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Rossi-Goldthorpe R, Silverstein SM, Gold JM, Schiffman J, Waltz JA, Williams TF, Powers AR, Woods SW, Zinbarg RE, Mittal VA, Ellman LM, Strauss GP, Walker EF, Levin JA, Castiello S, Kenney J, Corlett PR. Different learning aberrations relate to delusion-like beliefs with different contents. Brain 2024:awae122. [PMID: 38637303 DOI: 10.1093/brain/awae122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/20/2024] Open
Abstract
The prediction error account of delusions has had success. However, its explanation of delusions with different contents has been lacking. Persecutory delusions and paranoia are the common unfounded beliefs that others have harmful intentions towards us. Other delusions include believing that one's thoughts or actions are under external control, or that events in the world have specific personal meaning. We compare learning on two different cognitive tasks, probabilistic reversal learning (PRL) and Kamin blocking, that have relationships to paranoid and non-paranoid delusion-like beliefs, respectively. We find that Clinical High-Risk status alone does not result in different behavioral results on the PRL task but that an individual's level of paranoia is associated with excessive switching behavior. During the Kamin blocking task, paranoid individuals learned inappropriately about the blocked cue. However, they also had decreased learning about the control cue, suggesting more general learning impairments. Non-paranoid delusion-like belief conviction (but not paranoia) was associated with aberrant learning about the blocked cue but intact learning about the control cue, suggesting specific impairments in learning related to cue combination. We fit task-specific computational models separately to behavioral data to explore how latent parameters vary within individuals between tasks, and how they can explain symptom-specific effects. We find that paranoia is associated with low learning rates on the PRL task as well as the blocking task. Non-paranoid delusion-like belief conviction was instead related to parameters controlling the degree and direction of similarity between cue updating during simultaneous cue presentation. These results suggest that paranoia and other delusion-like beliefs involve dissociable deficits in learning and belief updating, which - given the transdiagnostic status of paranoia - may have differential utility in predicting psychosis.
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Affiliation(s)
- Rosa Rossi-Goldthorpe
- Interdepartmental Neuroscience Program, Wu Tsai Institute, Yale University, New Haven, CT 06511, USA
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14623, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY 14623, USA
- Department of Opthalmology, University of Rochester Medical Center, Rochester, NY 14623, USA
| | - James M Gold
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Jason Schiffman
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
| | - James A Waltz
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Trevor F Williams
- Department of Psychology, Northwestern University, Evanston, IL 60208-2710, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL 60208-2710, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL 60208-2710, USA
| | | | - Gregory P Strauss
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Jason A Levin
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - Santiago Castiello
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06511, USA
| | - Joshua Kenney
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06511, USA
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, CT 06511, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06511, USA
- Department of Psychology, Yale University, New Haven, CT 06511, USA
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Boudewyn MA, Erickson MA, Winsler K, Barch DM, Carter CS, Frank MJ, Gold JM, MacDonald AW, Ragland JD, Silverstein SM, Yonelinas AP, Luck SJ. Assessing Trial-by-Trial Electrophysiological and Behavioral Markers of Attentional Control and Sensory Precision in Psychotic and Mood Disorders. Schizophr Bull 2024:sbae038. [PMID: 38616053 DOI: 10.1093/schbul/sbae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND AND HYPOTHESIS The current study investigated the extent to which changes in attentional control contribute to performance on a visual perceptual discrimination task, on a trial-by-trial basis in a transdiagnostic clinical sample. STUDY DESIGN Participants with schizophrenia (SZ; N = 58), bipolar disorder (N = 42), major depression disorder (N = 51), and psychiatrically healthy controls (N = 92) completed a visual perception task in which stimuli appeared briefly. The design allowed us to estimate the lapse rate and the precision of perceptual representations of the stimuli. Electroencephalograms (EEG) were recorded to examine pre-stimulus activity in the alpha band (8-13 Hz), overall and in relation to behavior performance on the task. STUDY RESULTS We found that the attention lapse rate was elevated in the SZ group compared with all other groups. We also observed group differences in pre-stimulus alpha activity, with control participants showing the highest levels of pre-stimulus alpha when averaging across trials. However, trial-by-trial analyses showed within-participant fluctuations in pre-stimulus alpha activity significantly predicted the likelihood of making an error, in all groups. Interestingly, our analysis demonstrated that aperiodic contributions to the EEG signal (which affect power estimates across frequency bands) serve as a significant predictor of behavior as well. CONCLUSIONS These results confirm the elevated attention lapse rate that has been observed in SZ, validate pre-stimulus EEG markers of attentional control and their use as a predictor of behavior on a trial-by-trial basis, and suggest that aperiodic contributions to the EEG signal are an important target for further research in this area, in addition to alpha-band activity.
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Affiliation(s)
- Megan A Boudewyn
- Department of Psychology, University of California, Santa Cruz, California, USA
| | - Molly A Erickson
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Kurt Winsler
- Department of Psychology, University of California, Davis, California, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Cameron S Carter
- Department of Psychiatry and Human Behavior, University of California, Irvine, California, USA
| | - Michael J Frank
- Department of Cognitive, Linguistics and Psychological Sciences, Brown University, Providence, Rhode Island, USA
| | - James M Gold
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Angus W MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - J Daniel Ragland
- Department of Psychology, University of California, Davis, California, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Andrew P Yonelinas
- Department of Psychology, University of California, Davis, California, USA
| | - Steven J Luck
- Department of Psychology, University of California, Davis, California, USA
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Culbreth AJ, Moran EK, Mahaphanit W, Erickson MA, Boudewyn MA, Frank MJ, Barch DM, MacDonald AW, Ragland JD, Luck SJ, Silverstein SM, Carter CS, Gold JM. A Transdiagnostic Study of Effort-Cost Decision-Making in Psychotic and Mood Disorders. Schizophr Bull 2024; 50:339-348. [PMID: 37901911 PMCID: PMC10919776 DOI: 10.1093/schbul/sbad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Research suggests that effort-cost decision-making (ECDM), the estimation of work required to obtain reward, may be a relevant framework for understanding motivational impairment in psychotic and mood pathology. Specifically, research has suggested that people with psychotic and mood pathology experience effort as more costly than controls, and thus pursue effortful goals less frequently. This study examined ECDM across psychotic and mood pathology. HYPOTHESIS We hypothesized that patient groups would show reduced willingness to expend effort compared to controls. STUDY DESIGN People with schizophrenia (N = 33), schizoaffective disorder (N = 28), bipolar disorder (N = 39), major depressive disorder (N = 40), and controls (N = 70) completed a physical ECDM task. Participants decided between completing a low-effort or high-effort option for small or larger rewards, respectively. Reward magnitude, reward probability, and effort magnitude varied trial-by-trial. Data were analyzed using standard and hierarchical logistic regression analyses to assess the subject-specific contribution of various factors to choice. Negative symptoms were measured with a clinician-rated interview. STUDY RESULTS There was a significant effect of group, driven by reduced choice of high-effort options in schizophrenia. Hierarchical logistic regression revealed that reduced choice of high-effort options in schizophrenia was driven by weaker contributions of probability information. Use of reward information was inversely associated with motivational impairment in schizophrenia. Surprisingly, individuals with major depressive disorder and bipolar disorder did not differ from controls. CONCLUSIONS Our results provide support for ECDM deficits in schizophrenia. Additionally, differences between groups in ECDM suggest a seemingly similar behavioral phenotype, reduced motivation, could arise from disparate mechanisms.
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Affiliation(s)
- Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, USA
| | - Erin K Moran
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, USA
| | - Wasita Mahaphanit
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, USA
| | - Molly A Erickson
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA
| | - Megan A Boudewyn
- Department of Psychology, University of California, Santa Cruz, USA
| | - Michael J Frank
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, USA
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, USA
| | | | - J Daniel Ragland
- Department of Psychiatry, University of California, Davis, School of Medicine, Davis, USA
| | - Steven J Luck
- Center for Mind and Brain, University of California, Davis, Davis, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, USA
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, School of Medicine, Davis, USA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, USA
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Bansal S, Bae GY, Robinson BM, Dutterer J, Hahn B, Luck SJ, Gold JM. Qualitatively Different Delay-Dependent Working Memory Distortions in People With Schizophrenia and Healthy Control Participants. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:1218-1227. [PMID: 37459911 PMCID: PMC10792108 DOI: 10.1016/j.bpsc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Impairments in working memory (WM) have been well documented in people with schizophrenia (PSZ). However, these quantitative WM impairments can often be explained by nonspecific factors, such as impaired goal maintenance. Here, we used a spatial orientation delayed response task to explore a qualitative difference in WM dynamics between PSZ and healthy control participants (HCs). More specifically, we took advantage of the discovery that WM representations may drift either toward or away from previous trial targets (serial dependence). We tested the hypothesis that WM representations would drift toward the previous trial target in HCs but away from the previous trial target in PSZ. METHODS We assessed serial dependence in PSZ (n = 31) and HCs (n = 25) using orientation as the to-be-remembered feature and memory delays lasting from 0 to 8 seconds. Participants were asked to remember the orientation of a teardrop-shaped object and reproduce the orientation after a delay period of varying length. RESULTS Consistent with prior studies, we found that current trial memory representations were less precise in PSZ than in HCs. We also found that WM for the current trial orientation drifted toward the previous trial orientation in HCs (representational attraction) but drifted away from the previous trial orientation in PSZ (representational repulsion). CONCLUSIONS These results demonstrate a qualitative difference in WM dynamics between PSZ and HCs that cannot be easily explained by nuisance factors such as reduced effort. Most computational neuroscience models also fail to explain these results because they maintain information solely by means of sustained neural firing, which does not extend across trials. The results suggest a fundamental difference between PSZ and HCs in longer-term memory mechanisms that persist across trials, such as short-term potentiation and neuronal adaptation.
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland.
| | - Gi-Yeul Bae
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Benjamin M Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Jenna Dutterer
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis, Davis, California
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland
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Calarco N, Oliver LD, Joseph M, Hawco C, Dickie EW, DeRosse P, Gold JM, Foussias G, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. Multivariate Associations Among White Matter, Neurocognition, and Social Cognition Across Individuals With Schizophrenia Spectrum Disorders and Healthy Controls. Schizophr Bull 2023; 49:1518-1529. [PMID: 36869812 PMCID: PMC10686342 DOI: 10.1093/schbul/sbac216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND AND HYPOTHESIS Neurocognitive and social cognitive abilities are important contributors to functional outcomes in schizophrenia spectrum disorders (SSDs). An unanswered question of considerable interest is whether neurocognitive and social cognitive deficits arise from overlapping or distinct white matter impairment(s). STUDY DESIGN We sought to fill this gap, by harnessing a large sample of individuals from the multi-center Social Processes Initiative in the Neurobiology of the Schizophrenia(s) (SPINS) dataset, unique in its collection of advanced diffusion imaging and an extensive battery of cognitive assessments. We applied canonical correlation analysis to estimates of white matter microstructure, and cognitive performance, across people with and without an SSD. STUDY RESULTS Our results established that white matter circuitry is dimensionally and strongly related to both neurocognition and social cognition, and that microstructure of the uncinate fasciculus and the rostral body of the corpus callosum may assume a "privileged role" subserving both. Further, we found that participant-wise estimates of white matter microstructure, weighted by cognitive performance, were largely consistent with participants' categorical diagnosis, and predictive of (cross-sectional) functional outcomes. CONCLUSIONS The demonstrated strength of the relationship between white matter circuitry and neurocognition and social cognition underscores the potential for using relationships among these variables to identify biomarkers of functioning, with potential prognostic and therapeutic implications.
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Affiliation(s)
- Navona Calarco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Michael Joseph
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pamela DeRosse
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Miklos Argyelan
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, Division of Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Robert W Buchanan
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Gold JM, Corlett PR, Erickson M, Waltz JA, August S, Dutterer J, Bansal S. Phenomenological and Cognitive Features Associated With Auditory Hallucinations in Clinical and Nonclinical Voice Hearers. Schizophr Bull 2023; 49:1591-1601. [PMID: 37350507 PMCID: PMC10686332 DOI: 10.1093/schbul/sbad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND HYPOTHESES Auditory verbal hallucinations (AVH) are central features of schizophrenia (SZ). However, AVH also occur in a small percentage of the general population who do not have a need for care, termed nonclinical voice hearers (NCVH). We sought to determine the degree to which the experience of AVH was similar in NCVH and in people with schizophrenia (PSZ) and evaluate the degree to which NCVH shared other features of SZ such as delusional beliefs, cognitive impairment, and negative symptoms. STUDY DESIGN We recruited 76 people with a DSM-V diagnosis of SZ/schizoaffective disorder (PSZ; 49 with current AVH, 27 without), 48 NCVH, and 51 healthy controls. Participants received a broad battery of clinician-administered and self-report symptom assessments and a focused cognitive assessment. STUDY RESULTS The AVH of NCVH and PSZ shared very similar sensory features. NCVH experienced less distress, had greater control over their AVH, and, unlike PSZ, rarely heard 2 voices speaking to each other. NCVH demonstrated a wide range of deeply held unusual beliefs, but reported less paranoia, and fewer first-rank symptoms such as passivity and alterations in self-experience. NCVH showed no evidence of cognitive deficits or negative symptoms. CONCLUSIONS The AVH in NCVH and PSZ demonstrate important similarities as well as clear differences. Specific features, rather than the presence, of AVH appear to determine the need for care. NCVH do not share the cognitive and motivational deficits seen in PSZ. These results suggest that AVH and unusual beliefs can be separated from the broader phenotype of SZ.
