Probing the Dynamic Updating of Value in Schizophrenia Using a Sensory-Specific Satiety Paradigm

It has been proposed that both positive and negative symptoms in schizophrenia (SZ) may derive, at least in part, from a disrupted ability to accurately and flexibly represent the value of stimuli and actions. To assess relationships between dimensions of psychopathology in SZ, and the tendency to devalue food stimuli, on which subjects were fed to satiety, we administered a sensory-specific satiety (SSS) paradigm to 42 SZ patients and 44 controls. In each of 2 sessions, subjects received 16 0.7-ml squirts of each of 2 rewarding foods and 32 squirts of a control solution, using syringes. In between the 2 sessions, each subject was instructed to drink one of the foods until he/she felt "full, but not uncomfortable." At 10 regular intervals, interspersed throughout the 2 sessions, subjects rated each liquid for pleasantness, using a Likert-type scale. Mann-Whitney U-tests revealed group differences in SSS effects. Within-group tests revealed that, while controls showed an effect of satiety that was sensory specific, patients showed an effect of satiety that was not, devaluing the sated and unsated foods similarly. In SZ patients, we observed correlations between the magnitude of SSS effects and measures of both positive and negative symptoms. We argue that the ability to flexibly and rapidly update representations of the value of stimuli and actions figures critically in the ability of patients with psychotic illness to process salient events and adaptively engage in goal-directed behavior.