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Akgül Ö, Fide E, Özel F, Alptekin K, Bora E, Akdede BB, Yener G. Early and late contingent negative variation (CNV) reflect different aspects of deficits in schizophrenia. Eur J Neurosci 2024; 59:2875-2889. [PMID: 38658367 DOI: 10.1111/ejn.16340] [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: 09/07/2023] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/26/2024]
Abstract
Abnormal reward processing and psychomotor slowing are well-known in schizophrenia (SZ). As a slow frontocentral potential, contingent negative variation (CNV) is associated with anticipatory attention, motivation and motor planning. The present study aims to evaluate the early and late amplitude and latencies of CNV in patients with SZ compared to healthy controls during a reward processing task and to show its association with clinical symptoms. We recruited 21 patients with SZ and 22 healthy controls to compare early and late CNV amplitude and latency values during a Monetary Incentive Delay (MID) Task between groups. Patients' symptom severity, levels of negative symptoms and depressive symptoms were assessed. Clinical features of the patients were further examined for their relation with CNV components. In conclusion, we found decreased early CNV amplitudes in SZ during the reward condition. They also displayed diminished and shortened late CNV responses for incentive cues, specifically at the central location. Furthermore, early CNV amplitudes exhibited a significant correlation with positive symptoms. Both CNV latencies were linked with medication dosage and the behavioural outcomes of the MID task. We revealed that early and late CNV exhibit different functions in neurophysiology and correspond to various facets of the deficits observed in patients. Our findings also emphasized that slow cortical potentials are indicative of deficient motivational processes as well as impaired reaction preparation in SZ. To gain a deeper understanding of the cognitive and motor impairments associated with psychosis, future studies must compare the effects of CNV in the early and late phases.
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Affiliation(s)
- Özge Akgül
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Arts and Sciences, Department of Psychology, Izmir Democracy University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Health, Department of Psychology, York University, Toronto, Canada
| | - Fatih Özel
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Köksal Alptekin
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Berna Binnur Akdede
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Görsev Yener
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
- Izmir International Biomedicine and Genome Institute, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Neurology, Izmir University of Economics, Izmir, Turkey
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Ghaderi S, Amani Rad J, Hemami M, Khosrowabadi R. Dysfunctional feedback processing in male methamphetamine abusers: Evidence from neurophysiological and computational approaches. Neuropsychologia 2024; 197:108847. [PMID: 38460774 DOI: 10.1016/j.neuropsychologia.2024.108847] [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: 08/07/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 03/11/2024]
Abstract
Methamphetamine use disorder (MUD) as a major public health risk is associated with dysfunctional neural feedback processing. Although dysfunctional feedback processing in people who are substance dependent has been explored in several behavioral, computational, and electrocortical studies, this mechanism in MUDs requires to be well understood. Furthermore, the current understanding of latent components of their behavior such as learning speed and exploration-exploitation dilemma is still limited. In addition, the association between the latent cognitive components and the related neural mechanisms also needs to be explored. Therefore, in this study, the underlying neurocognitive mechanisms of feedback processing of such impairment, and age/gender-matched healthy controls are evaluated within a probabilistic learning task with rewards and punishments. Mathematical modeling results based on the Q-learning paradigm suggested that MUDs show less sensitivity in distinguishing optimal options. Additionally, it may be worth noting that MUDs exhibited a slight decrease in their ability to learn from negative feedback compared to healthy controls. Also through the lens of underlying neural mechanisms, MUDs showed lower theta power at the medial-frontal areas while responding to negative feedback. However, other EEG measures of reinforcement learning including feedback-related negativity, parietal-P300, and activity flow from the medial frontal to lateral prefrontal regions, remained intact in MUDs. On the other hand, the elimination of the linkage between value sensitivity and medial-frontal theta activity in MUDs was observed. The observed dysfunction could be due to the adverse effects of methamphetamine on the cortico-striatal dopamine circuit, which is reflected in the anterior cingulate cortex activity as the most likely region responsible for efficient behavior adjustment. These findings could help us to pave the way toward tailored therapeutic approaches.
