Is poor social functioning of patients with psychosis a result of inability to transfer social reward value to future situations?

The Experience Sampling Method study

Abstract

Background: Poor social functioning is one of the main features of psychosis. It usually escalates over the course of the disorder and it is very resistant to treatment. A possible reason for poor social functioning in patients with psychosis is impaired reward sensitivity. The aim of this study was to investigate the extent to which positive affect experienced in social company leads to social engagement in the immediate future, and whether this pattern of consummatory experience informing social behavior differs between patients and controls.

Method: Patients with diagnosed psychotic disorder (N=46) and healthy individuals (N=54) participated in Experience Sampling Method (ESM) data collection. Data were collected 10 times per day for 6 consecutive days. The measures of interest were momentary positive affect (PA) and the subjectively rated pleasantness of company in everyday life.

Results: Patients experienced higher levels of PA while in the company of others than did controls, even when the pleasantness of company was rated »low«. Somewhat surprisingly, pleasantness of social company and PA while in company (t-1) were not predictive of future engagement in social company (t) in neither one of the two groups.

Conclusion: This study suggests that positive experience during social company does not predict being in similar situations in the immediate future for either group. Based on these results, altered reward learning is not specific for psychotic patients, but is also observed in healthy controls. However, some methodological issues of the current study could be the reason for such findings. Therefore, future studies should further investigate reward learning in patients with psychosis.