The relevance of goal-orientation for motivation in high versus low proneness to negative symptoms.

BACKGROUND: The psychological mechanisms of why individuals with negative symptoms fail to initiate and perform goal-directed behavior are not well understood. Drawing on the reward-sensitivity and expectancy-value theories, we investigate whether negative symptom-like experiences (NSLE) are associated with generating less approach goals (aimed at reaching a positive outcome) and more avoidance goals (aimed at avoiding a negative outcome) and whether this type of goal-orientation explains motivational deficits (i.e., perceiving goals as less feasible and important and being less committed to them). METHODS: Based on the continuum model of negative symptoms, we identified two parallelized extreme groups with high and low levels of NSLE (n = 37, respectively) in an ad-hoc online-sample of healthy individuals (N = 262) using the Community Assessment of Psychic Experiences. In an online study, these participants were instructed to generate approach and avoidance goals and to rate each goal in terms of feasibility, importance and goal-commitment. RESULTS: Participants with low levels of NSLE generated more approach than avoidance goals. Participants with high levels of NSLE showed no such difference due to increased numbers of avoidance goals. Furthermore, avoidance goal-orientation predicted reduced subjective feasibility and importance of goals and less goal-commitment. LIMITATIONS: Results are based on a healthy sample rather than people with psychosis. No longitudinal or behavioral data for goal-striving was collected. CONCLUSION: People with NSLE generate more avoidance goals than controls. This is dysfunctional because it correlates with feeling less committed to reach one's goals. Optimizing goal-setting could be a promising starting-point for psychological interventions aimed at reducing negative symptoms.

Concordance of self- and observer-rated motivation and pleasure in patients with negative symptoms and healthy controls.

This study examined the validity of using a self-rating scale for assessing the motivation and pleasure domain of negative symptoms in the general population by examining the concordance of self- and observer-rated negative symptoms in a healthy sample and by comparing it with a patient sample. The motivation and pleasure domain of negative symptoms was assessed using the observer-rated Clinical Assessment Interview for Negative Symptoms (CAINS) and the self-rated Motivation and Pleasure Scale-Self-Report (MAP-SR). We found 52.9% of the healthy individuals and 46% of the patients to have relatively equal self- and observer-ratings. Despite the absence of extreme discrepancies, 31.4% of the healthy individuals and 14% of the patients rated their negative symptoms as more severe, whereas 15.7% of the healthy individuals and 40% of the patients rated them as less severe than the observers. By using self-ratings in combination with observer-ratings, possible discrepancies can be uncovered, which may be relevant for the successful treatment of negative symptoms.

Motivation and Pleasure Scale-Self-Report (MAP-SR): Validation of the German version of a self-report measure for screening negative symptoms in schizophrenia.

OBJECTIVES: Validated self-report instruments could provide a time efficient screening method for negative symptoms in people with schizophrenia. The aim of this study was to examine the psychometric properties of a German version of the Motivation and Pleasure Scale-Self-Report (MAP-SR) which is based on the Clinical Assessment Interview for Negative Symptoms (CAINS). METHODS: In- and outpatients (N=50) with schizophrenia or schizoaffective disorder were assessed with standardized interviews and questionnaires on negative and positive symptoms and general psychopathology in schizophrenia, depression, and global functioning. RESULTS: The German version of the MAP-SR showed high internal consistency. Convergent validity was supported by significant correlations between the MAP-SR with the experience sub-scale of the CAINS and the negative symptom sub-scale of the Positive and Negative Syndrome Scale. The MAP-SR also exhibited discriminant validity indicated by its non-significant correlations with positive symptoms and general psychopathology, which is in line with the findings for the original version of the MAP-SR. However, the MAP-SR correlated moderately with depression. CONCLUSION: The German MAP-SR appears to be a valid and suitable diagnostic tool for the identification of negative symptoms in schizophrenia.

Anticipation and experience of emotions in patients with schizophrenia and negative symptoms. An experimental study in a social context.

Negative symptoms play a central role in the impairment of social functioning in schizophrenia. Healthy individuals use anticipated emotions to guide their decisions to seek out social interactions. It is unknown whether social withdrawal in negative symptoms is related to a biased anticipation of emotions that will arise in social situations. This study thus examined differences between patients with negative symptoms of schizophrenia and healthy controls in the anticipation and experience of positive and negative emotions related to a social interaction. In a between-subject factorial design, participants were instructed to either predict or to experience emotions related to a simulated social inclusion and exclusion interaction. Overall, patients anticipated more intense negative emotions than controls. Divided by the type of social situation, however, patients reported less intense positive emotions than controls with regard to social inclusion, but not with regard to social exclusion. The lack of an overall deficit in anticipation of positive emotions speaks against the assumption that anticipation abnormalities in negative symptoms are due to a neurocognitive deficit. Rather, the findings seem to reflect negative beliefs about potentially rewarding social situations in people with negative symptoms.

Subclinical negative symptoms and the anticipation, experience and recall of emotions related to social interactions: An experimental study.