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT and Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Molly Erickson
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sharon August
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jenna Dutterer
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
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Dalloul N, Moran EK, Gold JM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Luck SJ, Barch DM. Transdiagnostic Predictors of Everyday Functioning: Examining the Relationships of Depression and Reinforcement Learning. Schizophr Bull 2023; 49:1281-1293. [PMID: 37382553 PMCID: PMC10483466 DOI: 10.1093/schbul/sbad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND AND HYPOTHESIS Impairments in function (ie, the ability to independently accomplish daily tasks) have been established in psychotic disorders. Identifying factors that contribute to these deficits is essential to developing effective interventions. The current study had several goals: examine potential differential relationships across domains of neurocognition, assess whether reinforcement learning is related to function, identify if predictors of function are transdiagnostic, determine whether depression and positive symptoms contribute to function, and to explore whether the modality of assessment impacts observed relationships. STUDY DESIGN Data from 274 participants were examined with schizophrenia/schizoaffective disorder (SZ; n = 195) and bipolar disorder (BD; n = 79). To reduce dimensionality, a PCA was completed on neurocognitive tasks which resulted in 3 components. These components and clinical interview data were used to investigate predictors of functional domains across measures of function (self- and informant-report SLOF and UPSA). RESULTS Two components, working memory/processing speed/episodic memory (βs = 0.18-0.42), and negative/positive reinforcement learning (β = -0.04), predicted different functional domains. Predictors of function were largely transdiagnostic with two exceptions: reinforcement learning had a positive association with self-reported interpersonal relationships for SZ and a negative association for BD (β = 0.34), and the negative association between positive symptoms and self-reported social acceptability was stronger for BD than for SZ (β = 0.93). Depression robustly predicted self-reported but not informant-reported function, and anhedonia predicted all domains of informant-reported function. CONCLUSIONS These findings imply that reinforcement learning may differentially relate to function across disorders, traditional domains of neurocognition can be effective transdiagnostic targets for interventions, and positive symptoms and depression play a critical role in self-perceived functional impairments.
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Affiliation(s)
- Nada Dalloul
- Department of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
| | - Erin K Moran
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, MD, USA
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, CA, USA
| | - Angus W MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - J Daniel Ragland
- Department of Psychiatry, University of California, Davis, CA, USA
| | | | - Steven J Luck
- Department of Psychology, University of California, Davis, CA, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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Dutterer J, Bansal S, Robinson B, Gold JM. Sustained attention deficits in schizophrenia: Effect of memory load on the Identical Pairs Continuous Performance Test. Schizophr Res Cogn 2023; 33:100288. [PMID: 37273835 PMCID: PMC10239014 DOI: 10.1016/j.scog.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/06/2023]
Abstract
Background Sustained attention and vigilance impairments are well documented in people with schizophrenia (PSZ). The processes implicated in this impairment remain unclear. Here we investigated whether vigilance performance varied as a function of working memory load, and also examined the role of attentional lapsing that might arise from a loss of task set resulting in mind wandering. Method We examined Continuous Performance Test Identical Pairs (CPT-IP) data from a cumulative sample of 247 (PSZ) and 238 healthy control (HC) participants collected over a series of studies. Results PSZ performed more poorly that HC across conditions with signal/noise discrimination (d') decreasing with increasing working memory load across both groups However, there was a significant interaction of group and load suggesting that performance of PSZ was more negatively impacted by increasing load. We also found that PSZ has a significantly higher rate of attention lapsing than did HC. Discussion Our results suggest that difficulties maintaining task set and working memory limitations are implicated in the impairments observed on the Identical Pairs CPT. Difficulties with task set maintenance appear to explain the majority of between-group variance, with a more subtle impact of increasing working memory load.
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Affiliation(s)
- Jenna Dutterer
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, USA
| | - Sonia Bansal
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, USA
| | - Benjamin Robinson
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, USA
| | - James M. Gold
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, USA
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Williams TF, Walker EF, Strauss GP, Woods SW, Powers AR, Corlett PR, Schiffman J, Waltz JA, Gold JM, Silverstein SM, Ellman LM, Zinbarg RE, Mittal VA. The reliability and validity of the revised Green et al. paranoid thoughts scale in individuals at clinical high-risk for psychosis. Acta Psychiatr Scand 2023; 147:623-633. [PMID: 36905387 PMCID: PMC10463775 DOI: 10.1111/acps.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/27/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Paranoia is a common and impairing psychosis symptom, which exists along a severity continuum that extends into the general population. Individuals at clinical high-risk for psychosis (CHR) frequently experience paranoia and this may elevate their risk for developing full psychosis. Nonetheless, limited work has examined the efficient measurement of paranoia in CHR individuals. The present study aimed to validate an often-used self-report measure, the revised green paranoid thoughts scale (RGPTS), in this critical population. METHOD Participants were CHR individuals (n = 103), mixed clinical controls (n = 80), and healthy controls (n = 71) who completed self-report and interview measures. Confirmatory factor analysis (CFA), psychometric indices, group differences, and relations to external measures were used to evaluate the reliability and validity of the RGPTS. RESULTS CFA replicated a two-factor structure for the RGPTS and the associated reference and persecution scales were reliable. CHR individuals scored significantly higher on both reference and persecution, relative to both healthy (ds = 1.03, 0.86) and clinical controls (ds = 0.64, 0.73). In CHR participants, correlations between reference and persecution and external measures were smaller than expected, though showed evidence of discriminant validity (e.g., interviewer-rated paranoia, r = 0.24). When examined in the full sample, correlation magnitude was larger and follow-up analyses indicated that reference related most specifically to paranoia (β = 0.32), whereas persecution uniquely related to poor social functioning (β = -0.29). CONCLUSION These results demonstrate the reliability and validity of the RGPTS, though its scales related more weakly to severity in CHR individuals. The RGPTS may be useful in future work aiming to develop symptom-specific models of emerging paranoia in CHR individuals.
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Affiliation(s)
- Trevor F. Williams
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Elaine F. Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA, 30322, USA
| | - Gregory P. Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA, 30602, USA
| | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Philip R. Corlett
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Jason Schiffman
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, CA, 92697, USA
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21228, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21228, USA
| | - Steven M. Silverstein
- Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Lauren M. Ellman
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, 19122, USA
| | - Richard E. Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Vijay A. Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL, 60208, USA
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10
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Karp EL, Williams TF, Ellman LM, Strauss GP, Walker EF, Corlett PR, Woods SW, Powers AR, Gold JM, Schiffman JE, Waltz JA, Silverstein SM, Mittal VA. Self-reported Gesture Interpretation and Performance Deficits in Individuals at Clinical High Risk for Psychosis. Schizophr Bull 2023; 49:746-755. [PMID: 36939086 PMCID: PMC10154698 DOI: 10.1093/schbul/sbac197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND AND HYPOTHESIS Deficits in performing and interpreting communicative nonverbal behaviors, such as gesture, have been linked to varied psychopathology and dysfunction. Some evidence suggests that individuals at risk for psychosis have deficits in gesture interpretation and performance; however, individuals with internalizing disorders (eg, depression) may have similar deficits. No previous studies have examined whether gesture deficits in performance and interpretation are specific to those at risk for psychosis. Additionally, the underlying mechanisms (eg, cognition) and consequences (eg, functioning) of these deficits are poorly understood. STUDY DESIGN This study examined self-reported gesture interpretation (SRGI) and performance (SRGP) in those at clinical high risk for psychosis (CHR; N = 88), those with internalizing disorders (INT; N = 51), and healthy controls (HC; N = 53). Participants completed questionnaires, clinical interviews, and neurocognitive tasks. STUDY RESULTS Results indicated that the CHR group was characterized by significantly lower SRGI scores than the HC or INT groups (d = 0.41); there were no differences among groups in SRGP. Within CHR participants, greater deficits in SRGP were associated with lower verbal learning and memory (r = -.33), but not general intelligence or processing speed. Furthermore, gesture deficits were associated with higher cross-sectional risk for conversion to a full psychotic disorder in the CHR group. CONCLUSIONS Overall, these findings suggest that specific subdomains of gesture may reflect unique vulnerability for psychosis, self-report may be a viable assessment tool in understanding these phenomena, and gesture dysfunction may signal risk for transition to psychosis.
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Affiliation(s)
- Erica L Karp
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Trevor F Williams
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Gregory P Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA 30602, USA
| | - Elaine F Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA 30322, USA
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Jason E Schiffman
- Department of Psychological Science, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA 92697, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Steven M Silverstein
- Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Vijay A Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL 60208, USA
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11
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Corlett PR, Bansal S, Gold JM. Studying Healthy Psychosislike Experiences to Improve Illness Prediction. JAMA Psychiatry 2023; 80:515-517. [PMID: 36884241 PMCID: PMC10848166 DOI: 10.1001/jamapsychiatry.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Importance Distinguishing delusions and hallucinations from unusual beliefs and experiences has proven challenging. Observations The advent of neural network and generative modeling approaches to big data offers a challenge and an opportunity; healthy individuals with unusual beliefs and experiences who are not ill may raise false alarms and serve as adversarial examples to such networks. Conclusions and Relevance Explicitly training predictive models with adversarial examples should provide clearer focus on the features most relevant to casehood, which will empower clinical research and ultimately diagnosis and treatment.
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Affiliation(s)
- Philip R. Corlett
- Yale University, Department of Psychiatry, New Haven, CT, 06511
- Wu Tsai Institute, Yale University, New Haven, CT, 06511
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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12
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Bansal S, Bae GY, Robinson BM, Dutterer J, Hahn B, Luck SJ, Gold JM. Qualitatively different delay-dependent working memory distortions in people with schizophrenia and healthy control subjects. bioRxiv 2023:2023.04.04.535597. [PMID: 37066149 PMCID: PMC10104073 DOI: 10.1101/2023.04.04.535597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Impairments in working memory(WM) have been well-documented in people with schizophrenia(PSZ). However, these quantitative WM impairments can often be explained by nonspecific factors, such as impaired goal maintenance. Here, we used a spatial orientation delayed-response task to explore a qualitative difference in WM dynamics between PSZ and healthy control subjects(HCS). Specifically, we took advantage of the discovery that WM representations may drift either toward or away from previous-trial targets(serial dependence). We tested the hypothesis that WM representations drift toward the previous-trial target in HCS but away from the previous-trial target in PSZ. Methods We assessed serial dependence in PSZ(N=31) and HCS(N=25), using orientation as the to-be-remembered feature and memory delays from 0 to 8s. Participants were asked to remember the orientation of a teardrop-shaped object and reproduce the orientation after a varying delay period. Results Consistent with prior studies, we found that current-trial memory representations were less precise in PSZ than in HCS. We also found that WM for the current-trial orientation drifted toward the previous-trial orientation in HCS(representational attraction) but drifted away from the previous-trial orientation in PSZ(representational repulsion). Conclusions These results demonstrate a qualitative difference in WM dynamics between PSZ and HCS that cannot easily be explained by nuisance factors such as reduced effort. Most computational neuroscience models also fail to explain these results, because they maintain information solely by means of sustained neural firing, which does not extend across trials. The results suggest a fundamental difference between PSZ and HCS in longer-term memory mechanisms that persist across trials, such as short-term potentiation and neuronal adaptation.
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gi-Yeul Bae
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Benjamin M Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jenna Dutterer
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis, Davis, California
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
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13
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Fleming LM, Lemonde AC, Benrimoh D, Gold JM, Taylor JR, Malla A, Joober R, Iyer SN, Lepage M, Shah J, Corlett PR. Using dimensionality-reduction techniques to understand the organization of psychotic symptoms in persistent psychotic illness and first episode psychosis. Sci Rep 2023; 13:4841. [PMID: 36964175 PMCID: PMC10039017 DOI: 10.1038/s41598-023-31909-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/17/2023] [Indexed: 03/26/2023] Open
Abstract
Psychotic disorders are highly heterogeneous. Understanding relationships between symptoms will be relevant to their underlying pathophysiology. We apply dimensionality-reduction methods across two unique samples to characterize the patterns of symptom organization. We analyzed publicly-available data from 153 participants diagnosed with schizophrenia or schizoaffective disorder (fBIRN Data Repository and the Consortium for Neuropsychiatric Phenomics), as well as 636 first-episode psychosis (FEP) participants from the Prevention and Early Intervention Program for Psychosis (PEPP-Montreal). In all participants, the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) were collected. Multidimensional scaling (MDS) combined with cluster analysis was applied to SAPS and SANS scores across these two groups of participants. MDS revealed relationships between items of SAPS and SANS. Our application of cluster analysis to these results identified: 1 cluster of disorganization symptoms, 2 clusters of hallucinations/delusions, and 2 SANS clusters (asocial and apathy, speech and affect). Those reality distortion items which were furthest from auditory hallucinations had very weak to no relationship with hallucination severity. Despite being at an earlier stage of illness, symptoms in FEP presentations were similarly organized. While hallucinations and delusions commonly co-occur, we found that their specific themes and content sometimes travel together and sometimes do not. This has important implications, not only for treatment, but also for research-particularly efforts to understand the neurocomputational and pathophysiological mechanism underlying delusions and hallucinations.
