Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, SE5 8AF London, United Kingdom.
Wellcome Trust Centre for Neuroimaging, University College London, 12 Queen's Square, WC1N 3BG London, United Kingdom.
Psychiatry Res. 2018 Jan;259:295-301. doi: 10.1016/j.psychres.2017.10.031. Epub 2017 Oct 23.
Pathophysiology in schizophrenia has been linked to aberrant incentive salience, namely the dysfunctional processing of value linked to abnormal dopaminergic activity. In line with this, recent studies showed impaired learning of value in schizophrenia. However, how value is used to guide behaviour independently from learning, as in risky choice, has rarely been examined in this disorder. We studied value-guided choice under risk in patients with schizophrenia and in controls using a task requiring a choice between a certain monetary reward, varying trial-by-trial, and a gamble offering an equal probability of getting double this certain amount or nothing. We observed that patients compared to controls exhibited reduced sensitivity to values, implying that their choices failed to flexibly adapt to the specific values on offer. Moreover, the degree of this value sensitivity inversely correlated with aberrant salience experience, suggesting that the inability to tune choice to value may be a key element of aberrant salience in the illness. Our results help clarify the cognitive mechanisms underlying improper attribution of value in schizophrenia and may thus inform cognitive interventions aimed at reinstating value sensitivity in patients.
精神分裂症的病理生理学与异常激励显著性有关，即与异常多巴胺能活动相关的价值处理功能障碍。与此一致，最近的研究表明精神分裂症患者的价值学习受损。然而，在这种疾病中，很少有人研究价值如何独立于学习来指导行为，例如在风险选择中。我们使用需要在一定金额的确定奖励（每次试验都会变化）和赌博之间进行选择的任务，研究了精神分裂症患者和对照组在风险下的价值引导选择，赌博提供了获得两倍确定金额或什么都没有的同等可能性。我们观察到，与对照组相比，患者对价值的敏感性降低，这意味着他们的选择无法灵活适应所提供的特定价值。此外，这种价值敏感性的程度与异常显著性体验呈负相关，这表明无法根据价值调整选择可能是疾病中异常显著性的关键因素。我们的研究结果有助于阐明精神分裂症中价值不当归因的认知机制，从而为旨在恢复患者价值敏感性的认知干预提供信息。
