SPECIFIC PROGRAM FOR INTERVENTION IN INCIPIENT PSYCHOSIS INTRODUCED IN CATALONIA(SPAIN)

Abstract

Background: Elevated presynaptic striatal dopamine is thought to be a final common effect of multiple specific aetiologies, which in turn gives risk to psychosis through the disruption of incentive salience. In contrast to psychosis, negative symptoms are thought to emerge from the disruption of multiple neurophysiological systems (Howes & Kapur, 2009, Schizophr. Bull., 35, 549-62). We tested this model by examining the relationship of an ecologically valid measure of reward learning with anhedonia and intermediate phenotypes of schizophrenia, while controlling for neuropsychological impairment. Methods: Undergraduates (n=84) completed the stimulus chase task (SCT), which provided a measure of sensitivity to reward, selfreport measures of hedonic capacity, and self-report (Schizotypal Personality Questionnaire [SPQ]) and performance (psychobabble task) measures of intermediate phenotypes of schizophrenia. Motor reaction time, attention, and frontal functions were assessed with a small battery of neuropsychological tests. Results: After controlling for neuropsychological functioning, higher cognitive-perceptual SPQ scores predicted poorer performance on the SCT (r=-0.27, p<0.01). Higher interpersonal SPQ scores also predicted poorer SCT performance (r=-0.26, p<0.01). However, anhedonia and disorganization features were not associated with SCT scores. Discussion: The theoretical link between salience, or the efficacy of reward learning, and psychosis is evident at the level of the intermediate phenotypes of schizophrenia reported by ostensibly healthy individuals. However, an equally strong association of salience with intermediate phenotypes of negative symptoms complicates this picture. The observed associations are not attributable to neuropsychological impairment or anhedonia.