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Affiliation(s)
- Leah M Fleming
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Interdepartmental Neuroscience Department, Yale University, New Haven, CT, USA
| | | | - David Benrimoh
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jane R Taylor
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Ashok Malla
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
- The Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Qubec, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
- The Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Qubec, Canada
| | - Srividya N Iyer
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
- The Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Qubec, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
- The Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Qubec, Canada
| | - Jai Shah
- Department of Psychiatry, McGill University Montreal, Qubec, Canada
- The Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Qubec, Canada
| | - Philip R Corlett
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Department of Psychology, Yale University, New Haven, CT, USA.
- Wu Tsai Institute, Yale University, New Haven, CT, USA.
- Connecticut Mental Health Center, 34 Park St, New Haven, CT, 06519, USA.
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14
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Culbreth AJ, Schwartz EK, Frank MJ, Brown EC, Xu Z, Chen S, Gold JM, Waltz JA. A computational neuroimaging study of reinforcement learning and goal-directed exploration in schizophrenia spectrum disorders. Psychol Med 2023; 53:1-11. [PMID: 36752156 DOI: 10.1017/s0033291722003993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Prior evidence indicates that negative symptom severity and cognitive deficits, in people with schizophrenia (PSZ), relate to measures of reward-seeking and loss-avoidance behavior (implicating the ventral striatum/VS), as well as uncertainty-driven exploration (reliant on rostrolateral prefrontal cortex/rlPFC). While neural correlates of reward-seeking and loss-avoidance have been examined in PSZ, neural correlates of uncertainty-driven exploration have not. Understanding neural correlates of uncertainty-driven exploration is an important next step that could reveal insights to how this mechanism of cognitive and negative symptoms manifest at a neural level. METHODS We acquired fMRI data from 29 PSZ and 36 controls performing the Temporal Utility Integration decision-making task. Computational analyses estimated parameters corresponding to learning rates for both positive and negative reward prediction errors (RPEs) and the degree to which participates relied on representations of relative uncertainty. Trial-wise estimates of expected value, certainty, and RPEs were generated to model fMRI data. RESULTS Behaviorally, PSZ demonstrated reduced reward-seeking behavior compared to controls, and negative symptoms were positively correlated with loss-avoidance behavior. This finding of a bias toward loss avoidance learning in PSZ is consistent with previous work. Surprisingly, neither behavioral measures of exploration nor neural correlates of uncertainty in the rlPFC differed significantly between groups. However, we showed that trial-wise estimates of relative uncertainty in the rlPFC distinguished participants who engaged in exploratory behavior from those who did not. rlPFC activation was positively associated with intellectual function. CONCLUSIONS These results further elucidate the nature of reinforcement learning and decision-making in PSZ and healthy volunteers.
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Affiliation(s)
- A J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center (MPRC), University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M J Frank
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
- Department of Psychiatry and Brown Institute for Brain Science, Brown University, Providence, RI, USA
| | - E C Brown
- School of Health and Care Management, Arden University, Berlin, Germany
| | - Z Xu
- Applied LifeSciences & Systems, Morrisville, NC, USA
| | - S Chen
- Department of Psychiatry, Maryland Psychiatric Research Center (MPRC), University of Maryland School of Medicine, Baltimore, MD, USA
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center (MPRC), University of Maryland School of Medicine, Baltimore, MD, USA
| | - J A Waltz
- Department of Psychiatry, Maryland Psychiatric Research Center (MPRC), University of Maryland School of Medicine, Baltimore, MD, USA
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15
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Pratt DN, Luther L, Kinney KS, Osborne KJ, Corlett PR, Powers AR, Woods SW, Gold JM, Schiffman J, Ellman LM, Strauss GP, Walker EF, Zinbarg R, Waltz JA, Silverstein SM, Mittal VA. Comparing a Computerized Digit Symbol Test to a Pen-and-Paper Classic. Schizophr Bull Open 2023; 4:sgad027. [PMID: 37868160 PMCID: PMC10590153 DOI: 10.1093/schizbullopen/sgad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Background and Hypothesis Processing speed dysfunction is a core feature of psychosis and predictive of conversion in individuals at clinical high risk (CHR) for psychosis. Although traditionally measured with pen-and-paper tasks, computerized digit symbol tasks are needed to meet the increasing demand for remote assessments. Therefore we: (1) assessed the relationship between traditional and computerized processing speed measurements; (2) compared effect sizes of impairment for progressive and persistent subgroups of CHR individuals on these tasks; and (3) explored causes contributing to task performance differences. Study Design Participants included 92 CHR individuals and 60 healthy controls who completed clinical interviews, the Brief Assessment of Cognition in Schizophrenia Symbol Coding test, the computerized TestMyBrain Digit Symbol Matching Test, a finger-tapping task, and a self-reported motor abilities measure. Correlations, Hedges' g, and linear models were utilized, respectively, to achieve the above aims. Study Results Task performance was strongly correlated (r = 0.505). A similar degree of impairment was seen between progressive (g = -0.541) and persistent (g = -0.417) groups on the paper version. The computerized task uniquely identified impairment for progressive individuals (g = -477), as the persistent group performed similarly to controls (g = -0.184). Motor abilities were related to the computerized version, but the paper version was more related to symptoms and psychosis risk level. Conclusions The paper symbol coding task measures impairment throughout the CHR state, while the computerized version only identifies impairment in those with worsening symptomatology. These results may be reflective of sensitivity differences, an artifact of existing subgroups, or evidence of mechanistic differences.
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Affiliation(s)
- Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Kyle S Kinney
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | | | | | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Lauren M Ellman
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, Athens, GA, USA
- Department of Neuroscience, University of Georgia, Athens, GA, USA
| | - Elaine F Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA, USA
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - James A Waltz
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven M Silverstein
- Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL, USA
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16
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Erickson MA, Lopez-Calderon J, Robinson B, Gold JM, Luck SJ. Gamma-band entrainment abnormalities in schizophrenia: Modality-specific or cortex-wide impairment? J Psychopathol Clin Sci 2022; 131:895-905. [PMID: 36326630 PMCID: PMC9641553 DOI: 10.1037/abn0000778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A growing body of literature suggests that cognitive impairment in people with schizophrenia (PSZ) results from disrupted cortical excitatory/inhibitory (E-I) balance, which may be linked to gamma entrainment and can be measured noninvasively using electroencephalography (EEG). However, it is not yet known the degree to which these entrainment abnormalities covary within subjects across sensory modalities. Furthermore, the degree to which cross-modal gamma entrainment reflects variation in biological processes associated with cognitive performance remains unclear. We used EEG to measure entrainment to repetitive auditory and visual stimulation at beta (20 Hz) and gamma (30 and 40 Hz) frequencies in PSZ (n = 78) and healthy control subjects (HCS; n = 80). Three indices were measured for each frequency and modality: event-related spectral perturbation (ERSP), intertrial coherence (ITC), and phase-lag angle (PLA). Cognition and symptom severity were also assessed. We found little evidence that gamma entrainment covaried across sensory modalities. PSZ exhibited a modest correlation between modalities at 40 Hz for ERSP and ITC measures (r = 0.23-0.24); however, no other significant correlations between modalities emerged for either HCS or PSZ. Both univariate and multivariate analyses revealed that (a) the pattern of entrainment abnormalities in PSZ differed across modalities, and (b) modality rather than frequency band was the main source of variance. Finally, we observed a significant association between cognition and gamma entrainment in the auditory domain only in HCS. Gamma-band EEG entrainment does not reflect a unitary transcortical mechanism but is instead modality specific. To the extent that entrainment reflects the integrity of cortical E-I balance, the deficits observed in PSZ appear to be modality specific and not consistently associated with cognitive impairment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Molly A. Erickson
- University of Chicago Department of Psychiatry & Behavioral Neuroscience
| | | | - Ben Robinson
- Maryland Psychiatric Research Center, University of Maryland
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
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17
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Geana A, Barch DM, Gold JM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Frank MJ. Using Computational Modeling to Capture Schizophrenia-Specific Reinforcement Learning Differences and Their Implications on Patient Classification. Biol Psychiatry Cogn Neurosci Neuroimaging 2022; 7:1035-1046. [PMID: 33878489 PMCID: PMC9272137 DOI: 10.1016/j.bpsc.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychiatric diagnosis and treatment have historically taken a symptom-based approach, with less attention on identifying underlying symptom-producing mechanisms. Recent efforts have illuminated the extent to which different underlying circuitry can produce phenotypically similar symptomatology (e.g., psychosis in bipolar disorder vs. schizophrenia). Computational modeling makes it possible to identify and mathematically differentiate behaviorally unobservable, specific reinforcement learning differences in patients with schizophrenia versus other disorders, likely owing to a higher reliance on prediction error-driven learning associated with basal ganglia and underreliance on explicit value representations associated with orbitofrontal cortex. METHODS We used a well-established probabilistic reinforcement learning task to replicate those findings in individuals with schizophrenia both on (n = 120) and off (n = 44) antipsychotic medications and included a patient comparison group of bipolar patients with psychosis (n = 60) and healthy control subjects (n = 72). RESULTS Using accuracy, there was a main effect of group (F3,279 = 7.87, p < .001), such that all patient groups were less accurate than control subjects. Using computationally derived parameters, both medicated and unmediated individuals with schizophrenia, but not patients with bipolar disorder, demonstrated a reduced mixing parameter (F3,295 = 13.91, p < .001), indicating less dependence on learning explicit value representations as well as greater learning decay between training and test (F1,289 = 12.81, p < .001). Unmedicated patients with schizophrenia also showed greater decision noise (F3,295 = 2.67, p = .04). CONCLUSIONS Both medicated and unmedicated patients showed overreliance on prediction error-driven learning as well as significantly higher noise and value-related memory decay, compared with the healthy control subjects and the patients with bipolar disorder. Additionally, the computational model parameters capturing these processes can significantly improve patient/control classification, potentially providing useful diagnosis insight.
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Affiliation(s)
- Andra Geana
- Department of Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island.
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri; Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, Maryland
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, California
| | - Angus W MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - J Daniel Ragland
- Department of Psychiatry, University of California, Davis, California
| | | | - Michael J Frank
- Department of Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island
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Barch DM, Boudewyn MA, Carter CC, Erickson M, Frank MJ, Gold JM, Luck SJ, MacDonald AW, Ragland JD, Ranganath C, Silverstein SM, Yonelinas A. Cognitive [Computational] Neuroscience Test Reliability and Clinical Applications for Serious Mental Illness (CNTRaCS) Consortium: Progress and Future Directions. Curr Top Behav Neurosci 2022; 63:19-60. [PMID: 36173600 DOI: 10.1007/7854_2022_391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The development of treatments for impaired cognition in schizophrenia has been characterized as the most important challenge facing psychiatry at the beginning of the twenty-first century. The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) project was designed to build on the potential benefits of using tasks and tools from cognitive neuroscience to better understanding and treat cognitive impairments in psychosis. These benefits include: (1) the use of fine-grained tasks that measure discrete cognitive processes; (2) the ability to design tasks that distinguish between specific cognitive domain deficits and poor performance due to generalized deficits resulting from sedation, low motivation, poor test taking skills, etc.; and (3) the ability to link cognitive deficits to specific neural systems, using animal models, neuropsychology, and functional imaging. CNTRICS convened a series of meetings to identify paradigms from cognitive neuroscience that maximize these benefits and identified the steps need for translation into use in clinical populations. The Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRaCS) Consortium was developed to help carry out these steps. CNTRaCS consists of investigators at five different sites across the country with diverse expertise relevant to a wide range of the cognitive systems identified as critical as part of CNTRICs. This work reports on the progress and current directions in the evaluation and optimization carried out by CNTRaCS of the tasks identified as part of the original CNTRICs process, as well as subsequent extensions into the Positive Valence systems domain of Research Domain Criteria (RDoC). We also describe the current focus of CNTRaCS, which involves taking a computational psychiatry approach to measuring cognitive and motivational function across the spectrum of psychosis. Specifically, the current iteration of CNTRaCS is using computational modeling to isolate parameters reflecting potentially more specific cognitive and visual processes that may provide greater interpretability in understanding shared and distinct impairments across psychiatric disorders.
