Emotion, Motivation, and Reward Processing in Schizophrenia Spectrum Disorders: What We Know and Where We Need to Go

Abstract

Theorists and researchers on schizophrenia spectrum disorders have long recognized the central role that emotional processing may play in these illnesses since the times of Bleuler and Kraepelin.1,2 For example, our current diagnostic criteria for schizophrenia include reference to disturbances in a number of different aspects of emotional processing, including the ability to display affect either facially or vocally, the ability to display emotions that are deemed appropriate to the current context, and the ability to experience or anticipate pleasure. Further, clinicians have long noted the importance of negative mood and depression in understanding function, course, and outcome in this illness. However, despite the centrality of various aspects of emotional processing in several theories of the development of schizophrenia,3–6 there is a surprising dearth of empirical work examining emotion and motivation in schizophrenia, particularly when one considers the huge body of work on other aspects of the illness, such as cognition, hallucinations, and delusions. The need for more empirical data in this regard has recently been recognized in a number of initiatives, including an offshoot of the Measurement and Treatment Research To Improve Cognition in Schizophrenia initiative that has emphasized the importance of more empirical work on negative symptoms in schizophrenia,7,8 which include abnormalities in various aspects of emotional and motivational processing.