Anhedonia reflects impairment in making relative value judgments between positive and neutral stimuli in schizophrenia.
Anhedonia reflects impairment in making relative value judgments between positive and neutral stimuli in schizophrenia.
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快感缺失反映了精神分裂症患者在积极刺激和中性刺激之间做出相对价值判断的障碍。
DOI：
10.1016/j.schres.2018.02.016
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发表时间：
2018
影响因子：
4.5
通讯作者：
Buchanan,RobertW
中科院分区：
文献类型：
--
作者：
Strauss,GregoryP;Visser,KatherineFrost;Keller,WilliamR;Gold,JamesM;Buchanan,RobertW
快感缺乏症（即体验快乐的能力减弱）传统上被视为精神分裂症的核心症状。然而，现代基于实验室的研究表明，这一定义可能是不正确的，因为享乐能力可能是完整的。另一种概念提出，快感缺乏可能反映了在产生情感价值的心理表征方面的障碍，而情感价值是指导决策和发起动机行为所必需的。目前的研究在42名SZ门诊患者和19名健康对照（CN）中评估了这一假设，他们完成了两项任务：(a)一项情绪体验任务，要求他们指出他们对一张情绪或中性照片的反应是积极的、消极的、平静的/兴奋的；(b)相对价值判断任务，让他们从两张照片中选择自己喜欢的那一张。结果表明，中学生在情绪刺激和中性刺激下的积极情绪和觉醒水平相近；然而，SZ对中性和愉快刺激的负性影响高于CN。在相对价值判断任务中，神经网络对不同效价刺激表现出明显的偏好；然而，SZ对积极刺激的偏好比对中性刺激的偏好不那么明显。研究结果表明，尽管SZ对单一刺激的积极情绪的瞬间体验可能完好无损，但指导决策所需的相对价值判断能力受损。最初将快感缺乏症的概念定义为SZ愉悦能力的减弱可能是不准确的；快感缺乏可能更准确地反映了由于价值表征受损而导致的相对价值判断缺陷。
Anhedonia (i.e., diminished capacity to experience pleasure) has traditionally been viewed as a core symptom of schizophrenia (SZ). However, modern laboratory-based studies suggest that this definition may be incorrect, as hedonic capacity may be intact. Alternative conceptualizations have proposed that anhedonia may reflect an impairment in generating mental representations of affective value that are needed to guide decision-making and initiate motivated behavior. The current study evaluated this hypothesis in 42 outpatients with SZ and 19 healthy controls (CN) who completed two tasks: (a) an emotional experience task that required them to indicate how positive, negative, and calm/excited they felt in response to a single emotional or neutral photograph; (b) a relative value judgment task where they selected which of 2 photographs they preferred. Results indicated that SZ and CN reported similar levels of positive emotion and arousal in response to emotional and neutral stimuli; however, SZ reported higher negative affect for neutral and pleasant stimuli than CN. In the relative value judgment task, CN displayed clear preference for stimuli differing in valence; however, SZ showed less distinct preferences for positive over neutral stimuli. Findings suggest that although in-the-moment experiences of positive emotion to singular stimuli may be intact in SZ, the ability to make relative value judgments that are needed to guide decision-making is impaired. Original conceptualizations of anhedonia as a diminished capacity for pleasure in SZ may be inaccurate; anhedonia may more accurately reflect a deficit in relative value judgment that results from impaired value representation.