Experiential pleasure deficits in different stages of schizophrenia

A network analysis on the relationship between loneliness and schizotypy

BACKGROUND

Schizotypy is a multidimensional personality trait related to the heightened risk for the development of schizophrenia spectrum disorders. While it has been suggested that loneliness may be associated with schizotypy in general, whether it relates to the specific schizotypal traits differentially remains unknown. Besides, as loneliness often co-occurs with depression and anxiety, it is important to delineate its relationship with schizotypy in consideration of these co-occurring emotional disturbances.

METHODS

A demographically diverse sample of young people was obtained from multiple sources. The validated sample consisted of 2089 participants (68.4% female, age range: 18-30). The structural relationship between loneliness and schizotypy was modelled using a network analytic approach. The Gaussian graphical model with loneliness and nine schizotypal traits as nodes was first estimated without, and then with adjustment for the levels of depressive and anxiety symptoms. Edges were estimated as unique associations between nodes.

RESULTS

'Suspiciousness', 'odd beliefs or magical thinking', 'no close friends', 'constricted affect' and 'excessive social anxiety' were linked to loneliness directly. Loneliness was found to be more strongly associated with 'suspiciousness' and 'no close friends' than other schizotypal traits. After adjustment for the levels of depressive and anxiety symptoms, the above direct edges remained robust.

LIMITATIONS

The use of cross-sectional data indicated only undirected associations between variables.

CONCLUSIONS

Loneliness was more strongly linked to some schizotypal traits than others, with the relationships maintaining above and beyond the effects of anxiety and depression. These findings warrant further investigation of the specific relationships between loneliness and individual schizotypal traits.

Subclinical psychopathology and affective forecasting: Role of in-the-moment feelings

It is important for positive well-being and social engagement to understand how people predict future emotions, an ability known as affective forecasting. However, mechanisms underpinning the change to affective forecasting are not well understood in people with subclinical psychiatric symptoms. The current study differentiated components that comprise affective forecasting and investigated how non-clinical features relate to these. We recruited 319 participants to complete the social affective forecasting task and respond to questionnaires that captured schizotypal and autistic traits as well as depressive symptoms. Associations between affective forecasting and subclinical features were investigated using correlations, regression, and structure equation modeling. Results showed that interpersonal features of schizotypal traits negatively predicted anticipated emotions in positive social conditions via in-the-moment feelings but not via mental simulation. Findings highlight that in-the-moment feelings may be an intervention target to help people who have difficulties with social interactions to anticipate more pleasure for future social events.

Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth

Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension ("adaptive salience"). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL.

Network analysis of executive function, emotion, and social anhedonia

This study constructed the network structure of social anhedonia, emotion processing, and executive function in college students using network analysis. We calculated the strength of each node in the network. The results suggest that social anhedonia had negative effects on executive function, emotion experience, and emotion expression.

Altered cerebellocerebral structural covariance in individuals with attenuated psychosis syndrome

BACKGROUND

Reduced cerebellar volumes and altered cerebellocerebral structural covariance have been reported in patients with schizophrenia. However, it is not clear whether such altered cerebellocerebral structural covariance would be observed before the onset of psychosis. We examined brain structural changes, including cerebral and cerebellar volumes, and cerebellocerebral structural covariance in individuals with attenuated psychosis syndrome (APS).

MATERIALS AND METHODS

Twenty-one individuals with APS and 24 healthy controls (HC) were recruited and underwent structural MRI brain scan. Differences in voxel-based grey matter (GM) volume and cerebellar volume between the APS and HC groups were examined. The correlation between cerebellar volumes and voxel-based cerebral GM volumes were calculated to measure cerebellocerebral structural covariance in each group followed by group comparisons.

RESULTS

Compared with HC, individuals with APS exhibited extensive GM volume reduction in the frontal and striatal areas and reduced cerebellar volume. Structural covariance analysis indicated that the anterior and posterior parts of the cerebellum showed disparate correlation with cerebral voxel-based GM volumes. Abnormal cerebellar-cerebral correlation was also found in individuals with APS at the medial prefrontal gyrus.

CONCLUSIONS

Our findings suggest that prefrontal and striatal structural changes as well as cerebellar structural covariance at the medial prefrontal gyrus may underpin the risk for psychosis and may serve as a potential target for early intervention in individuals at-risk for psychosis.

