BennettLisa Rachelle Riso Lilenfeld Despite the importance of this concept in psychosis research, no questionnaire measures are available to assess aberrant salience. TallentChristie W. The Revised Social Anhedonia Scale. The Aberrant Salience Inventory: a new measure of psychosis proneness.

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Email: ku. The written permission of Cambridge University Press must be obtained for commercial re-use. This article has been cited by other articles in PMC. To test this hypothesis we investigated whether patients with schizophrenia showed impaired learning of task-relevant stimulus—reinforcement associations in the presence of distracting task-irrelevant cues.

Method We tested 20 medicated patients with schizophrenia and 17 controls on a reaction time game, the Salience Attribution Test. In this game, participants made a speeded response to earn money in the presence of conditioned stimuli CSs.

Each CS comprised two visual dimensions, colour and form. Probability of reinforcement varied over one of these dimensions task-relevant , but not the other task-irrelevant. Measures of adaptive and aberrant motivational salience were calculated on the basis of latency and subjective reinforcement probability rating differences over the task-relevant and task-irrelevant dimensions respectively. Results Participants rated reinforcement significantly more likely and responded significantly faster on high-probability-reinforced relative to low-probability-reinforced trials, representing adaptive motivational salience.

Patients exhibited reduced adaptive salience relative to controls, but the two groups did not differ in terms of aberrant salience. Patients with delusions exhibited significantly greater aberrant salience than those without delusions, and aberrant salience also correlated with negative symptoms. Conclusions These data support the hypothesis that aberrant salience is related to the presence of delusions in medicated patients with schizophrenia, but are also suggestive of a link with negative symptoms.

The relationship between aberrant salience and psychotic symptoms warrants further investigation in unmedicated patients. Keywords: Aberrant salience, dopamine, psychosis, reinforcement, salience attribution test, schizophrenia Introduction Together with direct evidence for dopamine dysregulation in medicated and unmedicated patients with schizophrenia Laruelle et al.

A number of theorists have hypothesized that positive psychotic symptoms may be related to abnormal learning of stimulus—reinforcement associations King et al.

A corollary of this is that antipsychotic medications will also necessarily attenuate adaptive motivational salience, that is the correct assignment of salience. This may result not only in positive symptom remission, but also negative side-effects related to loss of motivation, such as apathy and anhedonia. Despite the implications for understanding the neurobiological basis of schizophrenia, few studies have investigated reward learning in schizophrenia. Studies investigating Pavlovian conditioning in medicated patients found a deficit in learning stimulus—reinforcement associations Garmezy, ; Cohen, ; Waltz et al.

In order to extend these findings, here we employed a novel paradigm, the Salience Attribution Test SAT , to quantify adaptive and aberrant salience in patients with schizophrenia and controls. It has been hypothesized that dopamine antagonists reduce both adaptive and aberrant salience, and that in the absence of effective treatment patients with schizophrenia exhibit aberrant salience Kapur, Therefore, our first prediction was that that medicated patients with schizophrenia would exhibit reduced adaptive salience relative to controls, representing an undesirable side-effect of anti-psychotic medication.

Our second prediction was that medicated patients with schizophrenia would exhibit equivalent aberrant salience to controls, representing the beneficial effect of anti-psychotic medication, which is hypothesized to normalize aberrant salience from a previously elevated level Kapur, Our third prediction was that those patients with persistent positive symptoms, in whom medication is not entirely effective, would exhibit greater aberrant salience than patients without positive symptoms.

Our fourth prediction was that in the controls, individual differences in aberrant salience would be related to the personality trait of schizotypy, considered to be an index of psychosis proneness Chapman et al.

Method Participants Twenty patients were recruited from a prospective, longitudinal study of first-episode psychosis in West London, UK Joyce et al. The diagnosis was ascertained using a structured interview, the diagnostic module of the Diagnostic Interview for Psychosis Jablensky et al. In this longitudinal study, participants are contacted 1 and 3 years after presentation for repeat assessments, at which time the diagnosis is reviewed. The final diagnoses were schizophrenia in 19 patients and schizoaffective disorder in the remaining patient.

Three patients were unmedicated at the time of testing, two were taking first-generation drugs haloperidol, flupenthixol , and 15 second-generation drugs five olanzapine, four aripiprazole, two quetiapine, two risperidone, one clozapine and one a combination of aripiprazole and quetiapine. These patients were compared with 17 healthy volunteers, who were recruited by advertisement. However, participants were not informed of the contingencies between the different pictures and reward.

Hence, the SAT is relatively straightforward to perform for patients, since it simply requires participants to respond as quickly as they can when the probe appears on the screen.





Do patients with schizophrenia exhibit aberrant salience?



The Aberrant Salience Inventory: a new measure of psychosis proneness.


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