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Affiliation(s)
- Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
| | | | | | | | | | - James M Gold
- Maryland Psychiatric Research Center, Baltimore, MD, USA
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Millman ZB, Roemer C, Vargas T, Schiffman J, Mittal VA, Gold JM. Neuropsychological Performance Among Individuals at Clinical High-Risk for Psychosis vs Putatively Low-Risk Peers With Other Psychopathology: A Systematic Review and Meta-Analysis. Schizophr Bull 2022; 48:999-1010. [PMID: 35333372 PMCID: PMC9434467 DOI: 10.1093/schbul/sbac031] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND HYPOTHESIS Youth at clinical high-risk (CHR) for psychosis present with neuropsychological impairments relative to healthy controls (HC), but whether these impairments are distinguishable from those seen among putatively lower risk peers with other psychopathology remains unknown. We hypothesized that any excess impairment among CHR cohorts beyond that seen in other clinical groups is minimal and accounted for by the proportion who transition to psychosis (CHR-T). STUDY DESIGN We performed a systematic review and meta-analysis of studies comparing cognitive performance among CHR youth to clinical comparators (CC) who either sought mental health services but did not meet CHR criteria or presented with verified nonpsychotic psychopathology. STUDY RESULTS Twenty-one studies were included representing nearly 4000 participants. Individuals at CHR showed substantial cognitive impairments relative to HC (eg, global cognition: g = -0.48 [-0.60, -0.34]), but minimal impairments relative to CC (eg, global cognition: g = -0.13 [-0.20, -0.06]). Any excess impairment among CHR was almost entirely attributable to CHR-T; impairment among youth at CHR without transition (CHR-NT) was typically indistinguishable from CC (eg, global cognition, CHR-T: g = -0.42 [-0.64, -0.19], CHR-NT: g = -0.09 [-0.18, 0.00]; processing speed, CHR-T: g = -0.59 [-0.82, -0.37], CHR-NT: g = -0.12 [-0.25, 0.07]; working memory, CHR-T: g = -0.42 [-0.62, -0.22], CHR-NT: g = -0.03 [-0.14, 0.08]). CONCLUSIONS Neurocognitive impairment in CHR cohorts should be interpreted cautiously when psychosis or even CHR status is the specific clinical syndrome of interest as these impairments most likely represent a transdiagnostic vs psychosis-specific vulnerability.
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Affiliation(s)
- Zachary B Millman
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Caroline Roemer
- Psychology Department, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
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20
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Gold JM, Luck SJ. Working Memory in People with Schizophrenia. Curr Top Behav Neurosci 2022; 63:137-152. [PMID: 35915383 DOI: 10.1007/7854_2022_381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Working memory (WM) refers to the ability to maintain a small number of representations in an activated, easily accessible state for a short period of time in the service of ongoing cognitive processing and behavior. Because WM is a resource critical for multiple forms of complex cognition and executive control of behavior, it is of central interest in the study of disorders such as schizophrenia that involve a broad compromise of cognitive function and in the regulation of goal-directed behavior. There is now robust evidence that WM impairment is characteristic of people with schizophrenia. The impairment includes both elementary storage capacity as well as more complex forms of WM that involve the manipulation and updating of WM representations. These impairments appear to underlie a substantial portion of the generalized cognitive deficit in schizophrenia. Neuroimaging studies have implicated widespread abnormalities in the broad neural system that subserves WM performance, consistent with the evidence of broad cognitive impairment seen in PSZ.
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis, CA, USA
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21
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Catalano LT, Wynn JK, Green MF, Gold JM. Reduced neural activity when anticipating social versus nonsocial rewards in schizophrenia: Preliminary evidence from an ERP study. Schizophr Res 2022; 246:7-16. [PMID: 35696860 DOI: 10.1016/j.schres.2022.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/09/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022]
Abstract
Diminished social motivation is a core feature of schizophrenia that might reflect disturbances in social reward processing. It is not known whether these disturbances reflect anticipatory ("wanting") and/or consummatory ("liking") pleasure deficits. The primary aim of this study was to examine social versus nonsocial reward processing during these temporally distinct substages using event-related potential (ERP) components. Twenty-three schizophrenia participants and 20 healthy participants completed an incentive delay task with social (i.e., smiling expressions) and nonsocial (i.e., money) rewards. We measured two anticipatory ERPs (i.e., "wanting") (target anticipation: Contingent Negative Variation [CNV]; feedback anticipation: Stimulus Preceding Negativity [SPN]) and one consummatory ERP (i.e., "liking") (feedback receipt: P300). As a secondary aim, we examined correlations between the ERPs and interview-rated motivational negative symptoms and social functioning. Schizophrenia participants showed overall less target anticipation (blunted CNV) across all trials (social and nonsocial) than healthy participants. Importantly, schizophrenia participants exhibited less anticipation of social rewards relative to nonsocial rewards (SPN), whereas healthy participants showed similar anticipation for both reward types. Both groups showed similar responses to social and nonsocial reward receipt (P300). Furthermore, social reward anticipation during the incentive delay task was associated with more social approach behaviors in the real-world. Together, these findings provide preliminary evidence for intact social reward "liking" and impaired "wanting" in schizophrenia.
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
| | - Jonathan K Wynn
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - James M Gold
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
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22
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Abstract
Attention is clearly a core area of cognitive dysfunction in schizophrenia, but the concept of "attention" is complex and multifaceted. This chapter focuses on three different aspects of attentional function that are of particular interest in schizophrenia. First, we discuss the evidence that schizophrenia involves a reduction in global alertness, leading to an inward focusing of attention and a neglect of external stimuli and tasks. Second, we discuss the control of attention, the set of processes that allow general goals to be translated into shifts of attention toward task-relevant information. When a goal is adequately represented, people with schizophrenia often show no deficit in using the goal to direct attention in the visual modality unless challenged by stimuli that strongly activate the magnocellular processing pathway. Finally, we discuss the implementation of selection, the processes that boost relevant information and suppress distractors once attention has been directed to a given source of information. Although early evidence indicated an impairment in selection, more recent evidence indicating that people with schizophrenia actually focus their attention more narrowly and more intensely that healthy individuals (hyperfocusing). However, this hyperfocused attention may be directed toward goal-irrelevant information, creating the appearance of impaired attentional filtering.
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Affiliation(s)
- Steven J Luck
- Department of Psychology, Center for Mind and Brain, University of California, Davis, CA, USA.
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
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23
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Williams TF, Powers AR, Ellman LM, Corlett PR, Strauss GP, Schiffman J, Waltz JA, Silverstein SM, Woods SW, Walker EF, Gold JM, Mittal VA. Three prominent self-report risk measures show unique and overlapping utility in characterizing those at clinical high-risk for psychosis. Schizophr Res 2022; 244:58-65. [PMID: 35597134 PMCID: PMC9829103 DOI: 10.1016/j.schres.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/07/2022] [Accepted: 05/10/2022] [Indexed: 01/12/2023]
Abstract
Self-report questionnaires have been developed to efficiently assess psychosis risk and vulnerability. Despite this, the validity of these questionnaires for assessing specific positive symptoms in those at clinical high risk for psychosis (CHR) is unclear. Positive symptoms have largely been treated as a uniform construct in this critical population and there have been no reports on the construct validity of questionnaires for assessing specific symptoms. The present study examined the convergent, discriminant, and criterion validity of the Launay Slade Hallucination Scale-Revised (LSHS-R), Prodromal Questionnaire-Brief (PQB), and Community Assessment of Psychic Experiences positive scale (CAPE-P) using a multimethod approach. CHR individuals (N = 71) and healthy controls (HC; N = 71) completed structured clinical interviews, self-report questionnaires, and neuropsychological tests. Questionnaire intercorrelations indicated strong convergent validity (i.e., all rs > .50); however, evidence for discriminant validity was more variable. In examining relations to interviewer-assessed psychosis symptoms, all questionnaires demonstrated evidence of criterion validity, though the PQB showed the strongest convergent correlations (e.g., r = .48 with total symptoms). In terms of discriminant validity for specific positive symptoms, results were again more variable. PQB subscales demonstrated limited specificity with positive symptoms, whereas CAPE-P subscales showed some specificity and the LSHS-R showed high specificity. In addition, when correlations with internalizing and externalizing symptoms were examined, only the PQB showed consistent significant correlations. These results are interpreted in terms of the strengths and limitations of each measure, their value for screening, and their potential utility for clarifying differences between specific positive symptoms.
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Affiliation(s)
- Trevor F Williams
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA.
| | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Gregory P Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA, 30602, USA
| | - Jason Schiffman
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, CA 92697, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Steven M Silverstein
- Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Elaine F Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA 30322, USA
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Vijay A Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL 60208, USA
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24
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Spilka MJ, Keller WR, Buchanan RW, Gold JM, Koenig JI, Strauss GP. Endogenous oxytocin levels are associated with facial emotion recognition accuracy but not gaze behavior in individuals with schizophrenia. Acta Psychiatr Scand 2022; 145:494-506. [PMID: 35243618 PMCID: PMC9007857 DOI: 10.1111/acps.13421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/26/2022] [Accepted: 02/26/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Difficulties in social cognition are common in individuals with schizophrenia (SZ) and are not ameliorated by antipsychotic treatment. Intranasal oxytocin (OT) administration has been explored as a potential intervention to improve social cognition; however, results are inconsistent, suggesting potential individual difference variables that may influence treatment response. Less is known about the relationship between endogenous OT and social cognition in SZ, knowledge of which may improve the development of OT-focused therapies. We examined plasma OT in relationship to facial emotion recognition and visual attention to salient facial features in SZ and controls. METHODS Forty-two individuals with SZ and 23 healthy controls viewed photographs of facial expressions of varying emotional intensity and identified the emotional expression displayed. Participants' gaze behavior during the task was recorded via eye tracking. Plasma oxytocin concentrations were determined by radioimmunoassay. RESULTS SZ were less accurate than controls at identifying high-intensity fearful facial expressions and low-intensity sad expressions. Lower overall and high-intensity facial emotion recognition accuracy was associated with lower plasma OT levels in SZ but not controls. OT was not associated with visual attention to salient facial features; however, SZ had reduced visual attention to the nose region compared to controls. CONCLUSION Individual differences in endogenous OT predict facial emotion recognition ability in SZ but are not associated with visual attention to salient facial features. Increased understanding of the association between endogenous OT and social cognitive abilities in SZ may help improve the design and interpretation of OT-focused clinical trials in SZ.
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Affiliation(s)
| | - William R. Keller
- Dartmouth College, Geisel School of Medicine, Department of Psychiatry, USA
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, USA
| | - James I. Koenig
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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25
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Moran EK, Gold JM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Luck SJ, Barch DM. Both unmedicated and medicated individuals with schizophrenia show impairments across a wide array of cognitive and reinforcement learning tasks. Psychol Med 2022; 52:1115-1125. [PMID: 32799938 PMCID: PMC8095353 DOI: 10.1017/s003329172000286x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Schizophrenia is a disorder characterized by pervasive deficits in cognitive functioning. However, few well-powered studies have examined the degree to which cognitive performance is impaired even among individuals with schizophrenia not currently on antipsychotic medications using a wide range of cognitive and reinforcement learning measures derived from cognitive neuroscience. Such research is particularly needed in the domain of reinforcement learning, given the central role of dopamine in reinforcement learning, and the potential impact of antipsychotic medications on dopamine function. METHODS The present study sought to fill this gap by examining healthy controls (N = 75), unmedicated (N = 48) and medicated (N = 148) individuals with schizophrenia. Participants were recruited across five sites as part of the CNTRaCS Consortium to complete tasks assessing processing speed, cognitive control, working memory, verbal learning, relational encoding and retrieval, visual integration and reinforcement learning. RESULTS Individuals with schizophrenia who were not taking antipsychotic medications, as well as those taking antipsychotic medications, showed pervasive deficits across cognitive domains including reinforcement learning, processing speed, cognitive control, working memory, verbal learning and relational encoding and retrieval. Further, we found that chlorpromazine equivalency rates were significantly related to processing speed and working memory, while there were no significant relationships between anticholinergic load and performance on other tasks. CONCLUSIONS These findings add to a body of literature suggesting that cognitive deficits are an enduring aspect of schizophrenia, present in those off antipsychotic medications as well as those taking antipsychotic medications.