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Affiliation(s)
- Sadegh Ghaderi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Jamal Amani Rad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.
| | - Mohammad Hemami
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.
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3
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Akgül Ö, Fide E, Özel F, Alptekin K, Bora E, Akdede BB, Yener G. Enhanced Punishment Responses in Patients With Schizophrenia: An Event-Related Potential Study. Clin EEG Neurosci 2024; 55:219-229. [PMID: 37563908 DOI: 10.1177/15500594231190966] [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] [Indexed: 08/12/2023]
Abstract
It is well known that abnormal reward processing is a characteristic feature of various psychopathologies including schizophrenia. Reduced reward anticipation has been suggested as a core symptom of schizophrenia. The Monetary Incentive Delay Task (MID) is frequently used to detect reward anticipation. The present study aims to evaluate the amplitude and latency of event-related potential (ERP) P300 in patients with schizophrenia (SCH) compared to healthy controls during the MID task. Twenty patients with SCH and 21 demographically matched healthy controls (HC) were included in the study. ERP P300 amplitude and latency values were compared between groups using an MID task in which reward and loss cues were presented. Relations between P300 and clinical facets were investigated in the patient group. SCH group had enhanced mean P300 amplitudes and delayed peak latency in the punishment condition compared with HC. These higher responses were also associated with negative symptoms. SCH group showed altered reward processing as being more sensitive to loss of reward conditions as firstly evidenced by electrophysiological methods, possibly due to abnormality in various systems including social withdrawal, social defeat, and behavioral inhibition system.
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Affiliation(s)
- Özge Akgül
- Faculty of Arts and Sciences, Department of Psychology, Izmir Democracy University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Fatih Özel
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Köksal Alptekin
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Berna Binnur Akdede
- Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Görsev Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
- Faculty of Medicine, Department of Neurology, Izmir University of Economics, Izmir, Turkey
- Izmir International Biomedicine and Genome Institute, Dokuz Eylül University, Izmir, Turkey
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Gao Y, Panier LYX, Gameroff MJ, Auerbach RP, Posner J, Weissman MM, Kayser J. Feedback negativity and feedback-related P3 in individuals at risk for depression: Comparing surface potentials and current source densities. Psychophysiology 2024; 61:e14444. [PMID: 37740325 DOI: 10.1111/psyp.14444] [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: 11/14/2022] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/24/2023]
Abstract
Blunted responses to reward feedback have been linked to major depressive disorder (MDD) and depression risk. Using a monetary incentive delay task (win, loss, break-even), we investigated the impact of family risk for depression and lifetime history of MDD and anxiety disorder with 72-channel electroencephalograms (EEG) recorded from 29 high-risk and 32 low-risk individuals (15-58 years, 30 male). Linked-mastoid surface potentials (ERPs) and their corresponding reference-free current source densities (CSDs) were quantified by temporal principal components analysis (PCA). Each PCA solution revealed a midfrontal feedback negativity (FN; peak around 310 ms) and a posterior feedback-P3 (fb-P3; 380 ms) as two distinct reward processing stages. Unbiased permutation tests and multilevel modeling of component scores revealed greater FN to loss than win and neutral for all stratification groups, confirming FN sensitivity to valence. Likewise, all groups had greater fb-P3 to win and loss than neutral, confirming that fb-P3 indexes motivational salience and allocation of attention. By contrast, group effects were subtle, dependent on data transformation (ERP, CSD), and did not confirm reduced FN or fb-P3 for at-risk individuals. Instead, CSD-based fb-P3 was overall reduced in individuals with than without MDD history, whereas ERP-based fb-P3 was greater for high-risk individuals than for low-risk individuals for monetary, but not neutral outcomes. While the present findings do not support blunted reward processing in depression and depression risk, our side-by-side comparison underscores how the EEG reference choice affects the characterization of subtle group differences, strongly advocating the use of reference-free techniques.