Revisiting anticipatory hedonic processing in patients with schizophrenia: An examination between representation activation and maintenance

BACKGROUND

Anticipatory anhedonia is one of the key deficits found in patients with schizophrenia (SCZ). However, the underlying mechanism of this deficit remains unclear. The present study examined whether representation activation and maintenance capacity influenced anticipatory experiences in SCZ patients.

METHODS

We recruited 46 SCZ patients (26 males) and 45 matched healthy controls (24 males). The Reward Representation Activation and Maintenance (RRAM) Task was administrated to assess anticipatory experience and representation activation and maintenance capacity.

RESULTS

SCZ patients exhibited lower subjective arousal than controls in anticipation of rewards with high probability when representation activation and maintenance were difficult to accomplish. SCZ patients also tended to reduce their button presses more than HC when they were required to maintain reward representation.

CONCLUSIONS

Our findings suggest that representation activation and maintenance may partially account for anticipatory anhedonia observed in SCZ patients.

Network structure of anticipatory pleasure and risk features: Evidence from a large college sample

Investigating the relationship between anticipatory pleasure deficits and risk features of mental disorders not only theoretically benefits the understanding of anhedonia, but could also facilitate early detection and intervention of mental disorders. Using network analysis, the present study examined the pattern of relationship between anticipatory pleasure and risk features of schizophrenia spectrum, depressive, anxiety, autism spectrum, and obsessive-compulsive disorders in a large sample of college students (n = 2152). It was found that interpersonal features of schizotypal personality traits and poor social skills of autistic traits showed strong correlation with low social anticipatory pleasure. Depressive symptoms severity was weakly associated with reduced abstract anticipatory pleasure, while obsessive-compulsive traits were weakly associated with high contextual anticipatory pleasure. No significant correlation was found between anxiety symptoms severity and anticipatory pleasure. Social anticipatory pleasure had the highest strength centrality among all anticipatory pleasure components, while interpersonal features of schizotypal personality traits had the highest strength centrality in the whole network. Our findings suggest that impaired anticipatory pleasure, especially social anticipatory pleasure, is a particular feature of schizotypal personality traits and autistic traits. Our findings may have implications for intervention in that the social component may be a target to improve anhedonia in individuals with schizotypal and autistic traits, while interpersonal features may be a key treatment target given that it was central to the relationship between anticipatory pleasure and risk features.

Reward processing in certain versus uncertain contexts in schizophrenia: An event-related potential (ERP) study

Disturbances in motivation are prominent in the clinical presentation of people with schizophrenia and might reflect a disturbance in reward processing. Recent advances in affective neuroscience have subdivided reward processing into distinct components, but there are two limitations of the prior work in schizophrenia. First, studies typically focus on only one component rather than on the unfolding of reward processing across multiple stages. Second, studies have not considered the impact of certainty effects, which represent an important contextual factor that impacts processing. We examined whether individuals with schizophrenia show the typical certainty effects across three phases of reward processing: cue evaluation, feedback anticipation, and feedback receipt. Electroencephalography from 74 healthy controls and 92 people with schizophrenia was recorded during a cued gambling task under conditions in which cues indicated forthcoming reward outcomes that were certain or uncertain. Controls demonstrated the expected certainty effects across each stage. Initial cue evaluation (cue P300) was intact in the schizophrenia group, but people with schizophrenia showed diminished certainty effects during feedback anticipation (stimulus-preceding negativity [SPN]) and receipt (feedback reward positivity [fRewP] and feedback P300). During feedback receipt, event-related potentials in people with schizophrenia were similar to controls for the uncertain context but larger than controls for the certain context. Essentially, people with schizophrenia appeared to process certain feedback as though it were uncertain. These findings show, for the first time, that the fundamental distinction between certain and uncertain contexts is altered in schizophrenia at a neural level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Temporal Experience of Pleasure Scale (TEPS): Measurement Invariance Across Gender in Chinese University Students

The Temporal Experience of Pleasure Scale (TEPS) is a self-report instrument assessing pleasure experience. The present study aimed to confirm the factor model of the Chinese version of TEPS and test measurement invariance of the scale across gender in Chinese university students. Participants were 2977 (51% female) undergraduates aged from 16 to 27 years (Mean age = 18.9 years). Results indicated that the revised four-factor structure of the TEPS had acceptable fit in the total sample and in gender groups. Furthermore, configural, metric and partial scalar invariance across gender were established. Two of the items (item 4 and 8) demonstrated different intercepts and women scored higher than men on both items. With partial scalar invariance demonstrated, test of differences in latent means indicated that men had lower levels of pleasure when compared with women. To our knowledge, this study is the first attempt to test the measurement invariance of the TEPS across gender, which provides support for future research that involves examining hedonic capacity in Chinese men and women.

