Spared and impaired aspects of motivated cognitive control in schizophrenia.

Abstract

The ability to upregulate cognitive control in motivationally salient situations was examined in individuals with schizophrenia (patients) and healthy controls. Fifty-four patients and thirty-nine healthy controls were recruited. A computerized monetary response conflict task required participants to identity a picture, over which was printed a matching (congruent), neutral, or incongruent word. This baseline condition was followed by an incentive condition, in which participants were given the opportunity to win money on reward-cued trials. These reward-cued trials were interleaved with non-reward cued trials. Reaction times (RT) were examined for both incentive context effects (difference in RT between baseline and non-reward cue trials in the incentive condition) and incentive cue effects (difference in RT between non-reward and reward cue trials in the incentive condition). Compared to baseline, controls showed a speeding of responses during both the non-reward (incentive context effect) and reward cued (incentive cue effect) trials during the incentive condition, but with a larger incentive context than incentive cue effect, suggesting a reliance on proactive control strategies. Although patients also showed a speeding of responses to both non-reward and reward cued trials, they showed a significantly smaller incentive context effect than controls, suggesting a reduction in the use of proactive control and a greater reliance on the use of “just-in-time,” reactive control strategies. These results are discussed in light of the relationship between motivation and cognitive impairments in schizophrenia, and the potential role of impairments in prefrontally mediated active maintenance mechanisms.

Frontal-striatum dysfunction during reward processing: Relationships to amotivation in schizophrenia.

“…Different from our previous study (Mann et al, 2013) showing a reduced reward context effect in schizophrenia but an intact reward cue effect, we found that individuals with schizophrenia showed no significant differences from the HC in either reward cue or reward context effects. The discrepancy between two studies may be due to methodological differences.…”

“…The discrepancy between two studies may be due to methodological differences. The clearest difference in the current study from Mann et al (2013) is a modification of the task paradigm by adopting a mixed state-item fMRI design. Thus, the current study included a jittered period between the presentation of cues and target phase while our prior behavioral study did not include such a jittered period; the target phase was followed right after the presentation of each cue.…”

Effort, anhedonia, and function in schizophrenia: Reduced effort allocation predicts amotivation and functional impairment.

“…The SCZ reported significantly greater anhedonia across almost all of the self-report measures. However results for these self-report measures in a largely overlapping subset were previously reported in (Mann et al, in press). The SCZ reported significantly greater levels of depression.…”

“…These individuals were participating in a larger study on motivation and reward processing in schizophrenia, and the majority of these participants also participated in the study described in (Mann, Footer, Chung, Driscoll, & Barch, in press). Fifty-three of the SCZ were taking antipsychotic medications.…”

Mechanisms Underlying Motivational Deficits in Psychopathology: Similarities and Differences in Depression and Schizophrenia

“…Patients were able to speed their responses when presented with specific cues about winning reward and to a certain extent could speed their responses on trials in the reward "context" even when they could not earn money, an effect thought to reflect the maintenance of reward information through proactive control mechanisms. However, the individuals with schizophrenia showed a significantly smaller incentive context effect than controls, suggesting a reduction in the use of proactive control and a greater reliance on the use of "just-in-time," reactive control strategies (Mann et al 2013). To date, there are no published fMRI studies examining whether or not incentives modulate DLPFC activity during cognitive control or working memory tasks in schizophrenia.…”