阴性症状主要有5个核心组成部分,可以被分为2部分:(1)motivation dimension:avolition, anhedonia, asociality; (2) a diminished expressivity dimension: restricted affect, alogia;

以往认为sz患者无法完成目标指向的行为是因为他们无法在其中感受到愉快感,实验室研究发现,sz患者在即时的快乐体验主观激活是没有异常的,但是他们追求奖赏与快乐感受的动机行为明显较少,因此,为什么这些快乐感受体验没有转换成动机行为?

1. patients have deficits in reinforcement learning and reward anticipation that are needed for intact hedonic reponses to influence decision making

 两个神经系统:1. PFC(前额叶皮层),尤其是OFC(眶额叶皮层),主要功能:rapid learning(更新刺激价值的心理表征系统,使个体不但根据新异刺激灵活改变个体决策);2. BG(basal ganglia 基底核) gradual reinforcement learning

prediction errors (PEs): both systems make use of mismatches between expected and obtained outcomes               postive PE: better-than-expected outcomes               negative PE: worse-than-expected outcomes_______should be avoided

There is consistent evidence that patients are impaired at making rapid behavioral adjustments in response to feedback and that these impairments are associated with negative symptoms      基于trial-to-trail adjustments。-------OFC

基于motor, serial reaction time, and cognitive skill based learning tasks, 研究者发现gradual learning 是没有问题的,但是与task properties 以及病人本身状况有关,但目前行为研究很多证明gradual learning是没有问题的,但是其实忽视了脑影像研究中发现,这些正常的行为下都伴随着不正常的脑功能激活(BG)

 行为研究发现,伴动机缺损的sz患者对于愉快结果的学习(Go-Learning)有问题,在对于负性结果的学习(NoGo-learning)没有问题。 Explanation: 1. sz很难根据积极结果学习到postive PEs,可能是异常的多巴胺释放;2. sz无法在决策过程建立决策反馈的价值表征(OFC异常)

 



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