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精神分裂症快感缺乏的积极性偏移理论:基于数字表型分析的日常生活缺陷证据

The positivity offset theory of anhedonia in schizophrenia: evidence for a deficit in daily life using digital phenotyping.

作者信息

Bartolomeo Lisa A, Raugh Ian M, Strauss Gregory P

机构信息

Department of Psychology, University of Georgia, Athens, GA, USA.

出版信息

Psychol Med. 2023 Oct;53(14):6491-6499. doi: 10.1017/S0033291722003774. Epub 2023 Feb 1.

Abstract

BACKGROUND

Negative symptoms of schizophrenia have recently been proposed to result from a decoupling of (intact) hedonic experience and (diminished) approach behavior. The current study challenged this view by exploring the hypothesis that negative symptoms are driven by a specific type of emotional experience abnormality, a reduction in the positivity offset (i.e. the tendency to experience greater levels of positive relative to negative emotion in low-arousal contexts), which limits the production of approach behaviors in neutral environments.

METHODS

Participants included outpatients with SZ ( = 44) and healthy controls (CN: = 48) who completed one week of active (ecological momentary assessment surveys of emotional experience and symptoms) and passive (geolocation, accelerometry) digital phenotyping. Mathematical modeling approaches from Cacioppo's Evaluative Space Model were used to quantify the positivity offset in daily life. Negative symptoms were assessed via standard clinical ratings, as well as active (EMA surveys) and passive (geolocation, accelerometry) digital phenotyping measures.

RESULTS

Results indicated that the positivity offset was reduced in SZ and associated with more severe anhedonia and avolition measured via clinical interviews and active and passive digital phenotyping.

CONCLUSIONS

These findings suggest that current conceptual models of negative symptoms, which assume hedonic normality, may need to be revised to account for reductions in the positivity offset and its connection to diminished motivated behavior. Findings identify key real-world contexts where negative symptoms could be targeted using psychosocial treatments.

摘要

背景

最近有人提出精神分裂症的阴性症状是由(完整的)享乐体验与(减弱的)趋近行为脱钩所致。本研究对这一观点提出了质疑,通过探讨阴性症状是由一种特定类型的情绪体验异常所驱动的假设,即正性偏移减少(即在低唤醒情境中体验到相对于负性情绪更高水平正性情绪的倾向),这限制了在中性环境中趋近行为的产生。

方法

参与者包括精神分裂症门诊患者(n = 44)和健康对照者(CN:n = 48),他们完成了为期一周的主动(情绪体验和症状的生态瞬时评估调查)和被动(地理定位、加速度计)数字表型分析。采用来自卡乔波评估空间模型的数学建模方法来量化日常生活中的正性偏移。通过标准临床评定以及主动(EMA调查)和被动(地理定位、加速度计)数字表型分析措施对阴性症状进行评估。

结果

结果表明,精神分裂症患者的正性偏移减少,并且与通过临床访谈以及主动和被动数字表型分析测得的更严重的快感缺失和意志缺乏相关。

结论

这些发现表明,当前假设享乐正常的阴性症状概念模型可能需要修订,以考虑正性偏移的减少及其与动机行为减弱的联系。研究结果确定了可以使用心理社会治疗针对阴性症状的关键现实世界情境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e78/10600929/9e93cb8102d3/S0033291722003774_fig1.jpg

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