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. 2016 Jun:4:32-38.
doi: 10.1016/j.scog.2016.04.002.

Are persistent delusions in schizophrenia associated with aberrant salience?

Rafeef Abboud  1 , Jonathan P Roiser  1 , Hind Khalifeh  2 , Sheila Ali  1 , Isobel Harrison  3 , Helen T Killaspy  3 , Eileen M Joyce  4
Affiliations

Are persistent delusions in schizophrenia associated with aberrant salience?

Rafeef Abboud et al. Schizophr Res Cogn. 2016 Jun.

Abstract

Objective: It has been suggested that positive psychotic symptoms reflect 'aberrant salience'. Previously we provided support for this hypothesis in first-episode schizophrenia patients, demonstrating that delusional symptoms were associated with aberrant reward processing, indexed by the Salience Attribution Test (SAT). Here we tested whether salience processing is abnormal in schizophrenia patients with long-standing treatment-refractory persistent delusions (TRS).

Method: Eighteen medicated TRS patients and 31 healthy volunteers completed the SAT, on which participants made a speeded response to earn money in the presence of cues. Each cue comprised two visual dimensions, colour and form. Reinforcement probability varied over one of these dimensions (task-relevant), but not the other (task-irrelevant).

Results: Participants responded significantly faster on high-probability relative to low-probability trials, representing implicit adaptive salience; this effect was intact in TRS patients. By contrast, TRS patients were impaired on the explicit adaptive salience measure, rating high-probability stimuli less likely to be associated with reward than controls. There was little evidence for elevated aberrant salience in the TRS group.

Conclusion: These findings do not support the hypothesis that persistent delusions are related to aberrant motivational salience processing in TRS patients. However, they do support the view that patients with schizophrenia have impaired reward learning.

Keywords: Behaviour; Delusions; Psychosis; Reinforcement; Schizophrenia.

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Figures

Fig. 1
Fig. 1
Visual analogue scale (VAS) probability ratings in schizophrenia patients with treatment-resistant delusions (TRS) and controls. Controls exhibited significantly greater explicit adaptive salience (the difference in VAS rating between high and low probability stimuli) than TRS patients [controls: mean = 33.22, SD = 21.57; patients: mean = 7.85, SD = 12.03; F(1,47) = 20.997, P < 0.001]. This group difference was driven by a reduction in the ratings for high probability stimuli in TRS patients (* indicates P < 0.001), while there was no difference between the groups for the ratings of low probability stimuli. Error bars represent standard errors of the mean.
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