Ecological momentary assessment of negative symptoms in schizophrenia: Relationships to effort-based decision making and reinforcement learning.
Ecological momentary assessment of negative symptoms in schizophrenia: Relationships to effort-based decision making and reinforcement learning.
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DOI：
10.1037/abn0000240
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发表时间：
2017-01
影响因子：
4.6
通讯作者：
Barch DM
中科院分区：
文献类型：
--
作者：
Moran EK;Culbreth AJ;Barch DM
阴性症状是精神分裂症的一个核心临床特征，但目前工具的概念和方法问题可能使其评估具有挑战性。一种假设是，目前的症状评估可能受到记忆障碍的影响，可能无法完全反映实验室外的实际功能。本研究旨在探讨使用生态瞬时评估（EMA）评估阴性症状的有效性。患有精神分裂症的参与者（N=31）在智能手机上完成电子问卷，每天四次，持续一周。参与者还完成了基于努力的决策和强化学习（RL）任务，以评估EMA与实验室测量之间的关系，这些测量涉及阴性症状相关领域。分层线性模型分析显示，临床医生评定和自我报告的阴性症状的措施显着相关，通过EMA评估的阴性症状。然而，工作记忆调节EMA和阴性症状的回顾性措施之间的关系，这样EMA和回顾性阴性症状措施之间的关系更强的个人与更好的工作记忆。我们还发现，通过EMA评估的阴性症状与努力任务的表现不佳有关，而临床医生评定的症状和自我报告则无关。此外，我们发现，阴性症状与学习奖励意外事件的较差表现有关。我们的研究结果表明，阴性症状可以通过EMA进行评估，精神分裂症中常见的工作记忆障碍可能会影响症状的回忆。此外，这些研究结果表明，检查实验室任务和日常生活中评估的症状之间的关系的重要性。
Negative symptoms are a core clinical feature of schizophrenia, but conceptual and methodological problems with current instruments can make their assessment challenging. One hypothesis is that current symptom assessments may be influenced by impairments in memory and may not be fully reflective of actual functioning outside of the laboratory. The present study sought to investigate the validity of assessing negative symptoms using ecological momentary assessment (EMA). Participants with schizophrenia (N=31) completed electronic questionnaires on smartphones four times a day for one week. Participants also completed Effort-Based Decision Making and Reinforcement Learning (RL) tasks to assess the relationship between EMA and laboratory measures, which tap into negative symptom relevant domains. Hierarchical linear modeling analyses revealed that clinician-rated and self-report measures of negative symptoms were significantly related to negative symptoms assessed via EMA. However, working memory moderated the relationship between EMA and retrospective measures of negative symptoms, such that there was a stronger relationship between EMA and retrospective negative symptom measures among individuals with better working memory. We also found that negative symptoms assessed via EMA were related to poor performance on the Effort task, while clinician-rated symptoms and self-reports were not. Further, we found that negative symptoms were related to poorer performance on learning reward contingencies. Our findings suggest that negative symptoms can be assessed through EMA and that working memory impairments frequently seen in schizophrenia may affect recall of symptoms. Moreover, these findings suggest the importance of examining the relationship between laboratory tasks and symptoms assessed during daily life.