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Optimizing vs. matching: response strategy in a probabilistic learning task is associated with negative symptoms of schizophrenia.

ABSTRACT: Previous research indicates that behavioral performance in simple probability learning tasks can be organized into response strategy classifications that are thought to predict important personal characteristics and individual differences. Typically, relatively small proportion of subjects can be identified as optimizers for effectively exploiting the environment and choosing the more rewarding stimulus nearly all of the time. In contrast, the vast majority of subjects behaves sub-optimally and adopts the matching or super-matching strategy, apportioning their responses in a way that matches or slightly exceeds the probabilities of reinforcement. In the present study, we administered a two-choice probability learning paradigm to 51 individuals with schizophrenia (SZ) and 29 healthy controls (NC) to examine whether there are differences in the proportion of subjects falling into these response strategy classifications, and to determine whether task performance is differentially associated with symptom severity and neuropsychological functioning. Although the sample of SZ patients did not differ from NC in overall rate of learning or end performance, significant clinical differences emerged when patients were divided into optimizing, super-matching and matching subgroups based upon task performance. Patients classified as optimizers, who adopted the most advantageous learning strategy, exhibited higher levels of positive and negative symptoms than their matching and super-matching counterparts. Importantly, when both positive and negative symptoms were considered together, only negative symptom severity was a significant predictor of whether a subject would behave optimally, with each one standard deviation increase in negative symptoms increasing the odds of a patient being an optimizer by as much as 80%. These data provide a rare example of a greater clinical impairment being associated with better behavioral performance.

SUBMITTER: Kasanova Z

PROVIDER: S-EPMC3051026 | biostudies-literature | 2011 Apr

REPOSITORIES: biostudies-literature

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Optimizing vs. matching: response strategy in a probabilistic learning task is associated with negative symptoms of schizophrenia.

Kasanova Zuzana Z Waltz James A JA Strauss Gregory P GP Frank Michael J MJ Gold James M JM

Schizophrenia research 20110115 1-3

Previous research indicates that behavioral performance in simple probability learning tasks can be organized into response strategy classifications that are thought to predict important personal characteristics and individual differences. Typically, relatively small proportion of subjects can be identified as optimizers for effectively exploiting the environment and choosing the more rewarding stimulus nearly all of the time. In contrast, the vast majority of subjects behaves sub-optimally and ...[more]

PMID: 21239143

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Project description:ImportanceNegative symptoms are associated with a range of poor clinical outcomes, and currently available treatments generally do not produce a clinically meaningful response. Limited treatment progress may be owing in part to poor clarity regarding latent structure. Prior studies have inferred latent structure using exploratory factor analysis, which has led to the conclusion that there are 2 dimensions reflecting motivation and pleasure (MAP) and diminished expressivity (EXP) factors. However, whether these conclusions are statistically justified remains unclear because exploratory factor analysis does not test latent structure. Confirmatory factor analysis (CFA) is needed to test competing models regarding the latent structure of a construct.ObjectiveTo evaluate the fit of 4 models of the latent structure of negative symptoms in schizophrenia using CFA.Design, setting, and participantsThree cross-sectional studies were conducted on outpatients with schizophrenia who were rated on the 3 most conceptually contemporary measures: Scale for the Assessment of Negative Symptoms (SANS), Brief Negative Symptom Scale (BNSS), and Clinical Assessment Interview for Negative Symptoms (CAINS). Confirmatory factor analysis evaluated the following 4 models: (1) a 1-factor model; (2) a 2-factor model with EXP and MAP factors; (3) a 5-factor model with separate factors for the 5 domains of the National Institute of Mental Health consensus development conference (blunted affect, alogia, anhedonia, avolition, and asociality); and (4) a hierarchical model with 2 second-order factors reflecting EXP and MAP and 5 first-order factors reflecting the 5 consensus domains.Main outcomes and measuresOutcomes included CFA model fit statistics derived from symptom severity scores on the SANS, BNSS, and CAINS.ResultsThe study population included 860 outpatients with schizophrenia (68.0% male; mean [SD] age, 43.0 [11.4] years). Confirmatory factor analysis was conducted on each scale, including 268 patients for the SANS, 192 for the BNSS, and 400 for the CAINS. The 1- and 2-factor models provided poor fit for the SANS, BNSS, and CAINS as indicated by comparative fit indexes (CFIs) and Tucker Lewis indexes (TLIs) less than 0.950, RMSEAs that exceeded the 0.080 threshold, and WRMRs greater than 1.00. The 5-factor and hierarchical models provided excellent fit, with the 5-factor model being more parsimonious. The CFIs and TLIs met the 0.95 threshold and the 1.00 threshold for both factor models with all 3 measures. Interestingly, the RMSEAs for the 5-factor model and the hierarchical model fell under the 0.08 threshold for the BNSS and the CAINS but not the SANS.Conclusions and relevanceThese findings suggest that the recent trend toward conceptualizing the latent structure of negative symptoms as 2 distinct dimensions does not adequately capture the complexity of the construct. The latent structure of negative symptoms is best conceptualized in relation to the 5 consensus domains. Implications for identifying pathophysiological mechanisms and targeted treatments are discussed.

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Optimizing vs. matching: response strategy in a probabilistic learning task is associated with negative symptoms of schizophrenia.

Publications

Optimizing vs. matching: response strategy in a probabilistic learning task is associated with negative symptoms of schizophrenia.

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