Probabilistic Reversal Learning in Schizophrenia: Stability of Deficits and Potential Causal Mechanisms.
Probabilistic Reversal Learning in Schizophrenia: Stability of Deficits and Potential Causal Mechanisms.
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精神分裂症的概率逆转学习：缺陷的稳定性和潜在的因果机制。
DOI：
10.1093/schbul/sbv226
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发表时间：
2016
影响因子：
6.6
通讯作者：
Horan,WilliamP
中科院分区：
文献类型：
--
作者：
Reddy,LenaFelice;Waltz,JamesA;Green,MichaelF;Wynn,JonathanK;Horan,WilliamP
虽然精神分裂症患者在概率逆转学习（PRL）任务中表现出反馈驱动学习受损，但导致这些缺陷的具体因素仍然未知。最近的研究提出了几个潜在的原因，包括神经认知障碍，临床症状和特定类型的反馈相关错误。为了研究这个问题，我们对126名稳定的精神分裂症门诊患者和72名匹配的对照者进行了PRL任务，并在4周后对患者进行了重新测试。该任务涉及一个初始的概率歧视学习阶段和随后的逆转阶段，在这些阶段中，受试者必须调整他们对强化突发事件的反应。患者表现出较差的性能比对照组的初始歧视和逆转学习阶段的任务，和性能整体表现出良好的重测信度的患者。对具有良好初始辨别学习的患者（n= 64）和对照组（n= 49）进行的亚组分析显示，逆转学习没有组间差异，表明能够实现所有初始概率辨别的患者在逆转学习中没有受损。关于受损的歧视学习的潜在贡献者，有几个因素与不良PRL相关，包括更高水平的神经认知障碍，积极和消极反馈的学习不良，以及更高水平的无差别反应转移。结果表明，精神分裂症患者的PRL表现不佳可能是多种机制的产物。
Although individuals with schizophrenia show impaired feedback-driven learning on probabilistic reversal learning (PRL) tasks, the specific factors that contribute to these deficits remain unknown. Recent work has suggested several potential causes including neurocognitive impairments, clinical symptoms, and specific types of feedback-related errors. To examine this issue, we administered a PRL task to 126 stable schizophrenia outpatients and 72 matched controls, and patients were retested 4 weeks later. The task involved an initial probabilistic discrimination learning phase and subsequent reversal phases in which subjects had to adjust their responses to sudden shifts in the reinforcement contingencies. Patients showed poorer performance than controls for both the initial discrimination and reversal learning phases of the task, and performance overall showed good test–retest reliability among patients. A subgroup analysis of patients (n= 64) and controls (n= 49) with good initial discrimination learning revealed no between-group differences in reversal learning, indicating that the patients who were able to achieve all of the initial probabilistic discriminations were not impaired in reversal learning. Regarding potential contributors to impaired discrimination learning, several factors were associated with poor PRL, including higher levels of neurocognitive impairment, poor learning from both positive and negative feedback, and higher levels of indiscriminate response shifting. The results suggest that poor PRL performance in schizophrenia can be the product of multiple mechanisms.
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