最近的负面症状环境理论认为环境背景(例如,location,社交伙伴)在精神分裂症(SZ)的阴性症状中起着重要但往往无法解释的作用。“黄金标准”临床评定量表在评估环境如何影响症状方面提供了有限的精确度。为了克服这些限制,生态瞬时评估(EMA)用于确定经验阴性症状是否存在状态波动(快感缺失,废除,和相关性)在SZ中跨上下文(位置,活动,社交互动伙伴,社会互动方法)。患有SZ(n=52)和健康对照(CN:n=55)的门诊患者每天完成8次EMA调查,为期6天,评估阴性症状域(快感缺失,废除,和可用性)和上下文。多层次建模表明,阴性症状因地点而异,活动,社交互动伙伴,和社会互动方法。在大多数情况下,SZ和CN没有报告明显不同程度的阴性症状,SZ在进食时只报告比CN更高的阴性症状,休息,与重要的其他人互动,或者在家。Further,有几种情况下,阴性症状也同样减少(例如,娱乐,大多数社交互动)或提升(例如,使用电脑,工作,每组跑腿)。结果表明,经验阴性症状在SZ的上下文中动态变化。有些情况可能会使SZ的经验阴性症状“正常化”,而其他情况下,特别是一些用于促进功能恢复,可能会增加经验阴性症状。
A recent environmental theory of negative symptoms posits that environmental contexts (e.g., location, social partner) play a significant-yet often unaccounted for-role in negative symptoms of schizophrenia (SZ). \"Gold-standard\" clinical rating scales offer limited precision for evaluating how contexts impact symptoms. To overcome some of these limitations, Ecological Momentary Assessment (EMA) was used to determine whether there were state fluctuations in experiential negative symptoms (anhedonia,
avolition, and asociality) in SZ across contexts (locations, activities, social interaction partner, social interaction method). Outpatients with SZ (n = 52) and healthy controls (CN: n = 55) completed 8 daily EMA surveys for 6 days assessing negative symptom domains (anhedonia,
avolition, and asociality) and contexts. Multilevel modeling demonstrated that negative symptoms varied across location, activity, social interaction partner, and social interaction method. For the majority of contexts, SZ and CN did not report significantly different levels of negative symptoms, with SZ only reporting higher negative symptoms than CN while eating, resting, interacting with a significant other, or being at home. Further, there were several contexts where negative symptoms were similarly reduced (e.g., recreation, most social interactions) or elevated (e.g., using the computer, working, running errands) in each group. Results demonstrate that experiential negative symptoms dynamically change across contexts in SZ. Some contexts may \"normalize\" experiential negative symptoms in SZ, while other contexts, notably some used to promote functional recovery, may increase experiential negative symptoms.