Bartolomeo Lisa A, James Sydney H, Berglund Alysia M, Raugh Ian M, Mittal Vijay A, Walker Elaine F, Strauss Gregory P
University of Georgia, Department of Psychology, Athens, GA, USA.
Northwestern University, Department of Psychology, Evanston, IL, USA.
Schizophr Res. 2025 Jul;281:45-51. doi: 10.1016/j.schres.2025.04.029. Epub 2025 May 2.
Prior studies suggest that the "anhedonia paradox" in schizophrenia (i.e., discrepant results indicating intact hedonic reactivity despite reduced frequency of pleasure-seeking activity) can be explained by a reduction in the "positivity offset" (i.e., a reduction in the normative tendency to experience greater positive than negative affect during low arousal neutral contexts that promote reward-seeking behavior). In the current study, we examined whether the positivity offset is relevant to explaining anhedonia and liability for psychosis among individuals at clinical high-risk for psychosis (CHR) (i.e., individuals exhibiting attenuated hallucinations or delusions that cause distress and functional decline). Mathematical modeling approaches from Cacioppo's Evaluative Space Model were applied to six days of digital phenotyping data collected in daily life among 100 individuals at CHR and 57 healthy controls (CN). Participants reported levels of positive emotion, negative emotion, and arousal throughout the day via ecological momentary assessment (EMA) surveys while accelerometry was passively recorded. EMA surveys were used to calculate the positivity offset and examine associations with real-world motivated behavior. Results indicated that the positivity offset was present among individuals at CHR, but diminished compared to CN. Importantly, smaller positivity offset scores were associated with greater clinically rated anhedonia, particularly among CHR cases with comorbid mood disorder diagnoses. Findings suggest that reductions in the positivity offset are a mechanism underlying anhedonia across phases of psychotic illness and represent a novel treatment target that is relevant for the treatment of negative symptoms and prevention of psychotic disorders.
先前的研究表明，精神分裂症中的“快感缺乏悖论”（即尽管寻求愉悦活动的频率降低，但结果显示享乐反应完好）可以用“积极偏移”的降低来解释（即，在促进寻求奖励行为的低唤醒中性情境中，体验到更多积极情绪而非消极情绪的正常倾向降低）。在本研究中，我们检验了积极偏移是否与解释精神病临床高危个体（CHR）（即表现出引起痛苦和功能衰退的幻觉或妄想减弱的个体）的快感缺乏和精神病易感性相关。来自卡乔波评估空间模型的数学建模方法被应用于100名CHR个体和57名健康对照（CN）在日常生活中收集的六天数字表型数据。参与者通过生态瞬时评估（EMA）调查报告全天的积极情绪、消极情绪和唤醒水平，同时被动记录加速度计数据。EMA调查用于计算积极偏移并检验其与现实世界中有动机行为的关联。结果表明，CHR个体中存在积极偏移，但与CN相比有所减弱。重要的是，较小的积极偏移分数与更高的临床评定的快感缺乏相关，特别是在合并情绪障碍诊断的CHR病例中。研究结果表明，积极偏移的降低是精神病性疾病各阶段快感缺乏的潜在机制，并且代表了一个与阴性症状治疗和精神障碍预防相关的新的治疗靶点。