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Affiliation(s)
- Erin K. Moran
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - James M. Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | | | | | | | - Steven M. Silverstein
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School Hospital, Piscataway, NJ
| | - Steven J. Luck
- Department of Psychology, University of California, Davis, CA
| | - Deanna M. Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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26
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Browne J, Harvey PD, Buchanan RW, Kelly DL, Strauss GP, Gold JM, Holden JL, Granholm E. A Longitudinal Examination of Real-World Sedentary Behavior in Adults with Schizophrenia-Spectrum Disorders in a Clinical Trial of Combined Oxytocin and Cognitive Behavioral Social Skills Training. Behav Sci (Basel) 2022; 12:bs12030060. [PMID: 35323379 PMCID: PMC8945120 DOI: 10.3390/bs12030060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 12/11/2022] Open
Abstract
Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who participated in a 24-week randomized trial of cognitive behavioral social skills training (CBSST) and either intranasal oxytocin or placebo (NCT01752712). Participants (n = 57) were prompted with EMA surveys seven times per day for seven days during the baseline, 12-week, and 24-week timepoints to sample sedentary behavior ratings, positive and negative affect, interpersonal interactions, and interpersonal interaction appraisals. Results revealed that sedentary behavior and social interactions did not significantly change over the 24-week clinical trial; however, positive and negative affect and defeatist interaction appraisals improved with treatment, and oxytocin produced modest additional improvements in these EMA outcomes. Greater momentary positive affect was significantly associated with greater activity and greater frequency of interactions. Overall, CBSST was effective at improving functioning, momentary affect, and defeatist interaction appraisals, although it did not reduce sedentary behavior; therefore, targeting these factors is not sufficient to reduce sedentary behavior, and adjunct interventions are needed.
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Affiliation(s)
- Julia Browne
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC 27705, USA
- Correspondence:
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
- Research Service, Bruce W. Carter VA Medical Center, Miami, FL 33125, USA
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (R.W.B.); (D.L.K.); (J.M.G.)
| | - Deanna L. Kelly
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (R.W.B.); (D.L.K.); (J.M.G.)
| | | | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (R.W.B.); (D.L.K.); (J.M.G.)
| | - Jason L. Holden
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; (J.L.H.); (E.G.)
| | - Eric Granholm
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; (J.L.H.); (E.G.)
- Department of Psychiatry, University of California San Diego School of Medicine, San Diego, CA 92093, USA
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27
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Bansal S, Bae GY, Robinson BM, Hahn B, Waltz J, Erickson M, Leptourgos P, Corlett P, Luck SJ, Gold JM. Association Between Failures in Perceptual Updating and the Severity of Psychosis in Schizophrenia. JAMA Psychiatry 2022; 79:169-177. [PMID: 34851373 PMCID: PMC8811632 DOI: 10.1001/jamapsychiatry.2021.3482] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Recent accounts suggest that delusions and hallucinations may result from alterations in how prior knowledge is integrated with new information, but experimental evidence supporting this idea has been complex and inconsistent. Evidence from a simpler perceptual task would make clear whether psychotic symptoms are associated with overreliance on prior information and impaired updating. OBJECTIVE To investigate whether individuals with schizophrenia or schizoaffective disorder (PSZ) and healthy control individuals (HCs) differ in the ability to update their beliefs based on evidence in a relatively simple perceptual paradigm. DESIGN, SETTING, AND PARTICIPANTS This case-control study included individuals who met DSM-IV criteria for PSZ and matched HC participants in 2 independent samples. The PSZ group was recruited from the Maryland Psychiatric Research Center, Yale University, and community clinics, and the HC group was recruited from the community. To test perceptual updating, a random dot kinematogram paradigm was implemented in which dots moving coherently in a single direction were mixed with randomly moving dots. On 50% of trials, the direction of coherent motion changed by 90° midway through the trial. Participants were asked to report the direction perceived at the end of the trial. The Peters Delusions Inventory and Brief Psychiatric Rating Scale (BPRS) were used to quantify the severity of positive symptoms. Data were collected from September 2018 to March 2020 and were analyzed from approximately March 2020 to March 2021. MAIN OUTCOMES AND MEASURES Critical measures included the proportion of responses centered around the initial direction vs the subsequent changed direction and the overall precision of motion perception and reaction times. RESULTS A total of 48 participants were included in the PSZ group (31 [65%] male; mean [SD] age, 36.56 [9.76] years) and 36 in the HC group (22 [61%] male; mean [SD] age, 35.67 [10.74] years) in the original sample. An independent replication sample included 42 participants in the PSZ group (29 [69%] male; mean [SD] age, 33.98 [11.03] years) and 34 in the HC group (20 [59%] male; mean [SD] age, 34.29 [10.44] years). In line with previous research, patients with PSZ were less precise and had slower reaction times overall. The key finding was that patients with PSZ were significantly more likely (original sample: mean, 27.88 [95% CI, 24.19-31.57]; replication sample: mean, 26.70 [95% CI, 23.53-29.87]) than HC participants (original sample: mean, 18.86 [95% CI, 16.56-21.16]; replication sample: mean, 15.67 [95% CI, 12.61-18.73]) to report the initial motion direction rather than the final one. Moreover, the tendency to report the direction of initial motion correlated with the degree of conviction on the Peters Delusions Inventory (original sample: r = 0.32 [P = .05]; replication sample: r = 0.30 [P = .05]) and the Brief Psychiatric Rating Scale Reality Distortion score (original sample: r = 0.55 [P = .001]; replication sample: r = 0.35 [P = .03]) and severity of hallucinations (original sample: r = 0.39 [P = .02]; replication sample: r = 0.30 [P = .05]). CONCLUSIONS AND RELEVANCE The findings of this case-control study suggest that the severity of psychotic symptoms is associated with a tendency to overweight initial information over incoming sensory evidence. These results are consistent with predictive coding accounts of the origins of positive symptoms and suggest that deficits in very elementary perceptual updating may be a critical mechanism in psychosis.
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Gi-Yeul Bae
- Department of Psychology, Arizona State University, Tempe
| | - Benjamin M. Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - James Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Molly Erickson
- Department of Psychiatry, University of Chicago, Chicago, Illinois
| | - Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, Connecticut
| | - Phillip Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, Connecticut
| | - Steven J. Luck
- Center for Mind and Brain and Department of Psychology, University of California, Davis
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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28
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Ahmed AO, Kirkpatrick B, Granholm E, Rowland LM, Barker PB, Gold JM, Buchanan RW, Outram T, Bernardo M, Paz García-Portilla M, Mane A, Fernandez-Egea E, Strauss GP. Two Factors, Five Factors, or Both? External Validation Studies of Negative Symptom Dimensions in Schizophrenia. Schizophr Bull 2022; 48:620-630. [PMID: 35020936 PMCID: PMC9077418 DOI: 10.1093/schbul/sbab148] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Negative symptom studies frequently use single composite scores as indicators of symptom severity and as primary endpoints in clinical trials. Factor analytic and external validation studies do not support this practice but rather suggest a multidimensional construct. The current study used structural equation modeling (SEM) to compare competing dimensional models of negative symptoms to determine the number of latent dimensions that best capture variance in biological, psychological, and clinical variables known to have associations with negative symptoms. METHODS Three independent studies (total n = 632) compared unidimensional, two-factor, five-factor, and hierarchical conceptualizations of negative symptoms in relation to cognition, psychopathology, and community functioning (Study 1); trait emotional experience and defeatist performance beliefs (Study 2); and glutamate and gamma-aminobutyric acid levels in the anterior cingulate cortex quantified using proton magnetic resonance spectroscopy (Study 3). RESULTS SEM favored the five-factor and hierarchical models over the unidimensional and two-factor models regardless of the negative symptom measure or external validator. The five dimensions-anhedonia, asociality, avolition, blunted affect, and alogia-proved vital either as stand-alone domains or as first-order domains influenced by second-order dimensions-motivation and pleasure and emotional expression. The two broader dimensions sometimes masked important associations unique to the five narrower domains. Avolition, anhedonia, and blunted affect showed the most domain-specific associations with external variables across study samples. CONCLUSIONS Five domains and a hierarchical model reflect the optimal conceptualization of negative symptoms in relation to external variables. Clinical trials should consider using the two dimensions as primary endpoints and the five domains as secondary endpoints.
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Affiliation(s)
- Anthony O Ahmed
- To whom correspondence should be addressed; Department of Psychiatry, Weill Cornell Medicine, 21 Bloomingdale Road, White Plains, NY 10605, USA; tel: 914-997-5251, e-mail:
| | - Brian Kirkpatrick
- Department of Psychiatry, University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Laura M Rowland
- Department of Psychiatry and Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peter B Barker
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA,FM Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - James M Gold
- Department of Psychiatry and Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert W Buchanan
- Department of Psychiatry and Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tacina Outram
- Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, USA
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain,Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Anna Mane
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Institut de Neuropsiquiatria i Adiccions, Parc de Salut Mar, Barcelona, Spain,Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Gregory P Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA, USA
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Millman ZB, Schiffman J, Gold JM, Akouri-Shan L, Demro C, Fitzgerald J, Rakhshan Rouhakhtar PJ, Klaunig M, Rowland LM, Waltz JA. Linking Salience Signaling With Early Adversity and Affective Distress in Individuals at Clinical High Risk for Psychosis: Results From an Event-Related fMRI Study. Schizophrenia Bulletin Open 2022; 3:sgac039. [PMID: 35799887 PMCID: PMC9250803 DOI: 10.1093/schizbullopen/sgac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Evidence suggests dysregulation of the salience network in individuals with psychosis, but few studies have examined the intersection of stress exposure and affective distress with prediction error (PE) signals among youth at clinical high-risk (CHR). Here, 26 individuals at CHR and 19 healthy volunteers (HVs) completed a monetary incentive delay task in conjunction with fMRI. We compared these groups on the amplitudes of neural responses to surprising outcomes—PEs without respect to their valence—across the whole brain and in two regions of interest, the anterior insula and amygdala. We then examined relations of these signals to the severity of depression, anxiety, and trauma histories in the CHR group. Relative to HV, youth at CHR presented with aberrant PE-evoked activation of the temporoparietal junction and weaker deactivation of the precentral gyrus, posterior insula, and associative striatum. No between-group differences were observed in the amygdala or anterior insula. Among youth at CHR, greater trauma histories were correlated with stronger PE-evoked amygdala activation. No associations were found between affective symptoms and the neural responses to PE. Our results suggest that unvalenced PE signals may provide unique information about the neurobiology of CHR syndromes and that early adversity exposure may contribute to neurobiological heterogeneity in this group. Longitudinal studies of young people with a range of risk syndromes are needed to further disentangle the contributions of distinct aspects of salience signaling to the development of psychopathology.
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Affiliation(s)
- Zachary B Millman
- Psychotic Disorders Division, McLean Hospital , 115 Mill Street, Belmont, MA 02478 , USA
- Department of Psychiatry, Harvard Medical School , 25 Shattuck Street, Boston, MA 02114 , USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine , 4201 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085 , USA
- Department of Psychology, University of Maryland , Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250 , USA
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine , 55 Wade Avenue, Catonsville, MD 21228 , USA
| | - LeeAnn Akouri-Shan
- Department of Psychology, University of Maryland , Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250 , USA
| | - Caroline Demro
- Department of Psychology, University of Minnesota, 75 East River Parkway , Minneapolis, MN 55455 , USA
| | - John Fitzgerald
- Department of Psychology, University of Maryland , Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250 , USA
| | - Pamela J Rakhshan Rouhakhtar
- Department of Psychology, University of Maryland , Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250 , USA
| | - Mallory Klaunig
- Department of Psychology, University of Maryland , Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250 , USA
| | - Laura M Rowland
- Maryland Psychiatric Research Center, University of Maryland School of Medicine , 55 Wade Avenue, Catonsville, MD 21228 , USA
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine , 55 Wade Avenue, Catonsville, MD 21228 , USA
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Culbreth AJ, Kasanova Z, Ross TJ, Salmeron BJ, Gold JM, Stein EA, Waltz JA. Schizophrenia Patients Show Largely Similar Salience Signaling Compared to Healthy Controls in an Observational Task Environment. Brain Sci 2021; 11:brainsci11121610. [PMID: 34942913 PMCID: PMC8699423 DOI: 10.3390/brainsci11121610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Recent evidence suggests that the aberrant signaling of salience is associated with psychotic illness. Salience, however, can take many forms in task environments. For example, salience may refer to any of the following: (1) the valence of an outcome, (2) outcomes that are unexpected, called reward prediction errors (PEs), or (3) cues associated with uncertain outcomes. Here, we measure brain responses to different forms of salience in the context of a passive PE-signaling task, testing whether patients with schizophrenia (SZ) showed aberrant signaling of particular types of salience. We acquired event-related MRI data from 29 SZ patients and 23 controls during the performance of a passive outcome prediction task. Across groups, we found that the anterior insula and posterior parietal cortices were activated to multiple different types of salience, including PE magnitude and heightened levels of uncertainty. However, BOLD activation to salient events was not significantly different between patients and controls in many regions, including the insula, posterior parietal cortices, and default mode network nodes. Such results suggest that deficiencies in salience processing in SZ may not result from an impaired ability to signal salience per se, but instead the ability to use such signals to guide future actions. Notably, no between-group differences were observed in BOLD signal changes associated with PE-signaling in the striatum. However, positive symptom severity was found to significantly correlate with the magnitudes of salience contrasts in default mode network nodes. Our results suggest that, in an observational environment, SZ patients may show an intact ability to activate striatal and cortical regions to rewarding and non-rewarding salient events. Furthermore, reduced deactivation of a hypothesized default mode network node for SZ participants with high levels of positive symptoms, following salient events, point to abnormalities in interactions of the salience network with other brain networks, and their potential importance to positive symptoms.
