The Clinical Assessment Interview for Negative Symptoms (CAINS) is an empirically developed interview measure of negative symptoms. Building on prior work, this study examined the reliability and validity of a self-report measure based on the CAINS - the Motivation and Pleasure Scale - Self Report (MAP-SR) - that assesses the motivation and pleasure domain of negative symptoms. Thirty-seven participants with schizophrenia or schizoaffective disorder completed the 18-item MAP-SR, the CAINS, and other measures of functional outcome. Item analyses revealed three items that performed poorly. The revised 15-item MAP-SR demonstrated good internal consistency and convergent validity with the clinician-rated Motivation and Pleasure scale of the CAINS, as well as good discriminant validity, with little association with psychotic symptoms or depression/anxiety. MAP-SR scores were related to social anhedonia, social closeness, and clinician-rated social functioning. The MAP-SR is a promising self-report measure of severity of negative symptoms.
Abnormalities in emotional experience have long been viewed as core features of schizophrenia. Numerous studies indicate that people with schizophrenia report less pleasure than controls when reporting non-current feelings using trait, hypothetical, prospective, and retrospective emotional self-report formats; however, current research has demonstrated that schizophrenia patients and controls do not differ in their subjective reactions to emotional stimuli in most laboratory studies. Although substantial attention has been paid to studies examining self-reported valence in schizophrenia, subjective reports of arousal in response to affective stimuli have been neglected. Understanding the role of arousal in schizophrenia is imperative given that valence and arousal are differentially associated with physiological and behavioral responses. To understand the role of self-reported arousal, a meta-analysis of 26 published studies employing laboratory emotion induction paradigms in patients with schizophrenia and healthy controls was conducted. Medline, PsycINFO, Web of Science, and PubMed electronic databases and reference lists from identified articles were used as data sources. Using a random effects model, analyses demonstrated that controls and people with schizophrenia reported similar levels of subjective arousal in response to pleasant and unpleasant stimuli; however, people with schizophrenia reported experiencing greater arousal than controls in response to neutral stimuli. Furthermore, moderator analyses suggested that gender and methodological factors, such as rating scale and stimulus type, may affect these patterns of results and play a key role in determining whether patients and controls differ in self-reported arousal.
It has been about 15 years since we published our article asking whether we are measuring the "Right Stuff" as we search for predictors and determinants of functional outcome in schizophrenia. At that time, we raised the question as to whether the neurocognitive assessments used to study outcome in schizophrenia were too narrow to capture the wide variability in factors that determine daily functioning. While the study of the determinants of functioning in schizophrenia has grown and matured, we are struck by 3 aspects of the article that evolved in different directions. First, the selection of outcome domains in the Right Stuff meta-analysis reflects a focus at that time on predictors of psychiatric rehabilitation. Second, expansion beyond traditional neurocognitive domains occurred in one suggested area (social cognition), but not another (learning potential). Third, the field has responded assertively to the recommendation to evaluate more informed and informative theoretical models.
Social anhedonia is a promising indicator for the vulnerability towards developing schizophrenia-spectrum disorders and is an important determinant of the social impairment associated with these disorders. It is unknown if social anhedonia is associated with true deficits in experiential reactions or if lower social functioning in social anhedonia reflects behavioral deficits in social skill or initiation of social contact. Using a novel social interaction task, the current study compared controls (n=60) to individuals elevated on social anhedonia (n=49) on observer-rated social skill and facial affect and participant self-reports of their experiential reactions to an affiliative interaction. Compared to the control group, the social anhedonia group was rated as behaviorally less affiliative and less socially skilled during the affiliative interaction. In response to the social interaction, the social anhedonia group reported less change in positive affect, less willingness to engage in future social interactions with the interaction partner, and less positive reactions toward the interaction partner compared to controls. There were no group differences in facial displays of emotion. Using a standardized affiliative stimulus, it was demonstrated that individuals high in social anhedonia have alterations in both their social skill and in their self-reported experiential reactions during a social interaction.
Social anhedonia is an important feature of schizophrenia and it is a promising indicator of schizotypy. Although social anhedonia is defined as an affective construct (less pleasure derived from social encounters), little is known about the emotional responsivity and expressivity of individuals with high levels of social anhedonia. After screening a large sample of female undergraduate students (N = 1 085), a cohort of psychometrically identified individuals with high levels of social anhedonia (n = 34) and normally hedonic controls (n = 45) participated in laboratory assessments involving trait affectivity, self-reported dispositional emotional expressiveness, and the expression and experience of emotion in response to neutral, nonaffiliative (i.e., comedy) and affiliative film clips. Results revealed that individuals with high levels of social anhedonia are characterized by lower positive affect, both as a trait and in response to emotionally evocative stimuli, and are less facially expressive, both by their own self-report and in response to film clips. Attenuated positive affect was observed across film stimuli, indicating a general reduction in affective response rather than a specific decrease in responsivity for affiliative stimuli. Future work should continue to investigate whether there is a unique role for social stimuli in the emotional lives of individuals with high levels of social anhedonia or whether these individuals tend to experience anhedonia more broadly regardless of social context.
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