title: Behavioral approach and avoidance in schizophrenia: an evaluation of motivational profiles.
abstract: Schizophrenia is associated with motivational deficits that interfere with a wide range of goal directed activities. Despite their clinical importance, our current understanding of these motivational impairments is limited. Furthermore, different types of motivational problems are commonly seen among individuals within the broad diagnosis of schizophrenia. The goal of the current study was to examine whether clinically meaningful subgroups could be identified based on approach and avoidance motivational tendencies. We measured these tendencies in 151 individuals with schizophrenia. Although prior studies demonstrate elevated BIS sensitivity in schizophrenia at the overall group level, none have explored various combinations of BIS/BAS sensitivities within this disorder. Cluster analyses yielded five subgroups with different combinations of low, moderate, or high BIS and BAS. The subgroups had interpretable differences in clinically rated negative symptoms and self-reported anhedonia/socio-emotional attitudes, which were not detectable with the more commonly used linear BIS/BAS scores. Two of the subgroups had significantly elevated negative symptoms but different approach/avoidance profiles: one was characterized by markedly low BIS, low BAS and an overall lack of social approach motivation; the other had markedly high BIS but moderate BAS and elevated social avoidance motivation. The two subgroups with relatively good clinical functioning showed patterns of BAS greater than BIS. Our findings indicate that there are distinct motivational pathways that can lead to asociality in schizophrenia and highlight the value of considering profiles based on combined patterns of BIS and BAS in schizophrenia.
authors.affiliation: VA Greater Los Angeles Healthcare System, United States; Semel Institute for Neuroscience and Human Behavior, UCLA, United States.
authors.forename: L
authors.initials: L
authors.lastname: Felice Reddy
authors.affiliation: VA Greater Los Angeles Healthcare System, United States; Semel Institute for Neuroscience and Human Behavior, UCLA, United States.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Green
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, UCLA, United States; Department of Biostatistics, UCLA, United States.
authors.forename: Shemra
authors.initials: S
authors.lastname: Rizzo
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, UCLA, United States; Department of Biostatistics, UCLA, United States.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sugar
authors.affiliation: Department of Psychology, University of Maryland, College Park, United States.
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Blanchard
authors.affiliation: Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, United States.
authors.forename: Raquel E
authors.initials: RE
authors.lastname: Gur
authors.affiliation: Department of Psychology, University of California, Berkeley, United States.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Kring
authors.affiliation: VA Greater Los Angeles Healthcare System, United States; Semel Institute for Neuroscience and Human Behavior, UCLA, United States.
authors.forename: William P
authors.initials: WP
authors.lastname: Horan
mesh_terms: D000328:Adult; D059445:Anhedonia / Q000502:physiology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009042:Motivation; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D013223:Statistics as Topic
keywords: BIS/BAS; Behavioral approach and avoidance; Motivation; Negative symptoms; Schizophrenia; Social anhedonia