Diminished Anticipatory and Consummatory Pleasure in Dysphoria: Evidence From an Experience Sampling Study

Anhedonia, the experience of diminished pleasure, is a core feature of major depressive disorder and is often present long before the diagnosis of depression. Most previous studies have investigated anhedonia with self-report measures of trait anhedonia or with behavioral paradigms using laboratory stimuli, and the real-time characteristics of hedonic processing in subclinical depression remain under-investigated. We used the experience sampling method to evaluate momentary experience of hedonic feelings in the context of daily life. Dysphoric (n = 49) and non-dysphoric (n = 51) college students completed assessments of their current positive affect (PA), as well as state anticipatory and consummatory pleasure, 3 or 4 times a day every day for 2 weeks. The results showed that dysphoric individuals reported less state anticipatory and consummatory pleasure compared with non-dysphoric individuals. Moreover, significant time-lagged associations between anticipatory pleasure and follow-up consummatory pleasure were found in the whole sample, after adjustment for current PA. The current findings thus hold considerable promise in advancing our understanding of anhedonia as well as the important role of state anticipatory pleasure in relation to depression.

Network analysis of schizotypal personality traits and their association with other subclinical psychiatric features

Schizotypal personality (SP) traits have been found to be correlated with autistic traits, obsessive-compulsive traits, depressive symptoms and anxiety symptoms. However, the overall pattern of the relationship remains unclear. The purpose of this study was to investigate the network structure between SP traits and other subclinical features (symptoms or traits) and test the replicability of these relationships. A total of 2204 college students completed measurements for SP traits, autistic traits, obsessive-compulsive traits, depressive symptoms and anxiety symptoms, and a validated subsample of 814 completed the same questionnaires again three months later. Using network analysis, we constructed the network structure of subclinical features and then tested its replicability. We found that interpersonal features were the bridge node connecting SP traits and autistic traits (social skill: r = 0.50; attention switching: r = 0.14; communication: r = 0.12), while cognitive-perceptual (obsessing: r = 0.05; neutralizing: r = 0.06) and disorganization (obsessing: r = 0.11) features were the SP traits associated with obsessive-compulsive traits. In addition to interpersonal features (r = 0.10), disorganization (r = 0.12) and cognitive-perceptual (r = 0.05) features were also the overlap between depressive symptoms and SP traits. Anxiety symptoms only connected with interpersonal (r = 0.05) but not cognitive-perceptual features of SP traits. The network showed high predictability (43%) and interpersonal features of SP traits had the highest expected influence (1.67) among all nodes, which may be a potential target for intervention. High similarities were found on network structure (r = 0.86) and expected influence (r = 0.96), and no significant difference on global connectivity was found between these two networks (difference value = 0.45, p = 0.135), suggesting the replicability of the network structure.

Delay discounting and affective priming in individuals with negative schizotypy

Previous studies have demonstrated that patients with schizophrenia and individuals with schizotypy experience decreased anticipatory pleasure. However, it is unclear whether this decrease is contributed by altered reward processing at the proximal or distal future. In order to investigate the preference for receiving rewards in the proximal or distal future for individuals with schizophrenia spectrum disorders, individuals with either high or low levels of negative schizotypy performed a delay discounting task under positive, neutral and negative affective priming conditions. Compared with individuals with low levels of negative schizotypy, individuals with high levels of schizotypy exhibited increased delay discounting, preferring to choose immediate but smaller rewards instead of delayed but larger rewards across all three affective priming conditions. Negative affective priming elevated discounting for both groups compared with both the positive and neutral affective conditions. After dividing delayed temporal distance into the proximal and distal future, the results showed that individuals with high levels of negative schizotypy exhibited more preference for immediate but smaller rewards in the distal instead of proximal future compared with controls. Our results suggest that individuals with high levels of negative schizotypy have altered anticipatory reward processing, which is mainly attributed to alterations in representing rewards in the distal future. These findings extend the alterations in representing reward values from schizophrenia patients to schizotypal individuals, and suggest that diminished anticipatory pleasure in schizophrenia spectrum disorders may be due to changes in processing anticipatory rewards in the distal future.

