Patients with schizophrenia demonstrate inconsistent preference judgments for affective and nonaffective stimuli

Previous studies have typically found that individuals with schizophrenia (SZ) report levels of emotional experience that are similar to controls (CN) when asked to view a single evocative stimulus and make an absolute judgment of stimulus "value." However, value is rarely assigned in absolute terms in real-life situations, where one alternative or experience is often evaluated alongside others, and value judgments are made in relative terms. In the current study, we examined performance on a preference task that requires individuals to differentiate between the relative values of different stimuli. In this task, subjects were presented with many pairs of moderately positive stimuli and asked to indicate which stimulus they preferred in each pair. Resulting data indicated the rank order of preference across stimuli and the consistency of their transitive mapping (ie, if A > B and B > C, then A should be > C). Individuals with SZ (n = 38) were both less consistent in their rankings of stimuli and more likely to have larger magnitudes of discrepant responses than control subjects (n = 27). Furthermore, CN showed clear differentiation between different valence categories of stimuli (ie, highly positive > mildly positive > mildly negative > highly negative); while individuals with SZ showed the same general pattern of results but with less differentiation between the valence levels. These data suggest that individuals with SZ are impaired in developing or maintaining nuanced representations of the different attributes of a stimulus, thus making stimuli of similar general value easily confusable.