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精神分裂症患者的无效努力分配与阴性症状

Inefficient effort allocation and negative symptoms in individuals with schizophrenia.

作者信息

McCarthy Julie M, Treadway Michael T, Bennett Melanie E, Blanchard Jack J

机构信息

Department of Psychology, University of Maryland College Park, College Park, MD 20742, United States; McLean Hospital/Harvard Medical School, Belmont, MA 02478, United States.

McLean Hospital/Harvard Medical School, Belmont, MA 02478, United States.

出版信息

Schizophr Res. 2016 Feb;170(2-3):278-84. doi: 10.1016/j.schres.2015.12.017. Epub 2016 Jan 4.

Abstract

Negative symptoms like avolition and anhedonia are thought to involve difficulties with reward processing and motivation. The current study aimed to replicate and extend prior findings that individuals with schizophrenia display reduced willingness to expend effort for rewards and that such reduced effort is associated with negative symptoms, poor functioning, and cognitive impairment. The present study compared the effortful decision making of individuals with schizophrenia (n=48) and healthy controls (n=27) on the Effort Expenditure for Rewards Task (EEfRT). Individuals with schizophrenia chose a smaller proportion of hard tasks than healthy controls across all probability and reward levels with the exception of trials with a 12% probability and low or medium reward magnitude wherein both groups chose similarly few hard tasks. Contrary to expectations, in individuals with schizophrenia, greater negative symptoms were associated with making more effortful choices. Effortful decision making was unrelated to positive symptoms, depression, cognition, and functioning in individuals with schizophrenia. Our results are consistent with prior findings that revealed a pattern of inefficient decision making in individuals with schizophrenia relative to healthy controls. However the results did not support the hypothesized association of negative symptoms and reduced effort in schizophrenia and highlight prior inconsistencies in this literature. Future research is needed to understand what factors may be related to diminished effortful decision making in schizophrenia and the clinical significance of such performance deficits.

摘要

诸如意志缺乏和快感缺失等阴性症状被认为与奖赏处理和动机方面的困难有关。当前的研究旨在重复并扩展先前的研究发现,即精神分裂症患者为获取奖赏而付出努力的意愿降低,且这种努力减少与阴性症状、功能不良及认知障碍相关。本研究在奖赏任务的努力支出(EEfRT)方面比较了精神分裂症患者(n = 48)和健康对照者(n = 27)的费力决策情况。在所有概率和奖赏水平下,除了概率为12%且奖赏幅度为低或中等的试验中两组选择的困难任务同样少之外,精神分裂症患者选择困难任务的比例低于健康对照者。与预期相反,在精神分裂症患者中,更严重的阴性症状与做出更费力的选择有关。在精神分裂症患者中,费力决策与阳性症状、抑郁、认知及功能无关。我们的结果与先前的研究发现一致,即相对于健康对照者,精神分裂症患者存在低效决策模式。然而,结果并不支持精神分裂症中阴性症状与努力减少之间的假设关联,并凸显了该文献中先前的不一致之处。需要未来的研究来了解哪些因素可能与精神分裂症中费力决策减少有关,以及这种表现缺陷的临床意义。

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