Impact of long-term institutionalization on experiential pleasure and motivation in patients with schizophrenia

Anhedonia and amotivation, the hallmarks of negative symptoms in schizophrenia, are believed to be due to "emotion-behavior decoupling," a failure in translating pleasure experience into appropriate goal-directed behavior. A number of studies have reported that long-term institutionalized schizophrenia patients suffer from more severe negative symptoms than community-dwelling patients, but few studies have investigated pleasure experience and motivational behavior in schizophrenia patients who have experienced long-term institutionalization. In this study, we recruited 26 long-term institutionalized schizophrenia patients, 27 community-dwelling schizophrenia patients, and 27 healthy controls. Participants were administered two specific computer-based tasks to assess anhedonia and amotivation. The Anticipatory and Consummatory Pleasure (ACP) Task was used to measure emotion-behavior decoupling and the Effort-Expenditure for Rewards Task (EEfRT) was used to measure amotivation related to rewards. Findings from the ACP Task showed that compared with healthy controls, the coupling between emotion experience and motivated behavior was significantly weaker in both clinical groups, suggesting that emotion-behavior decoupling could be a stable trait in schizophrenia patients. In the EEfRT, compared with both community-dwelling patients and healthy controls, institutionalized patients with schizophrenia failed to expend more effort to gain potential rewards even when reward probability increased. These findings further reveal the underlying mechanism of anhedonia and amotivation and their potential relationships with long-term institutionalization in patients with schizophrenia.

The role of hedonics in the Human Affectome

Experiencing pleasure and displeasure is a fundamental part of life. Hedonics guide behavior, affect decision-making, induce learning, and much more. As the positive and negative valence of feelings, hedonics are core processes that accompany emotion, motivation, and bodily states. Here, the affective neuroscience of pleasure and displeasure that has largely focused on the investigation of reward and pain processing, is reviewed. We describe the neurobiological systems of hedonics and factors that modulate hedonic experiences (e.g., cognition, learning, sensory input). Further, we review maladaptive and adaptive pleasure and displeasure functions in mental disorders and well-being, as well as the experience of aesthetics. As a centerpiece of the Human Affectome Project, language used to express pleasure and displeasure was also analyzed, and showed that most of these analyzed words overlap with expressions of emotions, actions, and bodily states. Our review shows that hedonics are typically investigated as processes that accompany other functions, but the mechanisms of hedonics (as core processes) have not been fully elucidated.

Affective forecasting and accuracy in social anhedonia: Predicted and experienced emotion for a social interaction

OBJECTIVE

Previous research suggests people with social anhedonia (SocAnh) exhibit deficits in anticipated pleasure for social stimuli relative to controls. However, previous research has relied on hypothetical social stimuli and has focused on anticipated pleasure without examining negative affect.

METHOD

Participants were informed that they would complete an "enjoyable" sharing task with a peer and were asked to forecast positive and negative affect during the interaction. After the interaction, participants reported their experienced emotions.

RESULTS

We found SocAnh and controls anticipated and experienced similar levels of positive affect and that both groups underpredicted positive affect. The SocAnh group anticipated and experienced more negative affect than controls and was more accurate in forecasting negative affect.

CONCLUSION

This is the first study to show that SocAnh is associated with the heightened anticipation of negative affect and that experiencing heightened negative affect during social interactions could drive reduced motivation and desire to engage in future social interaction.

Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: A systematic review and meta-analysis

OBJECTIVES

Deficits in anticipating pleasure may be an important dimension of anhedonia and functioning in psychiatric disorders, particularly schizophrenia and depression; however, inconsistent findings have limited the conclusions that can be drawn. We conducted the first systemic review and meta-analysis of the extant literature for research comparing psychiatric groups to healthy control groups on anticipatory pleasure.

METHODS

Academic Search Complete, Science Direct, and CINAHL databases were systematically searched up to 9 June 2018 for relevant peer-reviewed articles, book chapters, and dissertations. Reference lists were also hand searched. A total of 36 studies were included in the review.

RESULTS

A moderate-sized deficit was observed in schizophrenia spectrum disorders (k = 32, 1,851 patients and 1,449 controls, g = -0.42 [95% CI = -0.53 to -0.31], p < .001), and a large deficit in major depression (k = 415 patients and 506 controls, g = -0.87 [95% CI = -1.23 to -0.51], p < .001), with this effect being significantly larger for depression (p < .05). Meta-regression showed that heterogeneity was partially explained in schizophrenia spectrum by longer duration of illness and lower cognitive functioning predicting larger deficits. In depression, some evidence was found that ruling out a history of psychiatric illness in controls may be related to larger effects. There was evidence for small study bias inflating estimates in schizophrenia spectrum disorders.