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Affiliation(s)
- Yifan Gao
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
| | - Lidia Y X Panier
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
| | - Marc J Gameroff
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Randy P Auerbach
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Jonathan Posner
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Jürgen Kayser
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
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Akgül Ö, Fide E, Özel F, Alptekin K, Bora E, Akdede BB, Yener G. Reduced Reward Processing in Schizophrenia: A Comprehensive EEG Event-Related Oscillation Study. Brain Topogr 2024; 37:126-137. [PMID: 38078985 DOI: 10.1007/s10548-023-01021-3] [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: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 01/07/2024]
Abstract
It is well known that abnormal reward processing is a characteristic feature of various psychopathologies including schizophrenia (SZ). Reduced reward anticipation has been suggested as a core symptom of SZ. The present study aims to evaluate the event-related oscillations (EROs) delta, theta, alpha, beta, and gamma in patients with SZ during the Monetary Incentive Delay (MID) task, which elicits the neural activity of reward processing. Twenty-one patients with SZ and twenty-two demographically matched healthy controls were included in the study. EROs were compared between groups and correlation analyses were conducted to determine a possible relationship between clinical scores and ERO values. Compared with healthy controls, the SZ group had reduced (1) delta and theta amplitudes in the reward condition (2) total beta and non-incentive cue-related beta amplitudes, and (3) incentive cue-related frontal gamma amplitudes. These reductions can be interpreted as impaired dopaminergic neurotransmission and disrupted cognitive functioning in the reward processing of SZ. In contrast, SZ patients showed higher incentive cue-related theta and occipital gamma amplitudes compared to controls. These increments may reflect negative symptoms in SZ. Moreover, theta amplitudes showed a negative correlation with Calgary Depression Scale for Schizophrenia scores and a positive correlation with attentional impulsivity. This is the first study showing the impairments of SZ patients in EROs from delta to gamma frequency bands compared with healthy controls during reward anticipation. Being the first comprehensive study, our results can be interpreted as providing evidence for disrupted brain dynamics in the reward processing of SZ studied by EROs. It may become possible to help patients' wellness by improving our understanding of reward processing in schizophrenia and developing innovative rehabilitation treatments based on these findings.
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Affiliation(s)
- Özge Akgül
- Department of Psychology, Faculty of Arts and Sciences, İzmir Democracy University, Izmir, Turkey
| | - Ezgi Fide
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
| | - Fatih Özel
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Köksal Alptekin
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Berna Binnur Akdede
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Görsev Yener
- Department of Neurosciences, Dokuz Eylul University, Izmir, Turkey.
- Department of Neurology, Faculty of Medicine, İzmir University of Economics, Izmir, Turkey.
- Izmir International Biomedicine and Genome Institute, Izmir, Turkey.
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Levinson T, Prettyman G, Savage C, White L, Moore TM, Calkins ME, Ruparel K, Gur RE, Gur RC, Satterthwaite TD, Wolf DH. Activation of Internal Correctness Monitoring Circuitry in Youths With Psychosis Spectrum Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:542-550. [PMID: 37019760 PMCID: PMC10164703 DOI: 10.1016/j.bpsc.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Self-directed performance monitoring is a critical contributor to cognitive performance and general functioning and is impacted by psychiatric symptoms and personality traits, but has been understudied in psychosis-risk states. We have shown that ventral striatum (VS) responds to correctness during cognitive tasks where no explicit feedback is required, and this intrinsic reinforcement response is reduced in schizophrenia. METHODS Here, we examined this phenomenon in youths (n = 796, age range 11-22 years) from the Philadelphia Neurodevelopmental Cohort (PNC) performing a working memory functional magnetic resonance imaging task. We hypothesized that VS would respond to internal correctness monitoring, while classic salience network regions, such as dorsal anterior cingulate cortex and anterior insular cortex, would reflect internal error monitoring and that these responses would increase with age. We expected that neurobehavioral measures of performance monitoring would be reduced in youths with subclinical psychosis spectrum features and would correlate with amotivation severity. RESULTS Supporting these hypotheses, we found correct>incorrect activation in VS and incorrect>correct activation in anterior cingulate cortex and anterior insular cortex. Furthermore, VS activation was positively correlated with age, reduced in youths with psychosis spectrum features, and inversely correlated with amotivation. However, these patterns were not significant in anterior cingulate cortex and anterior insular cortex. CONCLUSIONS These findings advance our understanding of the neural underpinnings of performance monitoring and its impairment in adolescents with psychosis spectrum features. Such understanding can facilitate investigation of the developmental trajectory of normative and aberrant performance monitoring; contribute to early identification of youths at elevated risk for poor academic, occupational, or psychiatric outcomes; and provide potential targets for therapeutic development.
