Psychological Medicine

  • Psychological Medicine / Volume 39 / Issue 02 / February 2009, pp 199-209
  • Copyright © 2008 Cambridge University Press The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use.
  • DOI: http://dx.doi.org/10.1017/S0033291708003863 (About DOI), Published online: 30 June 2008
  • OPEN ACCESS

Original Articles

Do patients with schizophrenia exhibit aberrant salience?

J. P. Roisera1a2 c1, K. E. Stephana2, H. E. M. den Oudena2, T. R. E. Barnesa3, K. J. Fristona2 and E. M. Joycea2

a1 Institute of Cognitive Neuroscience, University College London, London, UK

a2 Wellcome Trust Centre for Neuroimaging, London, UK

a3 Imperial College Faculty of Medicine, Department of Psychological Medicine, Imperial College London, Charing Cross Site, London, UK

Abstract

Background It has been suggested that some psychotic symptoms reflect ‘aberrant salience’, related to dysfunctional reward learning. To test this hypothesis we investigated whether patients with schizophrenia showed impaired learning of task-relevant stimulus–reinforcement associations in the presence of distracting task-irrelevant cues.

Method We tested 20 medicated patients with schizophrenia and 17 controls on a reaction time game, the Salience Attribution Test. In this game, participants made a speeded response to earn money in the presence of conditioned stimuli (CSs). Each CS comprised two visual dimensions, colour and form. Probability of reinforcement varied over one of these dimensions (task-relevant), but not the other (task-irrelevant). Measures of adaptive and aberrant motivational salience were calculated on the basis of latency and subjective reinforcement probability rating differences over the task-relevant and task-irrelevant dimensions respectively.

Results Participants rated reinforcement significantly more likely and responded significantly faster on high-probability-reinforced relative to low-probability-reinforced trials, representing adaptive motivational salience. Patients exhibited reduced adaptive salience relative to controls, but the two groups did not differ in terms of aberrant salience. Patients with delusions exhibited significantly greater aberrant salience than those without delusions, and aberrant salience also correlated with negative symptoms. In the controls, aberrant salience correlated significantly with ‘introvertive anhedonia’ schizotypy.

Conclusions These data support the hypothesis that aberrant salience is related to the presence of delusions in medicated patients with schizophrenia, but are also suggestive of a link with negative symptoms. The relationship between aberrant salience and psychotic symptoms warrants further investigation in unmedicated patients.

(Received January 23 2008)

(Revised April 28 2008)

(Accepted May 08 2008)

(Online publication June 30 2008)

Correspondence

c1 Address for correspondence: J. P. Roiser, Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AR, UK. (Email: j.roiser@ucl.ac.uk)

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