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Affiliation(s)
- Adam J. Culbreth
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
- Correspondence:
| | - Zuzana Kasanova
- Leuven Research & Development Spin-off & Innovation Unit, KU Leuven, Waaistraat 6-Box 5105, 3000 Leuven, Belgium;
| | - Thomas J. Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - Betty J. Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
| | - Elliot A. Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD 21224, USA; (T.J.R.); (B.J.S.); (E.A.S.)
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA; (J.M.G.); (J.A.W.)
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31
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Erickson MA, Hahn B, Kiat JE, Alliende LM, Luck SJ, Gold JM. Neural basis of the visual working memory deficit in schizophrenia: Merging evidence from fMRI and EEG. Schizophr Res 2021; 236:61-68. [PMID: 34399233 PMCID: PMC8464530 DOI: 10.1016/j.schres.2021.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/13/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022]
Abstract
Although people with schizophrenia (PSZ) exhibit robust and reliable deficits in working memory (WM) capacity, the neural processes that give rise to this impairment remain poorly understood. One reason for this lack of clarity is that most studies employ a single neural recording modality-each with strengths and weaknesses-with few examples of integrating results across modalities. To address this gap, we conducted a secondary analysis that combined data from an overlapping set of subjects in previously published electroencephalographic and functional magnetic resonance imaging studies that used nearly identical working memory tasks (visual change detection). The prior studies found similar patterns of results for both posterior parietal BOLD activation and suppression of the alpha frequency band within the EEG. Specifically, both signals exhibited abnormally shallow modulation as a function of the amount of information being stored in WM in PSZ. In the present study, both alpha suppression and posterior parietal BOLD activity increased as the number of items stored in WM increased. The magnitude of alpha suppression modulation was correlated with the magnitude of BOLD signal modulation in PSZ, but not in HCS. This finding suggests that the same illness-related biological processes constrain both alpha suppression and BOLD signal modulation as a function of WM storage in PSZ. The complementary strengths of these two techniques may thus combine to advance the identification of the processes underlying WM deficits in PSZ.
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Affiliation(s)
- Molly A. Erickson
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60622,Corresponding author
| | - Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - John E. Kiat
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - Luz Maria Alliende
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60622
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
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Hahn B, Robinson BM, Kiat JE, Geng J, Bansal S, Luck SJ, Gold JM. Impaired Filtering and Hyperfocusing: Neural Evidence for Distinct Selective Attention Abnormalities in People with Schizophrenia. Cereb Cortex 2021; 32:1950-1964. [PMID: 34546344 DOI: 10.1093/cercor/bhab327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Although schizophrenia is classically thought to involve impaired attentional filtering, people with schizophrenia (PSZ) exhibit a more intense and more exclusive attentional focus than healthy control subjects (HCS) in many tasks. To resolve this contradiction, this functional magnetic resonance imaging study tested the impact of attentional control demands on the modulation of stimulus-induced activation in the fusiform face area and parahippocampal place area when participants (43 PSZ and 43 HCS) were looking for a target face versus house. Stimuli were presented individually, or as face-house overlays that challenged attentional control. Responses were slower for house than face stimuli and when prioritizing houses over faces in overlays, suggesting a difference in salience. Blood-oxygen-level-dependent activity reflected poorer attentional selectivity in PSZ than HCS when attentional control was challenged most, that is, when stimuli were overlaid and the task required detecting the lower-salience house target. By contrast, attentional selectivity was exaggerated in PSZ when control was challenged least, that is, when stimuli were presented sequentially and the task required detecting the higher-salience face target. These findings are consistent with 2 distinct attentional abnormalities in schizophrenia leading to impaired and exaggerated selection under different conditions: attentional control deficits, and hyperfocusing once attention has been directed toward a stimulus.
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Affiliation(s)
- Britta Hahn
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, Baltimore, MD 21228, USA
| | - Benjamin M Robinson
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, Baltimore, MD 21228, USA
| | - John E Kiat
- University of California Davis, Center for Mind and Brain, Davis, CA 95618, USA
| | - Joy Geng
- University of California Davis, Center for Mind and Brain, Davis, CA 95618, USA
| | - Sonia Bansal
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, Baltimore, MD 21228, USA
| | - Steven J Luck
- University of California Davis, Center for Mind and Brain, Davis, CA 95618, USA
| | - James M Gold
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, Baltimore, MD 21228, USA
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33
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Nassar MR, Waltz JA, Albrecht MA, Gold JM, Frank MJ. All or nothing belief updating in patients with schizophrenia reduces precision and flexibility of beliefs. Brain 2021; 144:1013-1029. [PMID: 33434284 DOI: 10.1093/brain/awaa453] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 01/11/2023] Open
Abstract
Schizophrenia is characterized by abnormal perceptions and beliefs, but the computational mechanisms through which these abnormalities emerge remain unclear. One prominent hypothesis asserts that such abnormalities result from overly precise representations of prior knowledge, which in turn lead beliefs to become insensitive to feedback. In contrast, another prominent hypothesis asserts that such abnormalities result from a tendency to interpret prediction errors as indicating meaningful change, leading to the assignment of aberrant salience to noisy or misleading information. Here we examine behaviour of patients and control subjects in a behavioural paradigm capable of adjudicating between these competing hypotheses and characterizing belief updates directly on individual trials. We show that patients are more prone to completely ignoring new information and perseverating on previous responses, but when they do update, tend to do so completely. This updating strategy limits the integration of information over time, reducing both the flexibility and precision of beliefs and provides a potential explanation for how patients could simultaneously show over-sensitivity and under-sensitivity to feedback in different paradigms.
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Affiliation(s)
- Matthew R Nassar
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence RI 02912-1821, USA.,Department of Neuroscience, Brown University, Providence RI 02912-1821, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Matthew A Albrecht
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michael J Frank
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence RI 02912-1821, USA.,Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence RI 02912-1821, USA
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Abstract
Schizophrenia is widely thought to involve elevated distractibility, which may reflect a general impairment in top-down inhibitory processes. Schizophrenia also appears to involve increased priming of previously performed actions. Here, we used a highly refined eye-tracking paradigm that makes it possible to concurrently assess distractibility, inhibition, and priming. In both healthy control subjects (HCS, N = 41) and people with schizophrenia (PSZ, N = 46), we found that initial saccades were actually less likely to be directed toward a salient "singleton" distractor than toward less salient distractors, reflecting top-down suppression of the singleton. Remarkably, this oculomotor suppression effect was as strong or stronger in PSZ than in HCS, indicating intact inhibitory control. In addition, saccades were frequently directed to the location of the previous-trial target in both groups, but this priming effect was much stronger in PSZ than in HCS. Indeed, PSZ directed gaze toward the location of the previous-trial target as often as they directed gaze to the location of the current-trial target. These results demonstrate that-at least in the context of visual search-PSZ are no more distractable than HCS and are fully capable of inhibiting salient-but-irrelevant stimuli. However, PSZ do exhibit exaggerated priming, focusing on recently attended locations even when this is not beneficial for goal attainment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine
| | - Nicholas Gaspelin
- Department of Psychology, Binghamton University, State University of New York
| | - Benjamin M. Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine
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35
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Akouri-Shan L, Schiffman J, Millman ZB, Demro C, Fitzgerald J, Rakhshan Rouhakhtar PJ, Redman S, Reeves GM, Chen S, Gold JM, Martin EA, Corcoran C, Roiser JP, Buchanan RW, Rowland LM, Waltz JA. Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth. Schizophr Bull 2021; 47:1534-1543. [PMID: 34240217 PMCID: PMC8530392 DOI: 10.1093/schbul/sbab075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- LeeAnn Akouri-Shan
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, USA
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, USA,Department of Psychological Science, University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, USA
| | - Zachary B Millman
- Center of Excellence in Psychotic Disorders, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Caroline Demro
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - John Fitzgerald
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, USA
| | | | - Samantha Redman
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, USA
| | - Gloria M Reeves
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA,Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, USA
| | - Cheryl Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, 1 Gustave L. Levy Place, New York, NY4, USA
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, England, UK
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Laura M Rowland
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA,To whom correspondence should be addressed; Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD 21228, USA; tel: 410-402-6044, fax: 410-402-7198, e-mail:
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Mittal VA, Ellman LM, Strauss GP, Walker EF, Corlett PR, Schiffman J, Woods SW, Powers AR, Silverstein SM, Waltz JA, Zinbarg R, Chen S, Williams T, Kenney J, Gold JM. Computerized Assessment of Psychosis Risk. J Psychiatr Brain Sci 2021; 6:e210011. [PMID: 34307899 PMCID: PMC8302046 DOI: 10.20900/jpbs.20210011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Early detection and intervention with young people at clinical high risk (CHR) for psychosis is critical for prevention efforts focused on altering the trajectory of psychosis. Early CHR research largely focused on validating clinical interviews for detecting at-risk individuals; however, this approach has limitations related to: (1) specificity (i.e., only 20% of CHR individuals convert to psychosis) and (2) the expertise and training needed to administer these interviews is limited. The purpose of our study is to develop the computerized assessment of psychosis risk (CAPR) battery, consisting of behavioral tasks that require minimal training to administer, can be administered online, and are tied to the neurobiological systems and computational mechanisms implicated in psychosis. The aims of our study are as follows: (1A) to develop a psychosis-risk calculator through the application of machine learning (ML) methods to the measures from the CAPR battery, (1B) evaluate group differences on the risk calculator score and test the hypothesis that the risk calculator score of the CHR group will differ from help-seeking and healthy controls, (1C) evaluate how baseline CAPR battery performance relates to symptomatic outcome two years later (i.e., conversion and symptomatic worsening). These aims will be explored in 500 CHR participants, 500 help-seeking individuals, and 500 healthy controls across the study sites. This project will provide a next-generation CHR battery, tied to illness mechanisms and powered by cutting-edge computational methods that can be used to facilitate the earliest possible detection of psychosis risk.
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Affiliation(s)
- Vijay A. Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL 60208, USA
| | - Lauren M. Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Gregory P. Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA 30602, USA
| | - Elaine F. Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA 30322, USA
| | | | - Jason Schiffman
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, CA 92697, USA
| | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Steven M. Silverstein
- Center for Visual Science, Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
- The Family Institute at Northwestern University, Evanston, IL 60208, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Trevor Williams
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Joshua Kenney
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
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37
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Zachary B Millman
- Center of Excellence in Psychotic Disorders, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
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Silverstein SM, Thompson JL, Gold JM, Schiffman J, Waltz JA, Williams TF, Zinbarg RE, Mittal VA, Ellman LM, Strauss GP, Walker EF, Woods SW, Levin JA, Kafadar E, Kenney J, Smith D, Powers AR, Corlett PR. Increased face detection responses on the mooney faces test in people at clinical high risk for psychosis. NPJ Schizophr 2021; 7:26. [PMID: 34001909 PMCID: PMC8129098 DOI: 10.1038/s41537-021-00156-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/19/2021] [Indexed: 02/03/2023]
Abstract
Identifying state-sensitive measures of perceptual and cognitive processes implicated in psychosis may allow for objective, earlier, and better monitoring of changes in mental status that are predictive of an impending psychotic episode, relative to traditional self-report-based clinical measures. To determine whether a measure of visual perception that has demonstrated sensitivity to the clinical state of schizophrenia in multiple prior studies is sensitive to features of the at-risk mental state, we examined differences between young people identified as being at clinical high risk for psychosis (CHR; n = 37) and non-psychiatric matched controls (n = 29) on the Mooney Faces Test (MFT). On each trial of the MFT, participants report whether they perceive a face in a degraded face image. The CHR group reported perceiving a greater number of faces in both upright and inverted MFT stimuli. Consistent with prior work, males reported more faces on the MFT than females in both conditions. However, the finding of greater reported face perception among CHR subjects was robustly observed in the female CHR group relative to the female control group. Among male CHR participants, greater reported face perception was related to increased perceptual abnormalities. These preliminary results are consistent with a small but growing literature suggesting that heightened perceptual sensitivity may characterize individuals at increased clinical risk for psychosis. Further studies are needed to determine the contributions of specific perceptual, cognitive, and motivational mechanisms to the findings.
