Department of Psychological & Brain Sciences, Washington University in St. Louis.
Department of Clinical Research, Nathan Kline Institute for Psychiatric Research.
J Psychopathol Clin Sci. 2024 Jan;133(1):37-47. doi: 10.1037/abn0000869. Epub 2023 Nov 27.
Despite evidence that individuals with schizophrenia (SZ) have an intact desire for social relationships, they have small social networks and report high levels of loneliness. Difficulty with reinforcement learning (RL), the ability to update behavior based on feedback, may inhibit the formation and maintenance of social relationships in SZ. However, impaired RL in SZ has largely been demonstrated via monetary tasks. Thus, it remains unclear whether SZ are similarly impaired in social and monetary RL, or whether social-specific factors may further inhibit their ability to learn from social feedback. Thirty-one individuals with SZ and 31 healthy controls (HCs) participated in a RL paradigm to test hypotheses about social versus monetary RL. SZ exhibited impaired RL compared to HCs in both social and monetary tasks. Further, a Group × Task interaction demonstrated that SZ was more impaired when learning from social than monetary reinforcement, (1, 59) = 5.99, = .017. This differential deficit to social RL was not accounted for by reported pleasure from social feedback, which did not differ between groups. Instead, SZ had poorer emotion recognition than HCs, (1, 60) = 4.80, < .001, particularly for negative emotions, and controlling for this eliminated the differential social RL impairment. These results suggest the possibility that difficulty recognizing social cues, especially those indicating negative feedback, may relate to a reduced ability to learn from others' feedback. Thus, future research could elucidate whether targeting these emotion recognition difficulties in treatment could serve as a potential mechanism for improving social functioning in SZ. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
尽管有证据表明精神分裂症（SZ）患者具有完整的社交关系欲望，但他们的社交网络很小，报告的孤独感很高。强化学习（RL）能力，即根据反馈更新行为的能力，可能会抑制 SZ 患者社交关系的形成和维持。然而，SZ 患者的 RL 受损主要是通过金钱任务来证明的。因此，目前尚不清楚 SZ 患者在社交和金钱 RL 方面是否同样受损，或者社交特定因素是否会进一步抑制他们从社交反馈中学习的能力。31 名 SZ 患者和 31 名健康对照组（HCs）参加了 RL 范式，以检验关于社交与金钱 RL 的假设。与 HCs 相比，SZ 在社交和金钱任务中均表现出 RL 受损。此外，组间×任务交互表明，当从社交而非金钱强化中学习时，SZ 的 RL 受损更为严重，(1, 59)=5.99, p=.017。这种对社交 RL 的差异缺陷不能用两组之间的社交反馈所带来的愉悦感来解释。相反，SZ 的情绪识别能力比 HCs 差，(1, 60)=4.80, p<.001，尤其是对负面情绪，控制这一点消除了社交 RL 受损的差异。这些结果表明，难以识别社交线索，尤其是那些表示负面反馈的线索，可能与从他人反馈中学习的能力降低有关。因此，未来的研究可以阐明是否针对治疗中的这些情绪识别困难可以作为改善 SZ 患者社交功能的潜在机制。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