Healthy individuals use anticipated and recalled emotions to guide their decisions to seek out social interactions. It is unknown whether individuals with negative symptoms of schizophrenia, who are commonly observed to socially withdraw, show a bias in anticipation and recall of emotions related to a social interaction. To close this knowledge gap, this study examines whether higher levels of subclinical negative symptoms are associated with less positive and more negative anticipated and recalled emotions related to a social interaction. In a mixed model design participants were instructed to either predict or to experience and then recall emotions related to a simulated social inclusion- or exclusion-interaction. Disregarding the type of situation, participants with higher levels of subclinical negative symptoms anticipated more intense fear than participants with lower levels of subclinical negative symptoms. Divided by type of situation, however, participants with higher levels of negative symptoms experienced and recalled more sadness related to being socially included and even recalled more positive emotions after being excluded. These specific associations are likely to reflect negative expectations about potentially rewarding social situations in people with negative symptoms. A replication in populations with clinically relevant negative symptoms and inclusion of measures to assess memory is warranted.

Validation of the German version of the Clinical Assessment Interview for Negative Symptoms (CAINS).

Validated assessment instruments could contribute to a better understanding and assessment of negative symptoms and advance treatment research. The aim of this study was to examine the psychometric properties of a German version of the Clinical Assessment Interview for Negative Symptoms (CAINS). In- and outpatients (N=53) with schizophrenia or schizoaffective disorder were assessed with standardized interviews and questionnaires on negative and positive symptoms and general psychopathology in schizophrenia, depression, the ability to experience anticipatory and consummatory pleasure, and global functioning. The results indicated good psychometric properties, high internal consistency and promising inter-rater agreement for the German version of the CAINS. The two-factor solution of the original version of the CAINS was confirmed, indicating good construct validity. Convergent validity was supported by significant correlations between the CAINS subscales with the negative symptom scale of the Positive and Negative Syndrome Scale, and with consummatory pleasure. The CAINS also exhibited discriminant validity indicated by its non-significant correlations with positive symptoms, general psychopathology and depression that are in line with the findings for the original version of the CAINS. In addition, the CAINS correlated moderately with global functioning. The German version of the CAINS appears to be a valid and suitable diagnostic tool for measuring negative symptoms in schizophrenia.

Anticipatory pleasure and approach motivation in schizophrenia-like negative symptoms.

Previous research of negative symptoms in schizophrenia has emphasized an anticipatory pleasure deficit, yet the relationship of this deficit to patients' motivation in everyday life is poorly understood. This study tested the link between anticipatory pleasure and two broad motivational systems that are said to regulate the intensity of approach and avoidance behavior, the Behavioral Inhibition system (BIS) and the Behavioral Activation System (BAS). It was hypothesized that high vulnerability for negative symptoms would be associated with low reward responsiveness and that this association will be mediated by the amount of anticipated pleasure. Students (n=171) with varying vulnerability for negative symptoms (assessed by the Community Assessment of Psychic Experiences) completed questionnaires regarding (a) anticipatory and consummatory pleasure, and (b) responsiveness to threat and reward. As hypothesized, anticipatory pleasure correlated significantly negatively with subclinical negative symptoms (r=-0.21) and significantly positively with BAS (r=0.55). Furthermore, evidence for a partial mediation effect was found. The findings support the notion of a close association between negative symptoms, the ability to anticipate pleasure and approach motivation that is evident even in healthy persons. It is suggested that the behavioral deficits immanent to negative symptoms reflect difficulties in the ability to translate emotions into motivation.

The impact of dietary cation anion difference (DCAD) on the acid-base balance and calcium metabolism of non-lactating, non-pregnant dairy cows fed equal amounts of different anionic salts.

We evaluated the impact of the dietary cation-anion difference (DCAD) on the influence of anionic salts (AS) on the metabolism of dairy cows using a study-design that included control of feed intake. Ten mature, non-lactating, non-pregnant, Holstein-Friesian-crossbreed cows received 2000 mEq of either one of the seven anionic salts tested, two combinations of the anionic salts or water as control via a rumen cannula. Salts and controls were assigned in a 10x10 Latin square design. Whole blood, serum and urine samples were taken during treatment (TP) and washout period. Samples of whole blood were tested for pH, base-excess and bicarbonate concentrations. In urine, pH and net acid-base excretion (NABE) were analysed. Calcium was measured in serum and urine. According to the different batches of hay, five groups of DCAD were created regarding cluster analysis. Changes in urine and blood parameters were statistically analysed for each DCAD group separately. The different DCAD had an impact on the amount of change in acid-base balance (ABB) and calcium metabolism and for how long these changes lasted. In the DCAD group receiving the highest amount of AS (239 mEq/kg dry matter with AS), changes of ABB were only noticeable in urine and these changes only differed from day zero in the first week of TP (P<0.05). In the other four groups changes of ABB were also visible in blood parameters, but only on a few days of TP did the deviations differ significantly (P<0.05) from day zero. Changes of ABB parameters in urine samples were more pronounced than those in blood and differed clearly from day zero (P<0.05). Parallel to the changes of ABB, calcium concentrations in these samples were significantly increased (P<0.001) in all DCAD groups. Except for the highest DCAD group, ionized calcium concentrations changed over time (P<0.020). However, the differences were very small and only differed from day zero on a few TP days. We conclude that the DCAD of a dairy cow's diet has an important impact on the effect of AS on ABB and calcium metabolism with respect to the duration and amount of change. The target regions of DCAD should be clearly below 100 mEq/kg dry matter to ensure the desired effect on ABB and calcium metabolism. Extremely negative DCAD should be avoided to minimize the risk of clinical acidosis induced by AS.