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Affiliation(s)
- Steven M. Silverstein
- grid.412750.50000 0004 1936 9166University of Rochester Medical Center, New York, NY USA
| | - Judy L. Thompson
- grid.412750.50000 0004 1936 9166University of Rochester Medical Center, New York, NY USA
| | - James M. Gold
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA
| | - Jason Schiffman
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA ,grid.266093.80000 0001 0668 7243Present Address: University of California, Irvine, CA USA
| | - James A. Waltz
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA
| | - Trevor F. Williams
- grid.16753.360000 0001 2299 3507Northwestern University, Evanston, IL USA
| | - Richard E. Zinbarg
- grid.16753.360000 0001 2299 3507Northwestern University, Evanston, IL USA
| | - Vijay A. Mittal
- grid.16753.360000 0001 2299 3507Northwestern University, Evanston, IL USA
| | - Lauren M. Ellman
- grid.264727.20000 0001 2248 3398Temple University, Philadelphia, PA USA
| | | | - Elaine F. Walker
- grid.189967.80000 0001 0941 6502Emory University, Atlanta, GA USA
| | - Scott W. Woods
- grid.47100.320000000419368710Yale University, New Haven, CT USA
| | - Jason A. Levin
- grid.213876.90000 0004 1936 738XUniversity of Georgia, Athens, GA USA
| | - Eren Kafadar
- grid.47100.320000000419368710Yale University, New Haven, CT USA
| | - Joshua Kenney
- grid.47100.320000000419368710Yale University, New Haven, CT USA
| | - Dillon Smith
- grid.16750.350000 0001 2097 5006Princeton University, Princeton, NJ USA
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Pratt DN, Barch DM, Carter CS, Gold JM, Ragland JD, Silverstein SM, MacDonald AW. Reliability and Replicability of Implicit and Explicit Reinforcement Learning Paradigms in People With Psychotic Disorders. Schizophr Bull 2021; 47:731-739. [PMID: 33914891 PMCID: PMC8084427 DOI: 10.1093/schbul/sbaa165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Motivational deficits in people with psychosis may be a result of impairments in reinforcement learning (RL). Therefore, behavioral paradigms that can accurately measure these impairments and their change over time are essential. METHODS We examined the reliability and replicability of 2 RL paradigms (1 implicit and 1 explicit, each with positive and negative reinforcement components) given at 2 time points to healthy controls (n = 75), and people with bipolar disorder (n = 62), schizoaffective disorder (n = 60), and schizophrenia (n = 68). RESULTS Internal consistency was acceptable (mean α = 0.78 ± 0.15), but test-retest reliability was fair to low (mean intraclass correlation = 0.33 ± 0.25) for both implicit and explicit RL. There were no clear effects of practice for these tasks. Largely, performance on these tasks shows intact implicit and impaired explicit RL in psychosis. Symptom presentation did not relate to performance in any robust way. CONCLUSIONS Our findings replicate previous literature showing spared implicit RL and impaired explicit reinforcement in psychosis. This suggests typical basal ganglia dopamine release, but atypical recruitment of the orbitofrontal and dorsolateral prefrontal cortices. However, we found that these tasks have only fair to low test-retest reliability and thus may not be useful for assessing change over time in clinical trials.
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Affiliation(s)
- Danielle N Pratt
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Deanna M Barch
- Department of Psychology, Washington University, St. Louis, MO
| | - Cameron S Carter
- Department of Psychiatry, University of California at Davis, Davis, CA
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - John D Ragland
- Department of Psychiatry, University of California at Davis, Davis, CA
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Culbreth AJ, Waltz JA, Frank MJ, Gold JM. Retention of Value Representations Across Time in People With Schizophrenia and Healthy Control Subjects. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 6:420-428. [PMID: 32712211 PMCID: PMC7708393 DOI: 10.1016/j.bpsc.2020.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/24/2020] [Accepted: 05/18/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The current study aimed to further etiological understanding of the psychological mechanisms underlying negative symptoms in people with schizophrenia. Specifically, we tested whether negative symptom severity is associated with reduced retention of reward-related information over time and thus a degraded ability to utilize such information to guide future action selection. METHODS Forty-four patients with a diagnosis of schizophrenia or schizoaffective disorder and 28 healthy control volunteers performed a probabilistic reinforcement-learning task involving stimulus pairs in which choices resulted in reward or in loss avoidance. Following training, participants indicated their valuation of learned stimuli in a test/transfer phase. The test/transfer phase was administered immediately following training and 1 week later. Percent retention was defined as accuracy at week-long delay divided by accuracy at immediate delay. RESULTS Healthy control subjects and people with schizophrenia showed similarly robust retention of reinforcement learning over a 1-week delay interval. However, in the schizophrenia group, negative symptom severity was associated with reduced retention of information regarding the value of actions across a week-long interval. This pattern was particularly notable for stimuli associated with reward compared with loss avoidance. CONCLUSIONS Our results show that although individuals with schizophrenia may initially learn about rewarding aspects of their environment, such learning decays at a more rapid rate in patients with severe negative symptoms. Thus, previously learned reward-related information may be more difficult to access to guide future decision making and to motivate action selection.
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Affiliation(s)
- Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland.
| | - James A Waltz
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Michael J Frank
- Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, Rhode Island
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, Maryland
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Beaudette DM, Gold JM, Waltz J, Thompson JL, Cherneski L, Martin V, Monteiro B, Cruz LN, Silverstein SM. Predicting Attention-Shaping Response in People With Schizophrenia. J Nerv Ment Dis 2021; 209:203-207. [PMID: 33315800 PMCID: PMC8516075 DOI: 10.1097/nmd.0000000000001286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with schizophrenia often experience attentional impairments that hinder learning during psychological interventions. Attention shaping is a behavioral technique that improves attentiveness in this population. Because reinforcement learning (RL) is thought to be the mechanism by which attention shaping operates, we investigated if preshaping RL performance predicted level of response to attention shaping in people with schizophrenia. Contrary to hypotheses, a steeper attentiveness growth curve was predicted by less intact pretreatment RL ability and lower baseline attentiveness, accounting for 59% of the variance. Moreover, baseline attentiveness accounted for over 13 times more variance in response to attention shaping than did RL ability. Results suggest attention shaping is most effective for lower-functioning patients, and those high in RL ability may already be close to ceiling in terms of their response to reinforcers. Attention shaping may not be a primarily RL-driven intervention, and other mechanisms of its effects should be considered.
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Affiliation(s)
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland, Catonsville, Maryland
| | - James Waltz
- Maryland Psychiatric Research Center, University of Maryland, Catonsville, Maryland
| | - Judy L Thompson
- Rutgers University, Behavioral Health Care, Piscataway Township, New Jersey
| | - Lindsay Cherneski
- Rutgers University, Behavioral Health Care, Piscataway Township, New Jersey
| | - Victoria Martin
- Rutgers University, Behavioral Health Care, Piscataway Township, New Jersey
| | - Brian Monteiro
- Rutgers University, Behavioral Health Care, Piscataway Township, New Jersey
| | - Lisa N Cruz
- Rutgers University, Behavioral Health Care, Piscataway Township, New Jersey
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Culbreth AJ, Wu Q, Chen S, Adhikari BM, Hong LE, Gold JM, Waltz JA. Temporal-thalamic and cingulo-opercular connectivity in people with schizophrenia. Neuroimage Clin 2020; 29:102531. [PMID: 33340977 PMCID: PMC7750447 DOI: 10.1016/j.nicl.2020.102531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 01/22/2023]
Abstract
A growing body of research has suggested that people with schizophrenia (SZ) exhibit altered patterns of functional and anatomical brain connectivity. For example, many previous resting state functional connectivity (rsFC) studies have shown that, compared to healthy controls (HC), people with SZ demonstrate hyperconnectivity between subregions of the thalamus and sensory cortices, as well as hypoconnectivity between subregions of the thalamus and prefrontal cortex. In addition to thalamic findings, hypoconnectivity between cingulo-opercular brain regions thought to be involved in salience detection has also been commonly reported in people with SZ. However, previous studies have largely relied on seed-based analyses. Seed-based approaches require researchers to define a single a priori brain region, which is then used to create a rsFC map across the entire brain. While useful for testing specific hypotheses, these analyses are limited in that only a subset of connections across the brain are explored. In the current manuscript, we leverage novel network statistical techniques in order to detect latent functional connectivity networks with organized topology that successfully differentiate people with SZ from HCs. Importantly, these techniques do not require a priori seed selection and allow for whole brain investigation, representing a comprehensive, data-driven approach to determining differential connectivity between diagnostic groups. Across two samples, (Sample 1: 35 SZ, 44 HC; Sample 2: 65 SZ, 79 HC), we found evidence for differential rsFC within a network including temporal and thalamic regions. Connectivity in this network was greater for people with SZ compared to HCs. In the second sample, we also found evidence for hypoconnectivity within a cingulo-opercular network of brain regions in people with SZ compared to HCs. In summary, our results replicate and extend previous studies suggesting hyperconnectivity between the thalamus and sensory cortices and hypoconnectivity between cingulo-opercular regions in people with SZ using data-driven statistical and graph theoretical techniques.
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Affiliation(s)
- Adam J Culbreth
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States.
| | - Qiong Wu
- Department of Mathematics, University of Maryland, College Park, United States
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States; Division of Biostatistics and Bioinformatics, University of Maryland, Baltimore, United States
| | - Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States
| | - James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, School of Medicine, United States
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Oliver LD, Hawco C, Homan P, Lee J, Green MF, Gold JM, DeRosse P, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. Social Cognitive Networks and Social Cognitive Performance Across Individuals With Schizophrenia Spectrum Disorders and Healthy Control Participants. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 6:1202-1214. [PMID: 33579663 DOI: 10.1016/j.bpsc.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSDs) feature social cognitive deficits, although their neural basis remains unclear. Social cognitive performance may relate to neural circuit activation patterns more than to diagnosis, which would have important prognostic and therapeutic implications. The current study aimed to determine how functional connectivity within and between social cognitive networks relates to social cognitive performance across individuals with SSDs and healthy control participants. METHODS Participants with SSDs (n = 164) and healthy control participants (n = 117) completed the Empathic Accuracy task during functional magnetic resonance imaging as well as lower-level (e.g., emotion recognition) and higher-level (e.g., theory of mind) social cognitive measures outside the scanner. Functional connectivity during the Empathic Accuracy task was analyzed using background connectivity and graph theory. Data-driven social cognitive networks were identified across participants. Regression analyses were used to examine network connectivity-performance relationships across individuals. Positive and negative within- and between-network connectivity strengths were also compared in poor versus good social cognitive performers and in SSD versus control groups. RESULTS Three social cognitive networks were identified: motor resonance, affect sharing, and mentalizing. Regression and group-based analyses demonstrated reduced between-network negative connectivity, or segregation, and greater within- and between-network positive connectivity in worse social cognitive performers. There were no significant effects of diagnostic group on within- or between-network connectivity. CONCLUSIONS These findings suggest that the neural circuitry of social cognitive performance may exist dimensionally. Across participants, better social cognitive performance was associated with greater segregation between social cognitive networks, whereas poor versus good performers may compensate via hyperconnectivity within and between social cognitive networks.
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Affiliation(s)
- Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Philipp Homan
- University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland; Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California; Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Miklos Argyelan
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Kafadar E, Mittal VA, Strauss GP, Chapman HC, Ellman LM, Bansal S, Gold JM, Alderson-Day B, Evans S, Moffatt J, Silverstein SM, Walker EF, Woods SW, Corlett PR, Powers AR. Modeling perception and behavior in individuals at clinical high risk for psychosis: Support for the predictive processing framework. Schizophr Res 2020; 226:167-175. [PMID: 32593735 PMCID: PMC7774587 DOI: 10.1016/j.schres.2020.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Early intervention in psychotic spectrum disorders is critical for maximizing key clinical outcomes. While there is some evidence for the utility of intervention during the prodromal phase of the illness, efficacy of interventions is difficult to assess without appropriate risk stratification. This will require biomarkers that robustly help to identify risk level and are also relatively easy to obtain. Recent work highlights the utility of computer-based behavioral tasks for understanding the pathophysiology of psychotic symptoms. Computational modeling of performance on such tasks may be particularly useful because they explicitly and formally link performance and symptom expression. Several recent studies have successfully applied principles of Bayesian inference to understanding the computational underpinnings of hallucinations. Within this framework, hallucinations are seen as arising from an over-weighting of prior beliefs relative to sensory evidence. This view is supported by recently-published data from two tasks: the Conditioned Hallucinations (CH) task, which determines the degree to which participants use expectations in detecting a target tone; and a Sine-Vocoded Speech (SVS) task, in which participants can use prior exposure to speech samples to inform their understanding of degraded speech stimuli. We administered both of these tasks to two samples of participants at clinical high risk for psychosis (CHR; N = 19) and healthy controls (HC; N = 17). CHR participants reported both more conditioned hallucinations and more pre-training SVS detection. In addition, relationships were found between participants' performance on both tasks. On computational modeling of behavior on the CH task, CHR participants demonstrate significantly poorer recognition of task volatility as well as a trend toward higher weighting of priors. A relationship was found between this latter effect and performance on both tasks. Taken together, these results support the assertion that these two tasks may be driven by similar latent factors in perceptual inference, and highlight the potential utility of computationally-based tasks in identifying risk.