CONCLUSIONS

Deficits in anticipatory pleasure are manifest in these disorders, and significantly more so in major depression. These findings indicate a possible therapeutic target to link cognitive, affective, and behavioural factors that precipitate and maintain disorder.

PRACTITIONER POINTS

Anticipatory pleasure is impaired in schizophrenia spectrum and major depression. A particular focus on enhancing anticipatory pleasure may improve motivation for rewarding behaviour and psychosocial functioning. The review contained only a small number of studies for major depression. Given the heterogeneity in effects, there are likely to be more moderators of anticipatory pleasure that require examination.

Deconstructing Avolition: Initiation vs persistence of reward-directed effort

Avolition, a decrease in the initiation and persistence of goal-directed behavior, is a critical determinant of disability in patients with schizophrenia. Recent studies have demonstrated that avolition can be modeled using reward-based, behavioral paradigms. These studies suggest that avolition represents a motivational deficit, accounted for by a diminished ability to anticipate pleasurable experiences. Notably, although data suggest that "initiation" and "persistence" of goal-directed behavior may depend on different processes, few studies have sought to distinguish between these two components of avolitional symptoms. Such distinctions could have real consequences for the development and evaluation of interventions designed to ameliorate avolitional symptoms. Thus, the present study examined the relationship between anticipatory pleasure, a key driver of avolition, and both the initiation and persistence of reward-directed, effortful responding during the Effort Expenditures for Rewards Task in 103 healthy participants. We found that anticipatory pleasure was not significantly predictive of the initiation of effortful responding but was significantly predictive of the persistence of effortful responding; most notably when the probabilities of reward and non-reward were equivalent. These data suggest that although deficits in reward processes contribute to the likelihood of persisting in reward-driven behavior, they contribute little to the initiation of such behavior.

Cross Cultural Validation and Extension of the Clinical Assessment Interview for Negative Symptoms (CAINS) in the Chinese Context: Evidence from a Spectrum Perspective

The Clinical Assessment Interview for Negative Symptoms (CAINS) was designed in accordance with the recent theory and research in social affective neuroscience and to address the psychometric and conceptual limitations of other instruments assessing negative symptoms. The present study aimed to provide a large-scale validation of the CAINS in China and examine its applicability and validity evidence across the schizophrenia spectrum. Using confirmatory factor analysis, our results replicated the original findings in the US development samples that the CAINS possesses a stable 2-factor structure, namely "motivation/pleasure" and "expression". We also found significant correlations between the CAINS and other negative symptom measures. The CAINS demonstrated good discriminant validity in differentiating negative symptoms in people with schizophrenia, nonpsychotic first-degree relatives and people with social anhedonia. People with schizophrenia exhibited significantly higher CAINS subscale scores than first-degree relatives and healthy controls. In addition, first-degree relatives had higher "motivation/pleasure" scores than healthy controls. The "motivation/pleasure" subscale scores of individuals with social anhedonia were also significantly higher than healthy controls.

Mediation effect of beliefs about pleasure and emotional experience between social anhedonia and prediction of pleasant events

Few studies have examined whether there is a relationship between social anhedonia and prediction of future events and the role of beliefs about pleasure and emotional experience. In this study, 513 college students were recruited to complete a set of self-reported questionnaires, including the Revised Social Anhedonia Scale (CSAS), the Temporal Experience of Pleasure Scale (TEPS), the Belief about Pleasure Scale (BAPS) and the Beck Depression Inventory. Moreover, a checklist of 100 daily life events was also administrated to all participants. Mediation analysis found that social anhedonia had a direct impact on prediction of pleasant events. Emotional experience partly mediated the relationship between social anhedonia and subjective prediction of pleasant events. However, beliefs about pleasure had no significant mediation effect between social anhedonia and prediction of pleasant events, but were shown to influence the subjective prediction of pleasant events completely through emotional experience. These findings suggest that beliefs about pleasure and emotional experience may be considered promising factors for interventions in individuals with anhedonia.

Profiling of experiential pleasure, emotional regulation and emotion expression in patients with schizophrenia

BACKGROUND

Emotion deficits may be the basis of negative symptoms in schizophrenia patients and they are prevalent in these patients. However, inconsistent findings about emotion deficits in schizophrenia suggest that there may be subtypes.

AIM

The present study aimed to examine and profile experiential pleasure, emotional regulation and expression in patients with schizophrenia.