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Affiliation(s)
- Tess Levinson
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts
| | - Greer Prettyman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chloe Savage
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lauren White
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Lifespan Informatics and Neuroimaging Center, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
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Social affective forecasting and social anhedonia in schizophrenia-spectrum disorders: a daily diary study. SCHIZOPHRENIA 2022; 8:97. [PMID: 36376338 PMCID: PMC9663197 DOI: 10.1038/s41537-022-00310-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
Social anhedonia (SA) is a trait-like phenomenon observed across schizophrenia-spectrum disorders (SSDs). While in-the-moment social pleasure experiences are intact in SSDs, anticipatory pleasure experiences may be disrupted. Thus, the prediction of future emotions in social situations, or social affective forecasting (SAF), may play a role in SA. Therefore, we utilized daily diary methods to examine SAF in SSD and the association between SAF and SA in 34 SSD and 43 non-SSD individuals. SAF was calculated as the absolute difference between anticipatory and consummatory ratings of 13 positive and negative emotions for daily social interactions reported across eight days. Results suggest that individuals with SSDs are less accurate in forecasting negative, but not positive emotions, for future social interactions. Further, poorer forecasting accuracy of negative emotions were associated with elevated levels of SA and lower social pleasure. Together, these data suggest that inaccuracies in forecasting negative emotions may be a worthwhile intervention target for reducing SA in SSDs.
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Abram SV, Roach BJ, Holroyd CB, Paulus MP, Ford JM, Mathalon DH, Fryer SL. Reward processing electrophysiology in schizophrenia: Effects of age and illness phase. Neuroimage Clin 2020; 28:102492. [PMID: 33395983 PMCID: PMC7695886 DOI: 10.1016/j.nicl.2020.102492] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND Reward processing abnormalities may underlie characteristic pleasure and motivational impairments in schizophrenia. Some neural measures of reward processing show age-related modulation, highlighting the importance of considering age effects on reward sensitivity. We compared event-related potentials (ERPs) reflecting reward anticipation (stimulus-preceding negativity, SPN) and evaluation (reward positivity, RewP; late positive potential, LPP) across individuals with schizophrenia (SZ) and healthy controls (HC), with an emphasis on examining the effects of chronological age, brain age (i.e., predicted age based on neurobiological measures), and illness phase. METHODS Subjects underwent EEG while completing a slot-machine task for which rewards were not dependent on performance accuracy, speed, or response preparation. Slot-machine task EEG responses were compared between 54 SZ and 54 HC individuals, ages 19 to 65. Reward-related ERPs were analyzed with respect to chronological age, categorically-defined illness phase (early; ESZ versus chronic schizophrenia; CSZ), and were used to model brain age relative to chronological age. RESULTS Illness phase-focused analyses indicated there were no group differences in average SPN or RewP amplitudes. However, a group × reward outcome interaction revealed that ESZ differed from HC in later outcome processing, reflected by greater LPP responses following loss versus reward (a reversal of the HC pattern). While brain age estimates did not differ among groups, depressive symptoms in SZ were associated with older brain age estimates while controlling for negative symptoms. CONCLUSIONS ESZ and CSZ did not differ from HC in reward anticipation or early outcome processing during a cognitively undemanding reward task, highlighting areas of preserved functioning. However, ESZ showed altered later reward outcome evaluation, pointing to selective reward deficits during the early illness phase of schizophrenia. Further, an association between ERP-derived brain age and depressive symptoms in SZ extends prior findings linking depression with reward-related ERP blunting. Taken together, both illness phase and age may impact reward processing among SZ, and brain aging may offer a promising, novel marker of reward dysfunction that warrants further study.