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Affiliation(s)
- Eren Kafadar
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Vijay A Mittal
- Northwestern University, Evanston, IL, United States of America
| | | | | | - Lauren M Ellman
- Temple University, Philadelphia, PA, United States of America
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Catonsville, MD, United States of America
| | - James M Gold
- Maryland Psychiatric Research Center, Catonsville, MD, United States of America
| | | | | | | | | | | | - Scott W Woods
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Philip R Corlett
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America.
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Millman ZB, Gallagher K, Demro C, Schiffman J, Reeves GM, Gold JM, Rakhshan PJ, Fitzgerald J, Andorko N, Redman S, Buchanan R, Rowland L, Waltz JA. Evidence of reward system dysfunction in youth at clinical high-risk for psychosis from two event-related fMRI paradigms. Schizophr Res 2020; 226:111-119. [PMID: 30995969 PMCID: PMC6801019 DOI: 10.1016/j.schres.2019.03.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 12/11/2022]
Abstract
Abnormal reward processing is thought to play an important role in the development of psychosis, but relatively few studies have examined reward prediction errors, reinforcement learning (RL), and the reward circuitry that subserves these interconnected processes among individuals at clinical high-risk (CHR) for the disorder. Here, we present behavioral and functional neuroimaging results of two experimental tasks designed to measure overlapping aspects of reward processing among individuals at CHR (n = 22) and healthy controls (n = 19). We found no group differences in response times to positive, negative, or neutral outcome-signaling cues, and no significant differences in brain activation during reward anticipation or receipt. Youth at CHR, however, displayed clear RL impairments, as well as attenuated responses to rewards and blunted prediction error signals in the ventral striatum, dorsal anterior cingulate cortex (dACC), and ventromedial prefrontal cortex (vmPFC). Greater contrasts for cue valence (gain-loss) and outcome magnitude (large-small) in the vmPFC were associated with more severe negative symptoms, and deficits in dACC signaling during RL were associated with more depressive symptoms. Our results provide evidence for RL deficits and abnormal prediction error signaling in the brain's reward circuitry among individuals at CHR, while also suggesting that reward motivation may be relatively preserved at this stage in development. Longitudinal studies, medication-free participants, and comparison of neurobehavioral measures against both healthy and clinical controls are needed to better understand the role of reward system abnormalities in the development of psychosis.
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Affiliation(s)
- Zachary B. Millman
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Keith Gallagher
- Department of Psychiatry, University of Maryland, Baltimore, 701 W. Pratt Street, Baltimore MD 21201 USA
| | - Caroline Demro
- Department of Psychiatry, University of Minnesota Medical School, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MD, 55454
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
| | - Gloria M. Reeves
- Department of Psychiatry, University of Maryland, Baltimore, 701 W. Pratt Street, Baltimore MD 21201 USA
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD, 21228
| | - Pamela J. Rakhshan
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - John Fitzgerald
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Nicole Andorko
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Samantha Redman
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Robert Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD, 21228
| | - Laura Rowland
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD, 21228
| | - James A. Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, 55 Wade Ave, Catonsville, MD, 21228
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Bansal S, Bae GY, Frankovich K, Robinson BM, Leonard CJ, Gold JM, Luck SJ. Increased repulsion of working memory representations in schizophrenia. J Abnorm Psychol 2020; 129:845-857. [PMID: 32881536 PMCID: PMC7606631 DOI: 10.1037/abn0000637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Computational neuroscience models propose that working memory (WM) involves recurrent excitatory feedback loops that maintain firing over time along with lateral inhibition that prevents the spreading of activity to other feature values. In behavioral paradigms, this lateral inhibition appears to cause a repulsion of WM representations away from each other and from other strong sources of input. Recent computational models of schizophrenia have proposed that reduction in the strength of inhibition relative to strength of excitation may underlie impaired cognition, and this leads to the prediction that repulsion effects should be reduced in people with schizophrenia spectrum disorders (PSZ) relative to healthy control subjects (HCS). We tested this hypothesis in 2 experiments measuring WM repulsion effects. In Experiment 1, 45 PSZ and 32 HCS remembered the location of a single object relative to a centrally presented visual landmark and reported this location after a short delay. The reported location was repelled away from the landmark in both groups, but this repulsion effect was increased rather than decreased in PSZ relative to HCS. In Experiment 2, 41 PSZ and 34 HCS remembered 2 sequentially presented orientations and reported each orientation after a short delay. The reported orientations were biased away from each other in both groups, and this repulsion effect was again more pronounced in PSZ than in HCS. Contrary to the widespread hypothesis of reduced inhibition in schizophrenia, we provide robust evidence from 2 experiments showing that the behavioral performance of PSZ exhibited an exaggeration rather than a reduction of competitive inhibition. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Sonia Bansal
- University of Maryland School of Medicine, Maryland Psychiatric Research Center
| | - Gi-Yeul Bae
- Department of Psychology, Arizona State University
| | - Kyle Frankovich
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | | | | | - James M. Gold
- University of Maryland School of Medicine, Maryland Psychiatric Research Center
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
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47
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Bansal S, Gaspar JM, Robinson BM, Leonard CJ, Hahn B, Luck SJ, Gold JM. Antisaccade Deficits in Schizophrenia Can Be Driven by Attentional Relevance of the Stimuli. Schizophr Bull 2020; 47:363-372. [PMID: 32766726 PMCID: PMC7965078 DOI: 10.1093/schbul/sbaa106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The antisaccade task is considered a test of cognitive control because it creates a conflict between the strong bottom-up signal produced by the cue and the top-down goal of shifting gaze to the opposite side of the display. Antisaccade deficits in schizophrenia are thought to reflect impaired top-down inhibition of the prepotent bottom-up response to the cue. However, the cue is also a highly task-relevant stimulus that must be covertly attended to determine where to shift gaze. We tested the hypothesis that difficulty in overcoming the attentional relevance of the cue, rather than its bottom-up salience, is key in producing impaired performance in people with schizophrenia (PSZ). We implemented 3 versions of the antisaccade task in which we varied the bottom-up salience of the cue while holding its attentional relevance constant. We found that difficulty in performing a given antisaccade task-relative to a prosaccade version using the same stimuli-was largely independent of the cue's bottom-up salience. The magnitude of impairment in PSZ relative to control subjects was also independent of bottom-up salience. The greatest impairment was observed in a version where the cue lacked bottom-up salience advantage over other locations. These results indicate that the antisaccade deficit in PSZ does not reflect an impairment in overcoming bottom-up salience of the cue, but PSZ are instead impaired at overcoming its attentional relevance. This deficit may still indicate an underlying inhibitory control impairment but could also reflect a hyperfocusing of attentional resources on the cue.
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Affiliation(s)
- Sonia Bansal
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Catonsville, MD,To whom correspondence should be addressed; Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, 55 Wade Avenue, Catonsville, MD 21228, USA; tel: (410)-402-6881, fax: (410)-401-7198, e-mail:
| | - John M Gaspar
- Department of Psychology, Center for Mind and Brain, University of California, Davis, CA
| | - Benjamin M Robinson
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Catonsville, MD
| | - Carly J Leonard
- Department of Psychology, University of Colorado, Denver, CO
| | - Britta Hahn
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Catonsville, MD
| | - Steven J Luck
- Department of Psychology, Center for Mind and Brain, University of California, Davis, CA
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Catonsville, MD
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Gold JM, Bansal S, Anticevic A, Cho YT, Repovš G, Murray JD, Hahn B, Robinson BM, Luck SJ. Refining the Empirical Constraints on Computational Models of Spatial Working Memory in Schizophrenia. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:913-922. [PMID: 32741701 DOI: 10.1016/j.bpsc.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/23/2020] [Accepted: 05/07/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Impairments in spatial working memory (sWM) have been well documented in schizophrenia. Here we provide a comprehensive test of a microcircuit model of WM performance in schizophrenia that predicts enhanced effects of increasing delay duration and distractors based on a hypothesized imbalance of excitatory and inhibitory processes. METHODS Model predictions were tested in 41 people with schizophrenia (PSZ) and 32 healthy control subjects (HCS) performing an sWM task. In one condition, a single target location was followed by delays of 0, 2, 4, or 8 seconds. In a second condition, distractors were presented during the 4-second delay interval at 20°, 30°, 40°, 50°, or 90° from the original target location. RESULTS PSZ showed less precise sWM representations than HCS, and the rate of memory drift over time was greater in PSZ than in HCS. Relative to HCS, the spatial recall responses of PSZ were more repelled by distractors presented close to the target location and more attracted by distractors presented far from the target location. The degree of attraction to distant distractors was correlated with the rate of memory drift in the absence of distractors. CONCLUSIONS Consistent with the microcircuit model, PSZ exhibited both a greater rate of drift and greater attraction to distant distractors relative to HCS. These two effects were correlated, consistent with the proposal that they arise from a single underlying mechanism. However, the repulsion effects produced by nearby distractors were not predicted by the model and thus require an updated modeling framework.
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Affiliation(s)
- James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Grega Repovš
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Benjamin M Robinson
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis, Davis, California
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Dwyer KR, Andrea AM, Savage CLG, Orth RD, Shan L, Strauss GP, Adams HA, Kelly DL, Weiner E, Gold JM, McMahon RP, Carpenter WT, Buchanan RW, Blanchard JJ. A Randomized Clinical Trial of Oxytocin or Galantamine in Schizophrenia: Assessing the Impact on Behavioral, Lexical, and Self-Report Indicators of Social Affiliation. ACTA ACUST UNITED AC 2020; 1:sgaa001. [PMID: 32803156 PMCID: PMC7418868 DOI: 10.1093/schizbullopen/sgaa001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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.
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Affiliation(s)
- Kristen R Dwyer
- Department of Psychology, University of Maryland College Park, Biology/Psychology Building, College Park, MD
| | - Alexandra M Andrea
- Department of Psychology, University of Maryland College Park, Biology/Psychology Building, College Park, MD
| | - Christina L G Savage
- Department of Psychology, University of Maryland College Park, Biology/Psychology Building, College Park, MD
| | - Ryan D Orth
- Department of Psychology, University of Maryland College Park, Biology/Psychology Building, College Park, MD
| | - LeeAnn Shan
- Department of Psychology, University of Maryland, Baltimore, MD
| | | | - Heather A Adams
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Deanna L Kelly
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Elaine Weiner
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - James M Gold
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Robert P McMahon
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - William T Carpenter
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Robert W Buchanan
- Maryland Psychiatric Research Center and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Jack J Blanchard
- Department of Psychology, University of Maryland College Park, Biology/Psychology Building, College Park, MD
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50
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Waltz JA, Wilson RC, Albrecht MA, Frank MJ, Gold JM. Differential Effects of Psychotic Illness on Directed and Random Exploration. Comput Psychiatr 2020; 4:18-39. [PMID: 33768158 PMCID: PMC7990386 DOI: 10.1162/cpsy_a_00027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/27/2020] [Indexed: 12/25/2022]
Abstract
Schizophrenia is associated with a number of deficits in decision-making, but the scope, nature, and cause of these deficits are not completely understood. Here we focus on a particular type of decision, known as the explore/exploit dilemma, in which people must choose between exploiting options that yield relatively known rewards and exploring more ambiguous options of uncertain reward probability or magnitude. Previous work has shown that healthy people use two distinct strategies to decide when to explore: directed exploration, which involves choosing options that would reduce uncertainty about the reward values (information seeking), and random exploration (exploring by chance), which describes behavioral variability that is not goal directed. We administered a recently developed gambling task designed to quantify both directed and random exploration to 108 patients with schizophrenia (PSZ) and 33 healthy volunteers (HVs). We found that PSZ patients show reduced directed exploration relative to HVs, but no difference in random exploration. Moreover, patients' directed exploration behavior clusters into two qualitatively different behavioral phenotypes. In the first phenotype, which accounts for the majority of the patients (79%) and is consistent with previously reported behavior, directed exploration is only marginally (but significantly) reduced, suggesting that these patients can use directed exploration, but at a slightly lower level than community controls. In contrast, the second phenotype, comprising 21% of patients, exhibit a form of "extreme ambiguity aversion," in which they almost never choose more informative options, even when they are clearly of higher value. Moreover, in PSZ, deficits in directed exploration were related to measures of intellectual function, whereas random exploration was related to positive symptoms. Taken together, our results suggest that schizophrenia has differential effects on directed and random exploration and that investigating the explore/exploit dilemma in psychosis patients may reveal subgroups of patients with qualitatively different patterns of exploration.
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Affiliation(s)
- James A. Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Robert C. Wilson
- Department of Psychology and Cognitive Science Program, University of Arizona, Tucson, Arizona, USA
| | - Matthew A. Albrecht
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Michael J. Frank
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island, USA
- Department of Psychiatry and Brown Institute for Brain Science, Brown University, Providence, Rhode Island, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
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