scholarly journals T62. A COMPUTATIONAL ANALYSIS OF MOTIVATIONAL DEFICITS IN SCHIZOPHRENIA SPECTRUM DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S255-S255
Author(s):  
James Waltz ◽  
Dennis Hernaus ◽  
Robert Wilson ◽  
Elliot Brown ◽  
Michael Frank ◽  
...  

Abstract Background We have found that measures of reinforcement learning (RL) performance correlate with negative symptoms severity in adult schizophrenia patients as well as in adolescents and young adults seeking psychiatric services. Most of these tasks assess reinforcement learning in stable environments, however. In unstable, or volatile environments, adaptive learning and decision making depend on the ability to use one’s own uncertainty to modulate attention to feedback. In stable RL environments, parameters called learning rates (signified by ⍺) capture the impact of prediction errors on changes in association strength with each subject having a single learning rate for a given kind of prediction error (positive and negative, e.g.). In volatile environments, learning rates might be more appropriately modeled as dynamic, modulated by uncertainty. Furthermore, uncertainty is known to guide what is called “the explore/exploit trade-off” – the threshold for choosing more informative options potentially at the expense of options with higher expected value. Methods We have examined the contribution of uncertainty processing to the emergence of negative symptoms in people along the schizophrenia spectrum, in several ways. First, in conjunction with fMRI, we administered 26 patients with schizophrenia (PSZ) and 23 healthy volunteers (HV) a 3-choice version of a probabilistic reversal learning task that required participants to resolve uncertainty and determine the new best option after sudden, sporadic contingency shifts. Second, we assessed the role of uncertainty in driving decision making under ambiguity, using two distinct tasks in cohorts of schizophrenia patients and healthy volunteers. Motivational symptoms were assessed in PSZ using the Scale for the Assessment of Negative Symptoms (SANS), from which we computed scores for Avolition/Role-Functioning, Anhedonia/Asociality, and an Avolition/Anhedonia/Asociality (AAA) factor. Results In the context of the 3-choice version of a probabilistic reversal learning task, we found that SZ patients with more severe anhedonia and avolition show a reduced ability to dynamically modulate learning rates in a volatile environment. A follow-up psychophysiological interaction analysis revealed decreased dmPFC-VS connectivity concurrent with learning rate modulation, most prominently in individuals with the most severe motivational deficits. Finally, in the context of decision making under ambiguity, we have found that SZ patients with more severe anhedonia and avolition, as measured by the SANS, show a reduced tendency to explore contingences in the service of reducing uncertainty. Furthermore, we found that mean negative symptom scores correlated negatively with change in information weight, a model-based measure of directed exploration. Discussion These results indicate that multiple potential mechanisms underlie motivational deficits in schizophrenia spectrum disorders, including processes related to the ability to flexibly modulate learning and decision making according to one’s level of certainty about contingencies in the environment. That is, beyond deficits in reward-seeking behavior, a reduced ability to use uncertainty to modulate learning rates and a reduced tendency to engage in information-seeking behavior may make substantial contributions to negative symptoms in people with psychotic illness and people at risk for psychotic illness. The ability to dynamically value actions in terms of both prospective reward and information is likely to contribute deficits in motivation across diagnoses.

2011 ◽  
Vol 26 (S2) ◽  
pp. 1458-1458
Author(s):  
N. Mossaheb ◽  
M. Schloegelhofer ◽  
R.M. Kaufmann ◽  
T. Aninilkumparambil ◽  
A. Gold ◽  
...  

IntroductionAssociations between smell identification deficits (SID) and impairments in basic cognitive domains have been shown in patients with neuropsychiatric disorders.ObjectivesWe analyzed social and basic cognitive deficits and SID.AimsTo assess differences in affective decision making tasks in patients with schizophrenia-spectrum disorders, their 1st degree relatives and healthy controls. Methods: We examined 51 patients with schizophrenia-spectrum disorders (49% female, age 33.1 years, SD 11), 21 first-degree relatives (61.9% female, age 49.5 years, SD 17.6, one affected, others non-affected) and 51 matched healthy controls (49% female, age 33 years, SD 12.1). Psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Subjects were administered the University of Pennsylvania Smell Identification Test (UPSIT), the Facially Expressed Emotion Labelling (FEEL) test, the spatial span subtest of the Wechsler Memory Scale-Revised (WMS-R) and the Mehrfachwahl-Wortschatz Test (MWT-B).ResultsPatients, controls and 1st degree relatives differed in age (p = 0.000), WMS-R (p = 0.000) and FEEL scores (p = 0.007). In healthy controls, patients and 1st degree relatives FEEL correlated with age (p = 0.005, p = 0.003, p = 0.004, respectively). In patients FEEL also correlated with MWT-B (p = 0.000), UPSIT (p = 0.000) and PANSS negative scores (p = 0.016); furthermore, UPSIT correlated with MWT-B (p = 0.001). In 1st degree relatives age correlated with WMS-R (p = 0.04) and FEEL (p = 0.004), both of which inter-correlated (p = 0.006).ConclusionWe found that SID, basic and social cognition, i.e. affective decision-making processes, inter-correlate in patients with schizophrenia-spectrum disorders and are partly under the influence of negative symptoms. Some of these relationships can also be seen in 1st degree relatives of patients.


