Using negative feedback to guide behavior: Impairments on the first 4 cards of the Wisconsin Card Sorting Test predict negative symptoms of schizophrenia

Vogel, Sally J.; Strauss, Gregory P.; Allen, Daniel N.

doi:10.1016/j.schres.2013.07.052

Cited by 16 publications

(10 citation statements)

References 30 publications

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“…These measures, however, do not disentangle the precise processes that ultimately manifest as goal-directed behavior or 'motivation.' In fact, across-studies clinical ratings of amotivation have been found to be related to a number of reward processes including, for example, effort cost computations (Fervaha et al, 2013b;Gold et al, 2013;Hartmann et al, 2014;Wolf et al, 2014), and reinforcement learning (Waltz et al, 2011;Vogel et al, 2013). It is important to move beyond examining effects of various variables, in our case, the effect of antipsychotic medication, on 'motivation' more broadly defined toward examining these effects on underlying subprocesses, ideally evaluating multiple reward-related components concurrently.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotics and Amotivation

Fervaha

Takeuchi

Lee

et al. 2015

Neuropsychopharmacol

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Antipsychotic drugs are thought to produce secondary negative symptoms, which can also exacerbate primary negative symptoms. In the present study, we examined whether motivational deficits in particular were related to antipsychotic treatment in patients with schizophrenia in a dose-dependent manner. Five hundred and twenty individuals with schizophrenia who were receiving antipsychotic monotherapy for at least 6 months and followed prospectively were included in the present study. Participants were receiving one of five antipsychotic medications (olanzapine, perphenazine, quetiapine, risperidone, or ziprasidone), and analyses were conducted for patients receiving each drug separately. Analysis of covariance models were constructed to examine the effect of antipsychotic dose on level of motivational impairment, controlling for selected demographic and clinical variables (eg, positive symptoms). Level of motivation, or deficits therein, were evaluated using a derived measure from the Quality of Life Scale, and in addition with scores derived from the Positive and Negative Syndrome Scale. Antipsychotic dose was not related to the level of amotivation for any of the medications examined. Moreover, severity of sedation was not significantly related to the degree of amotivation. One hundred and twenty-one individuals were identified as antipsychotic-free at baseline, and after 6 months of antipsychotic treatment, no change in motivation was found. Chronic treatment with antipsychotics does not necessarily impede or enhance goal-directed motivation in patients with schizophrenia. It is possible that the negative impact of antipsychotics in this regard is overstated; conversely, the present results also indicate that we must look beyond antipsychotics in our efforts to improve motivation.

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Section: Discussionmentioning

confidence: 99%

Antipsychotics and Amotivation

Fervaha

Takeuchi

Lee

et al. 2015

Neuropsychopharmacol

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“…Neuropsychological investigations reported discrepant findings, with some studies reporting a greater impairment in DS than in NDS on measures of fronto-parietal functions (i.e., attention, executive control and visuospatial functions, Buchanan et al, 1994;Bryson et al, 2001;Yu et al, 2015), prefrontal functions (verbal fluency, concept formation and cognitive flexibility, Cascella et al, 2008;Polgár et al, 2010) or cortico-striatal functions (reinforcement learning, Farkas et al, 2008;Polgár et al, 2010;Vogel et al, 2013). The majority of studies (Galderisi et al, , 2013aWang et al, 2008;Polgár et al, 2008;Réthelyi et al, 2012;Fervaha et al, 2015a) and a meta-analysis (Cohen et al, 2007) reported a generalized cognitive impairment in DS vs both NDS and controls.…”

Section: Neurocognitive Impairmentmentioning

confidence: 99%

Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases

Mucci

Merlotti

Üçok

et al. 2017

Schizophrenia Research

113

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“…4,5,14,15 Other factors that may contribute to poor PRL have been identified through analyses of the types of errors patients make. Some studies, but not others, have found that feedback valence affects learning (ie, patients are selectively impaired for learning from positive, but not negative, feedback) 1,[16][17][18][19][20] ). Others found that patients showed impaired response selection strategies; whereas controls tend to stay with the same selection following positive feedback and shift following negative feedback, patients have sometimes been found to shift more frequently and indiscriminately, regardless of the preceding feedback valence 5,7,8,10 (but see Waltz et al 19 ).…”

Section: Introductionmentioning

confidence: 99%

Probabilistic Reversal Learning in Schizophrenia: Stability of Deficits and Potential Causal Mechanisms

Reddy¹,

Waltz

Green³

et al. 2016

SCHBUL

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Although individuals with schizophrenia show impaired feedback-driven learning on probabilistic reversal learning (PRL) tasks, the specific factors that contribute to these deficits remain unknown. Recent work has suggested several potential causes including neurocognitive impairments, clinical symptoms, and specific types of feedback-related errors. To examine this issue, we administered a PRL task to 126 stable schizophrenia outpatients and 72 matched controls, and patients were retested 4 weeks later. The task involved an initial probabilistic discrimination learning phase and subsequent reversal phases in which subjects had to adjust their responses to sudden shifts in the reinforcement contingencies. Patients showed poorer performance than controls for both the initial discrimination and reversal learning phases of the task, and performance overall showed good test-retest reliability among patients. A subgroup analysis of patients (n = 64) and controls (n = 49) with good initial discrimination learning revealed no between-group differences in reversal learning, indicating that the patients who were able to achieve all of the initial probabilistic discriminations were not impaired in reversal learning. Regarding potential contributors to impaired discrimination learning, several factors were associated with poor PRL, including higher levels of neurocognitive impairment, poor learning from both positive and negative feedback, and higher levels of indiscriminate response shifting. The results suggest that poor PRL performance in schizophrenia can be the product of multiple mechanisms.

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Using negative feedback to guide behavior: Impairments on the first 4 cards of the Wisconsin Card Sorting Test predict negative symptoms of schizophrenia

Cited by 16 publications

References 30 publications

Antipsychotics and Amotivation

Antipsychotics and Amotivation

Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases

Probabilistic Reversal Learning in Schizophrenia: Stability of Deficits and Potential Causal Mechanisms

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