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精神分裂症患者的努力分配和愉悦预期:与现实世界功能的关系。

Allocating effort and anticipating pleasure in schizophrenia: Relationship with real world functioning.

机构信息

Department of Psychology, Hofstra University, New York, NY, USA; Department of Psychiatry, Ichan Mount Sinai School of Medicine, New York, NY, USA.

Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA.

出版信息

Eur Psychiatry. 2017 Oct;46:57-64. doi: 10.1016/j.eurpsy.2017.07.008. Epub 2017 Aug 1.

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.

摘要

背景

动机不足难以进行目标导向行为,这已被认为是精神分裂症谱系障碍(SZ)的标志性特征。SZ 患者的驱动力低下可能与预期奖励以及较差的工作记忆有关。然而,迄今为止,很少有研究检查过对自我效能和未来奖励(预期愉悦)的信念。此外,迄今为止,很少有研究检查这些缺陷如何影响 SZ 患者的现实世界功能。

方法

本研究检查了 SZ 患者(n=57)的预期愉悦、工作记忆、自我效能以及与阴性症状严重程度相关的现实世界功能。

结果

结果表明,SZ 患者的阴性症状严重程度与努力分配和奖励概率的决策、工作记忆缺陷、自我效能和对未来奖励的预期愉悦有关。努力分配缺陷也预测了患者的日常功能技能。

结论

具有高水平阴性症状的 SZ 患者不仅不喜欢努力,而且更难以有效地分配努力并预期参与费力活动的愉悦感。可能的情况是,不断未能从参与和参与中获得强化,可能导致 SZ 患者对自己的能力形成某些负面信念,从而导致动机不足和认知缺陷。最后,我们的发现进一步支持了 SZ 患者的日常功能生活技能与其努力分配之间的联系。

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