Schizophrenia is a neurodevelopmental and brain condition that affects cognition, emotion, and thinking processes. Although positive symptoms such as hallucinations and delusions are used to diagnose schizophrenia, negative symptoms such as anhedonia, amotivation, and expressive dysfunctions are used to determine the eventual functional outcome of people with schizophrenia. However, the true nature of the link between unpleasant symptoms and social functioning is unknown. Previous research into the link between negative symptoms and social functioning used a single negative symptom model. A two-factor model in schizophrenia that includes motivation/anhedonia and expressiveness dysfunctions has recently been proposed. More research is needed to understand the impact of amotivation, anhedonia, and expression on social functioning. Dr Raymond Chan and his team from the Chinese Academy of Sciences’ Institute of Psychology used network analysis to investigate the network structure and interrelationships between negative symptoms (at both the “symptom-dimension” and “symptom-item” levels), other psychopathology, and social functioning in 269 schizophrenia patients to clarify this enigmatic issue.
The Clinical Assessment Interview for Negative Symptoms and the Positive and Negative Syndrome Scale were used to examine negative symptoms, while the Social and Occupational Functioning Assessment Scale was used to assess social functioning. After controlling for drug side effects, illness duration, and other psychopathology, the researchers found that a component capturing anhedonia and amotivation were closely associated with social functioning in schizophrenia patients. At both the “symptom-dimension” and “symptom-item” levels, consistent patterns of network organisation were observed. Subsequent analysis revealed that the amotivation and anhedonia factors explained the most variance in social functioning. These findings suggest that amotivation and anhedonia, rather than expressive dysfunctions, are more important in defining social performance in schizophrenia patients. Amotivation and anhedonia are highlighted in this study as prospective intervention targets for enhancing functional outcomes in schizophrenia patients.
Dr Chan’s group is now looking at whether this pattern of relationship is specific to schizophrenia patients or if it is shared by other mental conditions like major depressive disorder and bipolar disorder that have similar anhedonia, amotivation, and expressive dysfunctions.
