Abstract:
Social anhedonia is a hallmark symptom of schizophrenia. Discrepancies in anticipated versus consummatory pleasure for non-social stimuli are well-documented. Thus, a similar emotional paradox may underlie social anhedonia. If so, our understanding of social anhedonia-including how to treat it in schizophrenia-could be enhanced. This project used a 5-day experience sampling method (ESM) to measure discrepancies between anticipated and consummatory pleasure for real-world social activities in people with schizophrenia and healthy controls (n = 30/group). ESM results were compared to laboratory assessments of negative symptoms and neurocognition. The schizophrenia group exhibited similar levels of anticipated and consummatory social pleasure as controls throughout daily life, and both groups were accurate in their short-term predictions of pleasure. Clinical interviews revealed those with schizophrenia showed significant deficits in long-term social pleasure prediction (i.e., a 1-week timeframe). Thus, people with schizophrenia may exhibit differences in ability to predict pleasure in the short-term versus the long-term. Negative symptoms and neurocognition were related to anticipated, but not consummatory, social pleasure, suggesting anhedonia is driven by deficits in thinking about pleasure, rather than inability to experience pleasure. Clinical implications include focusing on building upon short-term ability to predict pleasure in therapy to increase social motivation in schizophrenia.
摘要:
社交快感缺失是精神分裂症的标志性症状。有据可查的非社会刺激的预期愉悦与圆满愉悦的差异。因此,类似的情感悖论可能是社会快感缺失的基础。如果是,我们对社会快感缺失的理解,包括精神分裂症患者如何治疗。该项目使用了5天的经验抽样方法(ESM)来衡量精神分裂症患者和健康对照者(n=30/组)在现实世界社交活动中的预期和圆满愉悦之间的差异。将ESM结果与阴性症状和神经认知的实验室评估进行比较。在整个日常生活中,精神分裂症组表现出与对照组相似的预期和完善的社会愉悦水平,两组对快乐的短期预测都是准确的。临床访谈显示,精神分裂症患者在长期社交愉悦预测中表现出显著缺陷(即,一周的时间范围)。因此,精神分裂症患者在短期和长期预测快乐的能力上可能存在差异.阴性症状和神经认知与预期相关,但不是圆满的,社会愉悦,表明快感缺失是由对快乐的思考不足驱动的,而不是无法体验快乐。临床意义包括专注于建立短期能力来预测治疗中的快乐,以增加精神分裂症的社会动机。