Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth
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Date
2021-07-08
Type of Work
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Citation of Original Publication
LeeAnn Akouri-Shan and others, Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth, Schizophrenia Bulletin, Volume 47, Issue 6, November 2021, Pages 1534–1543, https://doi.org/10.1093/schbul/sbab075
Rights
This is a pre-copyedited, author-produced version of an article accepted for publication in Schizophrenia Bulletin following peer review. The version of record LeeAnn Akouri-Shan and others, Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth, Schizophrenia Bulletin, Volume 47, Issue 6, November 2021, Pages 1534–1543, https://doi.org/10.1093/schbul/sbab075 is available online at:https://doi.org/10.1093/schbul/sbab075.
Subjects
Abstract
Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension (“adaptive salience”). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL.