Patients With Schizophrenia Demonstrate Inconsistent Preference Judgments for Affective and Nonaffective Stimuli

Department of Psychiatry, University of Maryland School of Medicine, Baltimore,MD 21228, USA.
Schizophrenia Bulletin (Impact Factor: 8.61). 11/2011; 37(6):1295-304. DOI: 10.1093/schbul/sbq047
Source: PubMed

ABSTRACT Previous studies have typically found that individuals with schizophrenia (SZ) report levels of emotional experience that are similar to controls (CN) when asked to view a single evocative stimulus and make an absolute judgment of stimulus "value." However, value is rarely assigned in absolute terms in real-life situations, where one alternative or experience is often evaluated alongside others, and value judgments are made in relative terms. In the current study, we examined performance on a preference task that requires individuals to differentiate between the relative values of different stimuli. In this task, subjects were presented with many pairs of moderately positive stimuli and asked to indicate which stimulus they preferred in each pair. Resulting data indicated the rank order of preference across stimuli and the consistency of their transitive mapping (ie, if A > B and B > C, then A should be > C). Individuals with SZ (n = 38) were both less consistent in their rankings of stimuli and more likely to have larger magnitudes of discrepant responses than control subjects (n = 27). Furthermore, CN showed clear differentiation between different valence categories of stimuli (ie, highly positive > mildly positive > mildly negative > highly negative); while individuals with SZ showed the same general pattern of results but with less differentiation between the valence levels. These data suggest that individuals with SZ are impaired in developing or maintaining nuanced representations of the different attributes of a stimulus, thus making stimuli of similar general value easily confusable.

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Available from: Michael Joshua Frank, Sep 01, 2015
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    • "Indeed, schizophrenia subjects experience more intense negative and less intense positive emotions than healthy subjects using a structured time-sampling technique during daily life (Myin-Germeys et al., 2000). These heterogeneous findings indicate that valence ratings are strongly influenced by the applied methodological approach (Strauss et al., 2011). The valence rating used in our study might not represent subjective experience but rather a cognitive categorisation. "
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    • "A number of studies have reported evidence for impaired representation of the value of positive outcomes, or in using this information to effectively and adaptively guide goal-directed behavior in patients (Barch and Dowd, 2010; Gold et al, 2008). In particular, patients appear severely impaired in situations that require relative value judgments (Strauss et al, 2011), as in the effort-related choice procedure and the concurrent schedules used in the current studies. "
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    • "This formulation would suggest that patients are likely to display alterations in a host of decision making contexts where the relative prospective value of different stimuli and response alternatives must be weighed. Indeed, there is evidence that this is the case as seen in studies of delay discounting (Heerey et al., 2007, 2011) and in the demonstration of reduced transitivity of preferences (Strauss et al., 2011). Furthermore, impaired response selection in schizophrenia has been associated with increased response times (Luck et al., 2009). "
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