Learning and Motivation for Rewards in Schizophrenia: Implications for Behavioral Rehabilitation

Abstract

Purpose of ReviewImpaired reward processing and amotivation are well documented in schizophrenia. We aim to review the current state of neuroimaging and behavioral research addressing components of motivational deficits in this complex and impairing syndrome. Evidence will be integrated to inform the ongoing development of effective strategies for behavioral rehabilitation.Recent FindingsWhile striatal dopamine and aberrant reward prediction errors have been connected to amotivation in schizophrenia, they are not sufficiently full explanations of reward processing impairments. Frontal dysfunction and associated cognitive control deficits also have evidenced involvement in atypical reward prediction, learning, and valuation. Ongoing work supports the utility of interventions (e.g., cognitive remediation) for improved motivation for rewards.SummaryWithin schizophrenia, greater negative symptoms (avolition and anhedonia) are associated with poorer functioning and more severely impaired reward processing. Utilizing behavioral interventions such as cognitive remediation and social cognition training hold promise for rehabilitation and increased community integration.