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Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, USA; Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brian J Roach
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Clay B Holroyd
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | | | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Susanna L Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA; Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
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Leicht G, Andreou C, Nafe T, Nägele F, Rauh J, Curic S, Schauer P, Schöttle D, Steinmann S, Mulert C. Alterations of oscillatory neuronal activity during reward processing in schizophrenia. J Psychiatr Res 2020; 129:80-87. [PMID: 32619750 DOI: 10.1016/j.jpsychires.2020.05.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Reward system dysfunctions are considered to be a pathophysiological mechanism in schizophrenia. Electrophysiological studies of reward system functions have identified frequency-specific brain networks for the processing of positive (high-beta frequency) and negative (theta frequency) events. Remarkably, midbrain dopaminergic signalling also includes theta and high-beta frequency modes, which have been assumed to reflect tonic and phasic dopamine responses, respectively. The aim of the present study was to identify alterations of oscillatory responses to reward feedback in patients with schizophrenia. METHODS Seventeen patients with schizophrenia and 18 healthy controls performed a gambling task during recording of 64-channel electroencephalography. The theta and high-beta band total power were investigated in response to feedback events depending on feedback valence (loss or gain) and magnitude (5 vs. 25 points). RESULTS Both the increase of theta oscillatory activity in response to loss feedback (compared to gain feedback) and the increase of high-beta oscillatory activity in response to gain feedback (compared to loss feedback) were reduced in patients. The difference in high-beta responses to gain versus loss feedback in patients was associated with the severity of negative symptoms. CONCLUSIONS Our findings are consistent with current models of reward system dysfunction in schizophrenia, and indicate deficits in both cortical tonic and subcortical phasic dopamine activity, consistent with the complex dopaminergic abnormalities in schizophrenia.
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Affiliation(s)
- Gregor Leicht
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany.
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Till Nafe
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Felix Nägele
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Jonas Rauh
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Stjepan Curic
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Paul Schauer
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Daniel Schöttle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Saskia Steinmann
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany
| | - Christoph Mulert
- Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany; Center of Psychiatry, Justus-Liebig University, Klinikstr. 36, 35385, Giessen, Germany
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10
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Zhao Z, Wang C, Yuan Q, Zhao J, Ren Q, Xu Y, Li J, Yu Y. Dynamic changes of brain networks during feedback-related processing of reinforcement learning in schizophrenia. Brain Res 2020; 1746:146979. [PMID: 32544500 DOI: 10.1016/j.brainres.2020.146979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 06/01/2020] [Accepted: 06/09/2020] [Indexed: 12/28/2022]
Abstract
Previous studies have reported that schizophrenia (SZ) patients showed selective reinforcement learning deficits and abnormal feedback-related event-related potential (ERP) components. However, how the brain networks and their topological properties evolve over time during transient feedback-related cognition processing in SZ patients has not been investigated so far. In this paper, using publicly available feedback-related ERP data which were recorded from SZ patients and healthy controls (HC) when they performed a reinforcement learning task, we carried out an event-related network analysis where topology of brain functional networks was characterized with some graph measures including clustering coefficient (C), global efficiency (Eglobal) and local efficiency (Elocal) on a millisecond timescale. Our results showed that the brain functional networks displayed rapid rearrangements of topological properties during transient feedback-related cognition process for both two groups. More importantly, we found that SZ patients exhibited significantly reduced theta-band (time window of 170-350 ms after stimuli onset) brain functional connectivity strength, Eglobal, Elocal and C in response to negative feedback stimuli compared to HC group. The network based statistic (NBS) analysis detected one significantly decreased theta-band subnetwork in SZ patients mainly involving in frontal-occipital and temporal-occipital connections compared to HC group. In addition, clozapine treatment seemed to greatly reduce theta-band power and topological measures of brain networks in SZ patients. Finally, the theta-band power, graph measures and functional connectivity were extracted to train a support vector machine classifier for classification of HC from SZ, or Cloz + SZ or Cloz- SZ, and a relatively good classification accuracy of 84.48%, 89.47% and 78.26% was obtained, respectively. The above results suggested a less optimal organization of theta-band brain network in SZ patients, and studying the topological parameters of brain networks evolve over time during transient feedback-related processing could be useful for understanding the pathophysiologic mechanisms underlying reinforcement learning deficits in SZ patients.
