Abram Samantha V, Weittenhiller Lauren P, Bertrand Claire E, McQuaid John R, Mathalon Daniel H, Ford Judith M, Fryer Susanna L
Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
Front Behav Neurosci. 2022 Mar 23;16:827260. doi: 10.3389/fnbeh.2022.827260. eCollection 2022.
Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.
动机和愉悦感缺失在精神分裂症中很常见,与功能较差密切相关,可能反映了大脑中控制奖励处理和目标追求的功能的潜在改变。虽然有大量研究探讨了与精神分裂症中这些缺失相关的认知和奖励机制,但较少关注有助于抵御动机和愉悦感受损或增加其风险的心理特征。例如,涉及积极未来预期(如乐观)和有效情绪管理(如重新评价、正念)的心理倾向与奖励预期和评估的各个方面相关,这些方面能最佳地指导目标导向行为。相反,适应不良的思维模式(如失败主义的表现信念、反社会信念)以及放大负面认知的倾向(如沉思),可能会将认知资源从目标追求中转移出来,或降低付出努力的意愿。此外,社交方面,包括将社会联系体验为积极强化的倾向,可能与追求社会目标特别相关。在当前的综述中,我们讨论了几种心理特征在精神分裂症的动机和愉悦感方面所起的作用。我们认为,这些心理维度的个体差异与精神分裂症的动机和奖励处理研究相关,包括这些心理维度与更明确的影响动机的认知和奖励处理因素之间的相互作用。我们最后强调,在研究精神分裂症的动机和愉悦感功能时,考虑一系列广泛的调节因素的价值。