Impact of long‐term institutionalization on experiential pleasure and motivation in patients with schizophrenia

Abstract

Anhedonia and amotivation, the hallmarks of negative symptoms in schizophrenia, are believed to be due to “emotion–behavior decoupling,” a failure in translating pleasure experience into appropriate goal‐directed behavior. A number of studies have reported that long‐term institutionalized schizophrenia patients suffer from more severe negative symptoms than community‐dwelling patients, but few studies have investigated pleasure experience and motivational behavior in schizophrenia patients who have experienced long‐term institutionalization. In this study, we recruited 26 long‐term institutionalized schizophrenia patients, 27 community‐dwelling schizophrenia patients, and 27 healthy controls. Participants were administered two specific computer‐based tasks to assess anhedonia and amotivation. The Anticipatory and Consummatory Pleasure (ACP) Task was used to measure emotion–behavior decoupling and the Effort‐Expenditure for Rewards Task (EEfRT) was used to measure amotivation related to rewards. Findings from the ACP Task showed that compared with healthy controls, the coupling between emotion experience and motivated behavior was significantly weaker in both clinical groups, suggesting that emotion–behavior decoupling could be a stable trait in schizophrenia patients. In the EEfRT, compared with both community‐dwelling patients and healthy controls, institutionalized patients with schizophrenia failed to expend more effort to gain potential rewards even when reward probability increased. These findings further reveal the underlying mechanism of anhedonia and amotivation and their potential relationships with long‐term institutionalization in patients with schizophrenia.

Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults

“…Regarding the setting of recruitment, older adults admitted to LTI are often socially isolated, have more depressive symptoms, a high prevalence of disability and multimorbidity, and increased cognitive decline (129)(130)(131). In the course of time, institutionalization can make things worse by contributing with the exacerbating of preexisting conditions and with the development of new ones (132)(133)(134)(135). Hence, it is possible that different results might be found in pre-frail and frail community-dwellers.…”

Co-expression of anticipatory and consummatory volitional deficits in schizophrenia and their association with memory impairment

“…However, the suggestion of a preferential impairment in representational/anticipatory response in schizophrenia has been challenged by more recent studies. Lui et al, (2016a) and Xie et al (2017) both reported a preferential decoupling in evoked/consummatory response, while Chu et al (2020) observed comparable impairment in both types of response. In addition, Heerey and Gold's (2007) finding concerning inappropriate responding to neutral stimuli by subjects with schizophrenia also appears far from robust.…”

“…Second, schizophrenia subjects exhibited excessive inappropriate responses to neutral stimuli (their Figure 3). The first finding has been replicated in people with acute as well as chronic schizophrenia (Lui et al, 2016a;Xie et al, 2017;Chu et al, 2020;Wang et al, 2020), and is widely taken as evidence for a decoupling of behaviour from emotional incentive. However, the suggestion of a preferential impairment in representational/anticipatory response in schizophrenia has been challenged by more recent studies.…”

“…In addition, Heerey and Gold's (2007) finding concerning inappropriate responding to neutral stimuli by subjects with schizophrenia also appears far from robust. Such disinhibited responding was absent (Chu et al, 2020), comparably observed in both types of response (Lui et al, 2016a(Lui et al, , 2016b, or more strongly expressed in evoked/consummatory response (Xie et al, 2017). Heerey and Gold (2007) claimed that their data further indicated a link between the emotionbehaviour coupling (specifically for representational/anticipatory response) and working memory function.…”

“…The LNS task (Gold et al, 1997) was identical to that in previous ACP studies in schizophrenia (Heerey & Gold, 2007;Chu et al, 2020;Lui et al, 2016a;Xie et al, 2017). After listening to a string of unique alphanumeric characters, subjects needed to re-state the numbers in ascending order followed by the letters in alphabetical order.…”