Environmental deprivation is associated with reward processing impairments and negative symptoms in schizophrenia

An environmental systems theory was recently proposed positing that negative symptoms of schizophrenia (SZ) are influenced by direct and indirect environmental factors that limit access to resources needed to complete social, recreational, and goal-directed activities.

Two studies were conducted to test key tenets of this theory. In each study, the Area Deprivation Index (ADI), an objective measure of resource deprivation, was calculated based on neighborhood-level geocoded data. Study 1 included healthy controls (CN: n = 78) and outpatients with schizophrenia (SZ: n = 114) who received clinical ratings of negative symptoms. Trait-level ADI scores were derived from home addresses at the time of testing. In Study 2, outpatients with SZ (n = 52) completed 1-week of digital phenotyping and a battery of laboratory-based reward processing tasks putatively related to the mechanisms underlying negative symptoms. ADI scores were derived at the state level using GPS coordinates at the time of ecological momentary assessment survey.

Across studies, greater resource deprivation measured via the ADI was associated with higher severity of negative symptoms and reward processing deficits.

Findings indicate that environmental factors restricting access to resources are associated with negative symptoms and their underlying mechanisms in SZ. Environmental systems-focused interventions may offer a promising adjunctive treatment for negative symptoms when combined with pharmacological and psychosocial approaches.