title: Apathy in schizophrenia as a deficit in the generation of options for action.
abstract: Negative symptoms are a core feature of schizophrenia and have been grouped into 2 factors: a motivational factor, which we refer to as apathy, and a diminished expression factor. Recent studies have shown that apathy is closely linked to functional outcome. However, knowledge about its mechanisms and its relation to decision-making is limited. In the current study, we examined whether apathy in schizophrenia is associated with predecisional deficits, that is, deficits in the generation of options for action. We applied verbal protocol analysis to investigate the quantity of options generated in ill-structured real world scenarios in 30 patients with schizophrenia or schizoaffective disorder and 21 healthy control participants. Patients generated significantly fewer options than control participants and clinical apathy ratings correlated negatively with the quantity of generated options. We show that the association between measures of psychopathology and option generation is most pronounced in regard to apathy symptoms and that it is only partially mediated by deficits in verbal fluency. This study provides empirical support for dysfunctional option generation as a possible mechanism for apathy in schizophrenia. Our data emphasize the potential importance of predecisional stages in the development and persistence of apathy symptoms in neuropsychiatric disorders and might also inform the development of novel treatment options in the realm of cognitive remediation.
authors: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich.
authors: Matthias N
authors: MN
authors: Hartmann
authors: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich.
authors: Agne
authors: A
authors: Kluge
authors: Department of Philosophy, Utrecht University.
authors: Annemarie
authors: A
authors: Kalis
authors: Institute of Psychology, University of Hildesheim.
authors: Andreas
authors: A
authors: Mojzisch
authors: Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich.
authors: Philippe N
authors: PN
authors: Tobler
authors: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich.
authors: Stefan
authors: S
authors: Kaiser
mesh_terms: D000328:Adult; D057565:Apathy / Q000502:physiology*; D003657:Decision Making / Q000502:physiology*; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000503:physiopathology*