انگیزش عاطفی فوری در اسکیزوفرنی اختلال نمی کند
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|30093||2014||7 صفحه PDF||سفارش دهید||5657 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Schizophrenia Research, Volume 159, Issue 1, October 2014, Pages 157–163
Abstract Background Among the various cognitive and affective evaluations that contribute to decisions about whether to engage in a future activity, three affective evaluations are particularly relevant: 1) interest in the activity itself, 2) the pleasure anticipated from the activity and 3) the excitement experienced while looking forward to the activity. In addition to these pre-activity evaluations, affective evaluations that are done after the activity is completed impact people's motivation to repeat the same activity. Although extant research suggests that these affective processes may be impaired in schizophrenia, it is not clear whether these impairments are mostly secondary to cognitive deficits.
Our decisions to engage in activity are guided (at least in part) by cognitive and affective evaluations (Kuhl, 2008). These affective and cognitive evaluations are combined to form a subjective motivational value, associated with a future activity, and guide the decision to approach the activity or not. Among these motivational attributes, three affective evaluations are of particular importance: anticipated pleasure, interest, and excitement (Izard and Ackerman, 2000 and Frijda, 2004). Anticipated pleasure is the degree to which individuals evaluate the pleasure they will experience from an upcoming activity. Interest is a primary emotion (Izard and Ackerman, 2000 and Silvia, 2005), and is different from enjoyment or pleasure (Silvia, 2005). Interest is part of the intrinsic motivation concept, and may be a better predictor of actual engagement than anticipated pleasure (Berlyne, 1974). Excitement reflects an individual's current positive arousal level and eagerness to engage in an activity (Alcaro and Panksepp, 2011). Different theories have emphasized the dynamic aspect of these affective evaluations. Consistent with Reinforcement Learning Theory (Dayan and Niv, 2008) and Decision Theory (Kahneman et al., 1997), research has demonstrated that evaluations of pleasure before and after an activity are often enhanced compared to the in-the-moment reports of the pleasure experienced during the activity (“consummatory pleasure”). Moreover, pre- and post-activity evaluations of pleasure are highly correlated, suggesting that people use posttest evaluations when they anticipate the pleasure they will have from repeating the same activity. Motivation is severely impaired in people with schizophrenia and greatly contributes to their poor functioning (Foussias et al., 2009 and Gard et al., 2009). Recently research has examined which components of motivation are impaired in schizophrenia. Kring (1999) introduced the distinction between anticipatory and consummatory pleasure in schizophrenia research, and hypothesized that anticipatory not consummatory pleasure is impaired in schizophrenia. This led to the development of a new self-report scale to measure anticipatory pleasure (Gard et al., 2006). However, responses to most items of this scale require various cognitive processes such as self-knowledge or episodic memory. Group differences with this kind of affect scale may reflect cognitive rather than affective differences (Strauss and Gold, 2012). In an event sampling study (Gard et al., 2007), participants were asked to rate the pleasure that they anticipated from future activities in their usual life setting. Patients reported less anticipated pleasure from goal-directed activities (such as making dinner, working) than controls, but not from non-goal-directed behaviors (such as eating, smoking). Goal-directed activities require effort, and people with schizophrenia are impaired in the evaluation of effort cost of future activities (Fervaha et al., 2013 and Gold et al., 2013). People with schizophrenia may anticipate more effort and consequently look forward to those goal-directed activities less than controls (see also Fervaha et al., 2014). Here again, it appears that group differences may reflect differences in cognitive evaluations and not in affective processes. Consequently in order to specifically study affective processes in schizophrenia, it is necessary to use tasks with minimal cognitive demands, as was done in the present study. People with schizophrenia are often clinically described as poorly motivated and lacking interest. Consequently, rating scales measuring symptoms (Andreasen, 1989), trait motivation (Heinrichs et al., 1984 and Marin et al., 1991), or task-specific intrinsic motivation (Choi et al., 2010), included items relating to interest. However, interest has often been combined with or understood as enjoyment/pleasure (as in our own previous paper (Trémeau et al., 2010)), and specific or individual reports on interest are missing in schizophrenia research. Interest is particularly important because, as stated above, it may be more related to motivation than pleasure. We know of only one study that examined self-reported excitement (positive arousal) before the onset of a task (Waltz et al., 2010). In that study, a modified monetary incentive delay task was used, patients and controls rated their arousal on a bipolar scale (from negative arousal/anxiety to positive arousal/excitement) before responding to the target cue. No group differences in excitement scores were observed for gains and losses. The current series of studies are to our knowledge the first attempt to clearly differentiate pleasure, interest, and excitement in schizophrenia. We examined these three aspects of affective motivation before and after the completion of computerized laboratory tasks in three independent studies (results on task performances are reported elsewhere), which have a low cognitive load. We reasoned that apparent lack of interest and impaired anticipation in schizophrenia might be secondary to cognitive deficits, and we hypothesized that people with schizophrenia's affective motivational evaluations are not impaired when cognitive demand is low, as in the present study.
نتیجه گیری انگلیسی
5. Conclusions Participants with schizophrenia or schizoaffective disorder did not show impaired immediate affective evaluations when tested with a laboratory task. Moreover, their anticipated pleasure and their posttest evaluations of pleasure and interest were greater than controls'. Anticipated pleasure and pretest excitement were negatively correlated with depression scores, and pretest interest with negative symptoms. Our results showed that not all affective processes are impaired in schizophrenia, and emphasize the need to disentangle affective from cognitive processes in order to shed light on the complex impairments present in schizophrenia.