2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Kristen R Dwyer ◽  
Alexandra M Andrea ◽  
Christina L G Savage ◽  
Ryan D Orth ◽  
LeeAnn Shan ◽  
...  

Abstract Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectrum disorders during a role-play designed to elicit affiliative responses. We tested the hypothesis that daily intranasal oxytocin administered for 6 weeks would improve social affiliation as manifested by increased social skill ratings, use of positive, affiliative, and social words, and subjective responses from a previously published randomized controlled trial. Forty outpatients with schizophrenia or schizoaffective disorder were randomized to the oxytocin, galantamine, or placebo group and completed affiliative role-plays and self-report questionnaires of affect, reactions to the affiliative confederate, and willingness to interact at baseline and post-treatment. Results demonstrated that oxytocin was not effective at improving behavioral or subjective indicators of social affiliation. This study adds to a growing literature that the prosocial effects of oxytocin in schizophrenia are limited or null.


2013 ◽  
Vol 23 (3) ◽  
pp. 271-279 ◽  
Author(s):  
B. Schrank ◽  
M. Amering ◽  
A. Grant Hay ◽  
M. Weber ◽  
I. Sibitz

Aims.Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables.Methods.A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables.Results.Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight.Conclusions.This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.


2011 ◽  
Vol 10 (1) ◽  
pp. 25-33
Author(s):  
Gretchen Snethen, PhD, LRT/CTRS ◽  
Bryan P. McCormick, PhD, CTRS ◽  
Marieke Van Puymbroeck, PhD, CTRS

Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.


2016 ◽  
Vol 33 (S1) ◽  
pp. S32-S32
Author(s):  
I. Melle

IntroductionThe symptomatic distribution in schizophrenia spectrum disorder is heterogeneous. Patients may experience hallucinations, delusions and combinations thereof, in addition to disorganized and negative symptoms. We have previously found that patients with monosymptomatic hallucinations exhibited a different clinical profile than patients with monosymptomatic delusions or combinations of the two; with an earlier age at onset and more suicidal symptoms.AimsTo replicate findings in a new group of patients with schizophrenia spectrum disorders.MethodsA total of 421 consecutive patients with schizophrenia spectrum disorders were included into the study. They were comprehensively assessed by specifically trained psychiatrists or clinical psychologists; using the SCID for DSM-IV for diagnostic purposes, the PANSS to assess current clinical symptoms and CDSS to assess current depression. Lifetime presence of different symptom types was ascertained during the diagnostic interview.ResultsA total of 346 (82%) had experienced both hallucinations and delusion, 63 (15%) had experienced delusions without hallucinations, 10 (2.5%) had experienced hallucinations without delusions and 2 patients (0.5%) had neither but experienced negative and severely disorganized symptoms. Contrary to hypothesis, we did not find any statistically significant differences in age at onset and in clinical symptoms (including suicidality) between these groups. We also did not find any differences in the type of hallucinatory experiences between hallucinating groups.ConclusionsIn a new sample of patients, we did not replicate previous findings of a different clinical profile in patients with monosymptomatic hallucinations. This type of psychotic disorder is relatively rare, which might pose a problem concerning statistical strength.Disclosure of interestThe author has not supplied his declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S274-S274 ◽  
Author(s):  
M. Minyaycheva ◽  
K. Kiselnikova ◽  
L. Movina ◽  
I. Gladyshev ◽  
O. Papsuev

IntroductionReduction of mental productivity and motivation in patients with schizophrenia is one of the core features of negative symptoms of schizophrenia spectrum disorders. Lack of motivation affects social functioning and outcomes, reduces effects of psychosocial treatment and rehabilitation.ObjectivesTo research AES abilities in measuring motivation in patients with schizophrenia spectrum disorders. The aim of the study was to investigate correlations of Russian translation of clinician-rated and self-rated versions with PANSS amotivation subscale and negative subscale items.MethodsFifty patients with schizophrenia spectrum disorders were recruited to participate in the study and were assessed with PANSS, AES-C and AES-S by trained raters. Only patients in “stabilized” state that met inclusion criteria of PANSS total score ≤ 80 points were eligible for consecutive AES assessment.ResultsOverall, moderate positive correlations were established between AES-C and PANSS amotivation subscale N2 and N4 items, N6 item and total PANSS negative subscale. No significant correlations with G16 item were registered. AES-C and AES-S versions also showed positive Spearman correlations (r = 0.43; P < 0.05), while no correlations between AES-S and amotivation PANSS items were registered.DiscussionModerately strong correlations between AES-C and PANSS N2, N4 and N6 items show feasibility of AES-C version in terms of measuring motivation in patients with schizophrenia spectrum disorders. Results of AES-S analysis demonstrate certain problems in patients’ abilities in self-assessing motivation. Patients with prevailing paranoid syndrome showed poorer results in AES-S scores.ConclusionsAES-C is a sensitive psychometric tool with good properties in measuring amotivation in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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