title: Study of positive and negative feedback sensitivity in psychosis using the Wisconsin Card Sorting Test.
abstract: BACKGROUND
  Schizophrenia involves marked motivational and learning deficits that may reflect abnormalities in reward processing. The purpose of this study was to examine positive and negative feedback sensitivity in schizophrenia using computational modeling derived from the Wisconsin Card Sorting Test (WCST). We also aimed to explore feedback sensitivity in a sample with bipolar disorder.
  
  
  METHODS
  Eighty-three individuals with schizophrenia and 27 with bipolar disorder were included. Demographic, clinical and cognitive outcomes, together with the WCST, were considered in both samples. Computational modeling was performed using the R syntax to calculate 3 parameters based on trial-by-trial execution on the WCST: reward sensitivity (R), punishment sensitivity (P), and choice consistency (D). The associations between outcome variables and the parameters were investigated.
  
  
  RESULTS
  Positive and negative sensitivity showed deficits, but P parameter was clearly diminished in schizophrenia. Cognitive variables, age, and symptoms were associated with R, P, and D parameters in schizophrenia. The sample with bipolar disorder would show cognitive deficits and feedback abnormalities to a lesser extent than individuals with schizophrenia.
  
  
  CONCLUSIONS
  Negative feedback sensitivity demonstrated greater deficit in both samples. Idiosyncratic cognitive requirements in the WCST might introduce confusion when supposing model-free reinforcement learning. Negative symptoms of schizophrenia were related to lower feedback sensitivity and less goal-directed patterns of choice.
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain; Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom. Electronic address: a.farreny@qmul.ac.uk.
authors.forename: Aida
authors.initials: A
authors.lastname: Farreny
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense (4)CIBERSAM; Department of Methodology, School of Psychology, Universidad Complutense, Madrid, Spain. Electronic address: alreymejias@gmail.com.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Del Rey-Mejías
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain. Electronic address: gescartin@pssjd.org.
authors.forename: Gemma
authors.initials: G
authors.lastname: Escartin
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain. Electronic address: jusall@pssjd.org.
authors.forename: Judith
authors.initials: J
authors.lastname: Usall
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain. Electronic address: ntous@pssjd.org.
authors.forename: Núria
authors.initials: N
authors.lastname: Tous
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain. Electronic address: jmharo@pssjd.org.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Parc Sanitari Sant Joan de Déu,(4)CIBERSAM, Barcelona, Spain. Electronic address: sochoa@pssjd.org.
authors.forename: Susana
authors.initials: S
authors.lastname: Ochoa
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology; D002755:Choice Behavior; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*; D012054:Reinforcement, Psychology; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D014145:Trail Making Test