The positivity offset theory of anhedonia in schizophrenia: evidence for a deficit in daily life using digital phenotyping | Psychological Medicine | Cambridge Core


Negative symptoms of schizophrenia have recently been proposed to
result from a decoupling of (intact) hedonic experience and (diminished)
approach behavior. The current study challenged this view by exploring
the hypothesis that negative symptoms are driven by a specific type of
emotional experience abnormality, a reduction in the positivity offset
(i.e. the tendency to experience greater levels of positive relative to
negative emotion in low-arousal contexts), which limits the production
of approach behaviors in neutral environments.


Participants included outpatients with SZ (n = 44) and healthy controls (CN: n
= 48) who completed one week of active (ecological momentary assessment
surveys of emotional experience and symptoms) and passive (geolocation,
accelerometry) digital phenotyping. Mathematical modeling approaches
from Cacioppo's Evaluative Space Model were used to quantify the
positivity offset in daily life. Negative symptoms were assessed via
standard clinical ratings, as well as active (EMA surveys) and passive
(geolocation, accelerometry) digital phenotyping measures.


Results indicated that the positivity offset was reduced in SZ and
associated with more severe anhedonia and avolition measured via
clinical interviews and active and passive digital phenotyping.


These findings suggest that current conceptual models of negative
symptoms, which assume hedonic normality, may need to be revised to
account for reductions in the positivity offset and its connection to
diminished motivated behavior. Findings identify key real-world contexts
where negative symptoms could be targeted using psychosocial

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