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Affiliation(s)
- Zongya Zhao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China.
| | - Chang Wang
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China
| | - Qingli Yuan
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China
| | - Junqiang Zhao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China
| | - Qiongqiong Ren
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China
| | - Yongtao Xu
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China
| | - Jie Li
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China
| | - Yi Yu
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453003, PR China; Engineering Technology Research Center of Neurosense and Control of Xinxiang City, Xinxiang 453003, PR China; Xinxiang Key Laboratory of Biomedical Information Research, Henan Engineering Laboratory of Combinatorial Technique for Clinical and Biomedical Big Data, Xinxiang 453003, PR China.
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11
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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: 22] [Impact Index Per Article: 5.5] [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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12
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Simonetti A, Lijffijt M, Kahlon RS, Gandy K, Arvind RP, Amin P, Arciniegas DB, Swann AC, Soares JC, Saxena K. Early and late cortical reactivity to passively viewed emotional faces in pediatric bipolar disorder. J Affect Disord 2019; 253:240-247. [PMID: 31060010 DOI: 10.1016/j.jad.2019.04.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/30/2019] [Accepted: 04/17/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND We studied emotional information processing in youth with pediatric bipolar disorder (pBD) using the late positive potential (LPP), assessing automatic allocation of attentional resources to emotionally salient stimuli, and the occipital P1, assessing early sensory processing. METHODS Participants were 20 youth with pBD and 26 healthy controls (HC). Participants passively viewed faces with a fearful, neutral or happy expressions. Group differences were tested with general linear models. P1 was included to examine modulating effects on LPP. We calculated Bayes factor (BF) values to express strength of evidence for choosing one hypothesis over another. RESULTS A significant emotion by group interaction for LPP amplitude was associated with a larger amplitude for happy faces for pBD than HC (F[1,40] = 6.04, p = .018); this was not modulated by P1 amplitude or latency. P1 amplitude did not differ between groups, although P1 peaked earlier for HC (F[1,40] = 5.45, p = .025). BF for LPP was 2.93, suggesting moderate evidence favoring H1. BF for P1 latency of 14.58 suggests strong evidence favoring H1. LIMITATIONS Inclusion of children and adolescents prohibited careful control for neurodevelopmental effects. CONCLUSIONS Larger LPP amplitude for happy faces without change in P1 suggests enhanced automatic allocation of attentional resources to positive information in pBD. Delayed P1 latency in pBD suggests slower early processing of emotional information.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Centro Lucio Bini, Rome, Italy.
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Ramandeep S Kahlon
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Kellen Gandy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Ruchir P Arvind
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Pooja Amin
- Center for Leading Edge Addiction Research (CLEAR), Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Behavioral Neurology Section, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA; Marcus Institute for Brain Health, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
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13
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Koudys JW, Traynor JM, Rodrigo AH, Carcone D, Ruocco AC. The NIMH Research Domain Criteria (RDoC) Initiative and Its Implications for Research on Personality Disorder. Curr Psychiatry Rep 2019; 21:37. [PMID: 31030293 DOI: 10.1007/s11920-019-1023-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC elements, and discuss the findings in reference to the constructs we consider most pertinent to PD. RECENT FINDINGS PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, implicating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the latter's Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and external stimuli. The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is especially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit formation) that subserve more fundamental processes relevant to personality functioning warrants further investigation.
