A Review of Reward Processing and Motivational Impairment in Schizophrenia

Strauss, Gregory P.; Waltz, James A.; Gold, James M.

doi:10.1093/schbul/sbt197

Cited by 365 publications

(327 citation statements)

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“…While auto-activation deficits are primarily observed in patients with basal ganglia lesions, compelling evidence points to motivational deficits in schizophrenia patients with apathy (for a recent review see Strauss, Waltz, & Gold, 2014). Option generation is a cognitive process occurring in a predecisional stage.…”

Section: Apathy As a Deficit In Option Generationmentioning

confidence: 99%

Apathy in schizophrenia as a deficit in the generation of options for action.

Hartmann¹,

Kluge²,

Kalis³

et al. 2015

Journal of Abnormal Psychology

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Negative symptoms are a core feature of schizophrenia and have been grouped into 2 factors: a motivational factor, which we refer to as apathy, and a diminished expression factor. Recent studies have shown that apathy is closely linked to functional outcome. However, knowledge about its mechanisms and its relation to decision-making is limited. In the current study, we examined whether apathy in schizophrenia is associated with predecisional deficits, that is, deficits in the generation of options for action. We applied verbal protocol analysis to investigate the quantity of options generated in ill-structured real world scenarios in 30 patients with schizophrenia or schizoaffective disorder and 21 healthy control participants. Patients generated significantly fewer options than control participants and clinical apathy ratings correlated negatively with the quantity of generated options. We show that the association between measures of psychopathology and option generation is most pronounced in regard to apathy symptoms and that it is only partially mediated by deficits in verbal fluency. This study provides empirical support for dysfunctional option generation as a possible mechanism for apathy in schizophrenia. Our data emphasize the potential importance of predecisional stages in the development and persistence of apathy symptoms in neuropsychiatric disorders and might also inform the development of novel treatment options in the realm of cognitive remediation. a motivational factor, which we refer to as apathy, and a diminished expression factor. Recent studies have shown that apathy is closely linked to functional outcome. However, knowledge about its mechanisms and its relation to decision-making is limited. In the current study, we examined whether apathy in schizophrenia is associated with predecisional deficits, that is, deficits in the generation of options for action. We applied verbal protocol analysis to investigate the quantity of options generated in ill-structured real world scenarios in 30 patients with schizophrenia or schizoaffective disorder and 21 healthy control participants. Patients generated significantly fewer options than control participants and clinical apathy ratings correlated negatively with the quantity of generated options. We show that the association between measures of psychopathology and option generation is most pronounced in regard to apathy symptoms and that it is only partially mediated by deficits in verbal fluency. This study provides empirical support for dysfunctional option generation as a possible mechanism for apathy in schizophrenia. Our data emphasize the potential importance of predecisional stages in the development and persistence of apathy symptoms in neuropsychiatric disorders and might also inform the development of novel treatment options in the realm of cognitive remediation.

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Section: Apathy As a Deficit In Option Generationmentioning

confidence: 99%

Apathy in schizophrenia as a deficit in the generation of options for action.

Hartmann¹,

Kluge²,

Kalis³

et al. 2015

Journal of Abnormal Psychology

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“…Motivational deficits, which are understood under the broader umbrella of negative symptoms 1 , are a core feature of schizophrenia and have important consequences for treatment response 2 . For example, previous research 3 demonstrated that negative symptoms cause people with schizophrenia to be disinterested in physical activity and exercise programmes.…”

Section: Introductionmentioning

confidence: 99%

Negative symptoms are associated with lower autonomous motivation towards physical activity in people with schizophrenia

Vancampfort

Hert

Stubbs

et al. 2015

Comprehensive Psychiatry

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Negative symptoms are associated with lower autonomous motivation towards physical activity in people with schizophrenia, Comprehensive Psychiatry (2014Psychiatry ( ), doi: 10.1016Psychiatry ( /j.comppsych.2014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A C C E P T E D M A N U S C R I P T A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT AbstractObjective: This cross-sectional study examined the association between psychiatric symptoms and motivation for physical activity within the self-determination theory (SDT) framework in people with schizophrenia.Method: Over a 4-month period, 55 (17♀) inpatients with a DSM-V diagnosis of schizophrenia were assessed with the Psychosis Evaluation tool for Common use by Caregivers (PECC) and the Behavioural Regulation in Exercise Questionnaire (BREQ-2), that provided separate scores for amotivation, external, introjected and autonomous regulation.Spearman correlations coefficients were examined between these motivation scores and symptom ratings.Results: The BREQ-2 score for autonomous regulations (2.6±1.1) was significantly correlated with the PECC negative symptoms score (10.3±4.1) (r=-0.34, p=0.011). No other significant correlations between BREQ-2 and PECC scores were found. The BREQ-2 score for external regulations (0.7±0.9) was associated with older age (35.2±11.3 years) (r=-0.30, p=0.024).Conclusions: These findings provide evidence that negative symptoms are associated with lower autonomous motivation towards physical activity in inpatients with schizophrenia.Future longitudinal research should confirm the current findings. Such research will guide physical activity approaches aimed at facilitating enhanced physical and mental health outcomes in individuals with schizophrenia.

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“…There was no observable impairment on a behavioural level. This may indicate no motivational deficits in SZ however it does not account for the dysfunctions found on a neural level [17]. Therefore, possible neuro-functional impairments of social and monetary reward processing should be investigated further.…”

Section: Discussionmentioning

confidence: 97%

“…The low activation during reward anticipation was associated with greater negative symptom severity [17]. Furthermore, patients appear to show inappropriately strong activations in reward-associated brain areas in response to neutral stimuli as compared to healthy controls [23,25].…”

Section: Reward Processing In Schizophreniamentioning

confidence: 87%

“…Irregularities in dopamine transmission are an important part of the pathophysiology of schizophrenia [13][14][15][16] and there is ample evidence that reward processing is disturbed in schizophrenia [17]. Motivational deficits often affect patients' quality of life while the common drug treatment seems to have a limited effect, which has implications for clinical treatment.…”

Section: Reward Processing In Schizophreniamentioning

confidence: 99%

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