When loss outweighs reward

Schizophrenia is often marked by reduced motivation and difficulty experiencing pleasure. In this new study, now online as a preprint, we asked why people with schizophrenia seem less driven by rewards yet remain sensitive to avoiding losses. We examined 50 individuals with schizophrenia spectrum disorders and 48 healthy participants while they completed a decision-making task during functional brain imaging.

We found that healthy people relied more on goal-directed strategies when pursuing rewards, whereas people with schizophrenia focused more on avoiding losses. This shift was mirrored in prefrontal brain activity. In particular, stronger loss-related activation in the anterior cingulate cortex was linked to reduced pleasure and predicted worsening motivation and social withdrawal over the following year.

Our findings suggest that people with schizophrenia devote more mental resources to avoiding losses than to pursuing rewards. This imbalance may underlie problems with motivation and pleasure, and it could guide the development of new treatments.

Congratulations to Wolfgang, Giacomo, and Akhil for leading this work, and many thanks to our collaborators.