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Affiliation(s)
- Jacob W Koudys
- Department of Psychology, University of Toronto Scarborough, Toronto, M1C 1A4, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Canada
| | - Jenna M Traynor
- Department of Psychology, University of Toronto Scarborough, Toronto, M1C 1A4, Canada
| | - Achala H Rodrigo
- Department of Psychology, University of Toronto Scarborough, Toronto, M1C 1A4, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Canada
| | - Dean Carcone
- Department of Psychology, University of Toronto Scarborough, Toronto, M1C 1A4, Canada
- Department of Psychological Clinical Science, University of Toronto, Toronto, Canada
| | - Anthony C Ruocco
- Department of Psychology, University of Toronto Scarborough, Toronto, M1C 1A4, Canada.
- Department of Psychological Clinical Science, University of Toronto, Toronto, Canada.
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14
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Ritsner MS, Ratner Y, Mendyk N, Gooding DC. The characterization of social anhedonia and its correlates in schizophrenia and schizoaffective patients. Psychiatry Res 2018; 270:922-928. [PMID: 30551345 DOI: 10.1016/j.psychres.2018.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/03/2018] [Accepted: 11/03/2018] [Indexed: 11/26/2022]
Abstract
Although social hedonic capacity is often assessed in clinical settings, its operational definitions have not been evaluated for concurrent validity. One hundred and twenty-five patients with schizophrenia and schizoaffective disorder were classified according to their self-reported social hedonic functioning into three groups on the basis of their total scores on the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Participants were assessed before discharge using questionnaires and psychiatric rating scales. Using an empirically based cutoff score, we identified three groups: an intact social hedonic group (WNL), a socially anhedonic group (SA), and a socially hypohedonic group (i.e., those with scores intermediate between normal functioning and aberrantly low functioning, H). The SA patients were significantly different from the two other groups (WNL and H) by their higher severity of psychopathology, lower levels of self-efficacy, and less self-esteem. The SA patients also reported less perceived social support, poorer quality of life, and less subjective recovery. Our findings indicate that social anhedonia is a meaningful target for intervention. Further implications of our findings are discussed.
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Affiliation(s)
- Michael S Ritsner
- Shaar Menashe Mental Health Center, Israel; National Insurance Institute in Israel, Haifa, Israel
| | | | | | - Diane Carol Gooding
- Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson Street, Madison, WI 53706, United States.
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15
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Martin EA, McCleery A, Moore MM, Wynn JK, Green MF, Horan WP. ERP indices of performance monitoring and feedback processing in psychosis: A meta-analysis. Int J Psychophysiol 2018; 132:365-378. [PMID: 30102934 PMCID: PMC6157731 DOI: 10.1016/j.ijpsycho.2018.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although individuals with, or at risk for, psychotic disorders often show difficulties with performance monitoring and feedback processing, findings from studies using event-related potentials (ERPs) to index these processes are not consistent. This meta-analytic review focused on studies of two different indexes of performance monitoring, the early error-related negativity (ERN; n = 25) and the later error positivity (Pe; n = 17), and one index of feedback processing, the feedback negativity (FN; n = 6). METHODS We evaluated whether individuals (1) with psychotic disorders, or (2) at heightened risk for these disorders differ from healthy controls in available studies of the ERN, Pe, and FN. RESULTS There was a significant, large ERN reduction in those with psychosis (g = -0.96) compared to controls, and a significant, moderate ERN reduction in those at-risk (g = -0.48). In contrast, there were uniformly non-significant, small between-group differences for Pe and FN (gs ≤ |0.16|). CONCLUSIONS The results reveal a differential pattern of impairment in psychosis. Early performance monitoring (ERN) impairments are substantial among those with psychotic disorders in general and may be a useful vulnerability indicator for these disorders. However, later performance monitoring (Pe) and basic feedback processing (FN) appear to be relatively spared in psychosis.
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Affiliation(s)
- Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, United States of America.
| | - Amanda McCleery
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Melody M Moore
- Department of Psychological Science, University of California, Irvine, United States of America
| | - Jonathan K Wynn
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Michael F Green
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - William P Horan
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
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