, University of California, San Francisco, CA, United States
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50
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Bergamini G, Sigrist H, Ferger B, Singewald N, Seifritz E, Pryce CR. Depletion of nucleus accumbens dopamine leads to impaired reward and aversion processing in mice: Relevance to motivation pathologies. Neuropharmacology 2016; 109:306-319. [DOI: 10.1016/j.neuropharm.2016.03.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/25/2016] [Accepted: 03/27/2016] [Indexed: 10/22/2022]
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