Do people with schizophrenia have difficulty anticipating pleasure, engaging in effortful behavior, or both?
Do people with schizophrenia have difficulty anticipating pleasure, engaging in effortful behavior, or both?
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精神分裂症患者难以期待愉悦，从事努力的行为或两者兼而有之？
DOI：
10.1037/abn0000005
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发表时间：
2014-11
影响因子：
4.6
通讯作者：
Vinogradov, Sophia
中科院分区：
文献类型：
--
作者：
Gard, David E.;Sanchez, Amy H.;Cooper, Kathryn;Fisher, Melissa;Garrett, Coleman;Vinogradov, Sophia
动机缺陷在精神分裂症中很常见，但人们对潜在的机制或精神分裂症患者在日常生活中设定的具体目标知之甚少。使用神经生物学的快乐预期和努力评估，我们检查了47人和41人没有精神分裂症的活动和目标的质量，利用生态瞬时评估。参与者被提供了手机，并在七天内每天打四次电话，询问他们目前的活动和对即将到来的目标的预期。活动和目标随后由独立评分员根据快乐和努力进行编码。根据最近关于精神分裂症患者努力计算缺陷的实验室研究结果，相对于健康参与者，精神分裂症患者报告参与不太费力的活动，并设定不太费力的目标，这与患者功能有关。此外，患者在估计一个努力目标的难度时表现出一些不准确性，这反过来又与较低的神经认知有关。与之前的研究相反，精神分裂症患者参与的活动和设定的目标更基于快乐，并且预期目标比对照组更快乐。因此，这项研究提供了努力行为的困难，而不是快乐的预期。这些发现可能有心理社会治疗的影响，重点是努力评估/努力支出。例如，为了帮助精神分裂症患者从事更有意义的目标追求，治疗提供者可以通过帮助患者将更大，更复杂的目标分解为与特定的愉快奖励相关的较小，较低努力的步骤来利用低努力的愉快目标。
Motivation deficits are common in schizophrenia, but little is known about underlying mechanisms, or the specific goals that people with schizophrenia set in daily life. Using neurobiological heuristics of pleasure anticipation and effort assessment, we examined the quality of activities and goals of 47 people with and 41 people without schizophrenia, utilizing Ecological Momentary Assessment. Participants were provided cell phones and called four times a day for seven days, and were asked about their current activities and anticipation of upcoming goals. Activities and goals were later coded by independent raters on pleasure and effort. In line with recent laboratory findings on effort computation deficits in schizophrenia, relative to healthy participants, people with schizophrenia reported engaging in less effortful activities and setting less effortful goals, which were related to patient functioning. In addition, patients showed some inaccuracy in estimating how difficult an effortful goal would be, which in turn was associated with lower neurocognition. In contrast to previous research, people with schizophrenia engaged in activities and set goals that were more pleasure-based, and anticipated goals as being more pleasurable than controls. Thus, this study provided evidence for difficulty with effortful behavior and not anticipation of pleasure. These findings may have psychosocial treatment implications, focusing on effort assessment/effort expenditure. For example, in order to help people with schizophrenia engage in more meaningful goal pursuits, treatment providers may leverage low-effort pleasurable goals by helping patients to break down larger, more complex goals into smaller, lower-effort steps that are associated with specific pleasurable rewards.
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影响因子：
4.5
作者：
Gard, David E.;Fisher, Melissa;Vinogradov, Sophia
通讯作者：
Vinogradov, Sophia
影响因子：
6.6
作者：
Blanchard, Jack J.;Kring, Ann M.;Gur, Raquel
通讯作者：
Gur, Raquel
影响因子：
4.5
作者：
Foussias, G.;Mann, S.;Remington, G.
通讯作者：
Remington, G.
影响因子：
1.9
作者：
Ehrenreich, Benjamin;Righter, Bryan;Himelhoch, Seth
通讯作者：
Himelhoch, Seth
影响因子：
6.6
作者：
Barch, DM
通讯作者：
Barch, DM