METHODS

A set of checklists specifically capturing experiential pleasure, emotional regulation, emotion expression, depressive symptoms and anhedonia were administered to 146 in-patients with schizophrenia and 73 demographically-matched healthy controls. Psychiatric symptoms and negative symptoms were also evaluated by a trained psychiatrist for patients with schizophrenia.

RESULTS

Two-stage cluster analysis and discriminant function analysis were used to analyze the profile of these measures in patients with schizophrenia. We found a three-cluster solution. Cluster 1 (n=41) was characterized by a deficit in experiential pleasure and emotional regulation, Cluster 2 (n=47) was characterized by a general deficit in experiential pleasure, emotional regulation and emotion expression, and Cluster 3 (n=57) was characterized by a deficit in emotion expression. Results of a discriminant function analysis indicated that the three groups were reasonably discrete.

CONCLUSION

The present findings suggest that schizophrenia patients can be classified into three subtypes based on experiential pleasure, emotional regulation and emotion expression, which are characterized by distinct clinical representations.

Olfactory identification deficit and its relationship with hedonic traits in patients with first-episode schizophrenia and individuals with schizotypy

OBJECTIVE

Olfactory identification impairments have been consistently found in schizophrenia patients. However, few previous studies have investigated this in first-episode patients. There are also inconsistent findings regarding olfactory identification ability in psychometrically-defined schizotypy individuals. In this study, we directly compared the olfactory identification ability of first-episode schizophrenia patients with schizotypy individuals. The relationship between olfactory identification impairments and hedonic traits was also examined.

METHODS

Thirty-five first-episode schizophrenia patients, 40 schizotypy individuals as defined by the Chapman's Anhedonia Scales and 40 demographically matched controls were recruited. The University of Pennsylvania Smell Identification Test was administered. Hedonic capacity was assessed using the Temporal Experience of Pleasure Scale (TEPS).

RESULTS

The results showed that both the schizophrenia and schizotypy groups showed poorer olfactory identification ability than controls, and the impairment was significantly correlated with reduced pleasure experiences.

CONCLUSION

Our findings support olfactory identification impairment as a trait marker for schizophrenia.

Psychometric evaluation of the Temporal Experience of Pleasure Scale (TEPS) in a German sample

Anhedonia, or the inability to experience pleasure, is commonly observed in schizophrenia. It has been suggested that patients with schizophrenia are unable to predict future pleasurable events, but show intact experience of in-the-moment pleasure. Therefore, the Temporal Experience of Pleasure Scale (TEPS), a self-report measure allowing the assessment of anticipatory and consummatory pleasure, has been developed. To validate the German version of the TEPS, we recruited 59 healthy control participants and 51 patients with schizophrenia or schizoaffective disorder who completed the TEPS as well as a battery of psychometric tests to assess psychopathology, in particular self-rated anhedonia and clinician-rated apathy as well as overall measures of negative symptoms. We found acceptable to good internal consistency and a factor structure comparable to the original version. Scores of the TEPS were related to measures of anhedonia and apathy, but not with other measures of psychopathology. The present results suggest that the German version of the TEPS shows adequate reliability and validity to assess the construct of anhedonia. However, differential aspects of anticipatory and consummatory pleasure should be further investigated in clinical samples.

An Examination of the Multi-Faceted Motivation System in Healthy Young Adults

Background: Amotivation is a prevalent symptom in schizophrenia (SZ) and depression (MDD), and is linked to poor functional outcomes in affected individuals. Conceptualizations of motivation have outlined a multi-faceted construct comprised of reward responsiveness, reward expectancy, reward valuation, effort valuation, and action selection/preference-based decision making. To date, findings from studies utilizing variable-centered approaches to examining isolated facets of motivation in SZ and MDD have been inconsistent. Thus, the present study adopted a person-centered approach, and comprehensively examined the reward system in a non-clinical sample in an attempt to explore potential subtypes of motivation impairments, while minimizing the effects of illness-related confounds. Methods: Ninety-six healthy undergraduate students were evaluated for amotivation, schizotypal traits, depressive symptoms, and cognition, and administered objective computerized tasks to measure the different facets of motivation. Cluster analysis was performed to explore subgroups of individuals based on similar motivation task performance. Additionally, correlational analyses were conducted in order to examine inter-relationships between motivation facets, and relations between clinical measures and facets of motivation. Results: Cluster analysis identified two subgroups of individuals with differential motivation performance profiles. Correlational analyses revealed that reward responsiveness was associated with amotivation, depressive symptoms, and negative schizotypy. Further, significant inter-correlations were found between reward responsiveness and reward expectancy, as well as between reward valuation and effort valuation. Conclusions: Our results mark important steps forward in understanding motivation in a non-clinical sample, and guide future dimensional and comprehensive analyses of the multi-faceted reward system. It remains to be seen whether these patterns of results will be similar in clinical populations such as SZ and MDD.

Pleasure Experience and Emotion Expression in Patients with Schizophrenia

Background

Impairments in emotional experience and expression have been observed in patients with schizophrenia. However, most previous studies have been limited to either emotional experience (especially anhedonia) or expression. Few studies have examined both the experience and expression of emotion in schizophrenia patients at the same time.

Aims

The present study aimed to examine pleasure experience and emotion expression in patients with schizophrenia. In particular, we specifically examined the relationship between emotion impairments (both pleasure experience and expression) and negative symptoms.

Methods

One hundred and fifty patients completed the Temporal Experience of Pleasure Scale and Emotional Expressivity Scale.

Results

Schizophrenia patients exhibited deficits in experiencing pleasure, but showed intact reported emotion expression. Patients with prominent negative symptoms showed reduced anticipatory pleasure, especially in abstract anticipatory pleasure.

Conclusion

The present findings suggest that patients with schizophrenia have deficits in pleasure experience, while their abilities to express emotion appear intact. Such deficits are more severe in patients with prominent negative symptoms.

Implication of reward alterations in the expression of negative symptoms in 22q11.2 deletion syndrome: a behavioural and DTI study

BACKGROUND

Alterations of the reward system have been proposed as one of the core mechanisms underlying the expression of negative symptoms in schizophrenia. Specifically, deficits in specific reward components and white matter (WM) integrity of the reward system have been highlighted. The putative link between negative symptoms and the hedonic experience, or structural connectivity of the reward system has never been examined in the 22q11.2 deletion syndrome (22q11DS), a condition with increased risk for psychosis.

METHOD

Anticipatory and consummatory dimensions of pleasure were assessed in participants with 22q11DS (N = 54) and healthy controls (N = 55). In patients with 22q11DS, the association between pleasure scores and positive or negative symptoms was investigated. Furthermore, WM integrity of the accumbofrontal tract was quantified using diffusion tensor imaging (DTI). Associations between DTI measures, pleasure dimensions and negative symptoms were examined.

RESULTS

Patients with 22q11DS showed reduced anticipatory and consummatory pleasure compared to controls. Furthermore, anticipatory pleasure scores were negatively correlated to negative and positive symptoms in 22q11DS. WM microstructural changes of the accumbofrontal tract in terms of increased fractional anisotropy and reduced radial anisotropy were also identified in patients. However, no significant correlation between the DTI measures and pleasure dimensions or psychotic symptoms was observed.

CONCLUSIONS

This study revealed that participants with 22q11DS differed in their experience of pleasure compared to controls. The anticipatory pleasure component appears to be related to negative and positive symptom severity in patients. Alterations of WM integrity of the accumbofrontal tract seem to be related to myelination abnormalities in 22q11DS patients.

Emotion processing deficits in the different dimensions of psychometric schizotypy

Schizotypy refers to a personality structure indicating "proneness" to schizophrenia. Around 10% of the general population has increased schizotypal traits, they also share other core features with schizophrenia and are thus at heightened risk for developing schizophrenia and spectrum disorders. A key aspect in schizophrenia-spectrum pathology is the impairment observed in emotion-related processes. This review summarizes findings on impairments related to central aspects of emotional processes, such as emotional disposition, alexithymia, facial affect recognition and speech prosody, in high schizotypal individuals in the general population. Although the studies in the field are not numerous, the current findings indicate that all these aspects of emotional processing are deficient in psychometric schizotypy, in accordance to the schizophrenia-spectrum literature. A disturbed frontotemporal neural network seems to be the critical link between these impairments, schizotypy and schizophrenia. The limitations of the current studies and suggestions for future research are discussed.

The effects of working memory training on enhancing hedonic processing to affective rewards in individuals with high social anhedonia

Anhedonia is a core feature of the negative symptoms of schizophrenia and is less responsive to antipsychotic medication. Little is known whether anhedonia could be alleviated by cognitive training. The present study aimed to examine whether hedonic deficits observed in individuals with high social anhedonia could be reduced by working memory (WM) training. Thirty-four individuals with high social anhedonia were randomly assigned to either a WM training group or a control group. The WM training group received 20 sessions of dual n-back task training for four weeks. The affective incentive delay task was administered in all participants before the training and one month later. The results showed that individuals who received the WM training showed significant improvement in WM performance (F(19, 304)=55.80, p<0.001) and they also showed significant improvement in approach sensitivity to rewards (p=0.004). These preliminary findings suggest that hedonic processing could be improved through WM training in individuals with high social anhedonia. These results may have important implications for the development of non-pharmacological interventions to alleviate anhedonia in patients with schizophrenia.

The neural transfer effect of working memory training to enhance hedonic processing in individuals with social anhedonia

Anhedonia, the diminished ability to experience pleasure, is a challenging negative symptom in patients with schizophrenia and can be observed in at-risk individuals with schizotypy. Deficits in hedonic processing have been postulated to be related to decreased motivation to engage in potentially rewarding events. It remains unclear whether non-pharmacological interventions, such as cognitive training, could improve anhedonia. The present study aimed to examine the neural mechanism for alleviating hedonic deficits with working memory (WM) training in individuals with social anhedonia. Fifteen individuals with social anhedonia were recruited and received 20 sessions of training on a dual n-back task, five sessions a week. Functional imaging paradigms of the Monetary Incentive Delay (MID) and the Affective Incentive Delay (AID) tasks were administered both before and after the training to evaluate the neural transfer effects on hedonic processing ability. Enhanced brain activations related to anticipation were observed at the anterior cingulate cortex, the left dorsal striatum and the left precuneus with the AID task, and at the dorsolateral prefrontal cortex and the supramarginal gyrus with the MID task. The present findings support that WM training may improve monetary-based and affective-based hedonic processing in individuals with social anhedonia.

Experiential pleasure deficits in the prodrome: A study of emotional experiences in individuals at ultra-high risk for psychosis and recent-onset schizophrenia

BACKGROUND

Previous studies report deficits in noncurrent but not current pleasure experience in schizophrenia, but little is known about pleasure experiences of the prodrome. This study investigated noncurrent and current pleasure experiences and its relationship with neurocognitive function and self-esteem in ultra-high risk (UHR) for psychosis and recent-onset schizophrenia (ROSPR).

METHODS

Twenty-four UHR, 25 ROSPR and 42 normal controls completed the physical and social anhedonia scales for noncurrent emotional experience and the laboratory-based assessment of valence and arousal evoked by positive, neutral and negative emotional stimuli for current emotional experience. Relationships of current and noncurrent emotional experience, episodic memory and self-esteem were investigated.

RESULTS

For ROSPR, noncurrent pleasure, but not current pleasure evoked by positive stimuli, was diminished. Noncurrent anhedonia in ROSPR was related to episodic memory deficits and low self-esteem. In UHR subjects, both noncurrent pleasure and current pleasure to positive and neutral stimuli were diminished. Noncurrent anhedonia in UHR was not associated with episodic memory nor self-esteem. For arousal, ROSPR patients showed higher arousal than UHR subjects to positive stimuli.

CONCLUSIONS

Findings indicate the presence of experiential hedonic deficits during the prodrome phase. Diminished noncurrent pleasure reports exist in ROSPR, which seems to be associated with cognitive deficits and low self-concept. Future research is needed to probe into further underlying mechanisms.

A Review of Anticipatory Pleasure in Schizophrenia

PURPOSE OF REVIEW

Anhedonia, traditionally defined as a diminished capacity to experience pleasure, has long been considered a core symptom of schizophrenia. However, recent research calls into question whether individuals with schizophrenia are truly anhedonic, suggesting intact subjective and neurophysiological response to rewarding stimuli in-the-moment. Despite a presumably intact capacity to experience pleasure, people with schizophrenia still engage in fewer reward-seeking behaviors. This discrepancy has been explained as a dissociation between "liking" and "wanting", with dopaminergic and prefrontal influences on incentive salience leading hedonic responses to not effectively translate into motivated behavior. In the current review, the literature on a key aspect of the wanting deficit is reviewed, anticipatory pleasure.

RECENT FINDINGS

Results provide consistent evidence for impairment in some aspects of anticipatory pleasure (e.g., prospection, associative learning between reward predictive cues and outcomes), and inconsistent evidence for others (e.g., anticipatory affect and affective forecasting).

SUMMARY

Mechanisms underlying anticipatory pleasure abnormalities in schizophrenia are discussed and a new model of anticipatory pleasure deficits is proposed. Findings suggest that anticipatory pleasure may be a critical component of impairments in wanting that impact motivated behavior in schizophrenia.