Learning to Expect Less: An Ecological Momentary Assessment Study of Prediction Errors, Reward Anticipation, and Negative Symptoms in Daily Lives of People with Schizophrenia.

Abstract

Background and hypotheses: The brain continuously generates predictions about future experiences. When outcomes deviate from expectations, positive (+RPE) and negative (-RPE) reward prediction errors recalibrate predictions. Neuroimaging evidence indicates that amotivation in schizophrenia-spectrum disorders (SSD) is linked to blunted processing of +RPEs. Yet the nature of RPEs and their processing in the everyday lives of people with SSD remains unknown.

Study design: This preregistered analysis pooled data from two studies (N = 147; SSD = 68, healthy controls [HC] = 79) to quantify daily-life +RPEs and -RPEs and test their association with subsequent updating of anticipatory pleasure. Participants completed six days of ecological momentary assessment capturing current and anticipated pleasure. +RPEs were defined as EMA assessments in which current pleasure exceeded anticipated pleasure at the previous prompt, -RPEs were defined as occasions in which current pleasure fell short of prior anticipation. Linear mixed-effects models tested group differences in RPE frequency and magnitude; time-lagged models assessed updating of anticipatory pleasure.

Study results: Individuals with SSD reported fewer +RPEs (β = -0.05, p = .025), with no group difference in -RPEs or RPE magnitude. Within SSD, higher baseline amotivation was associated with smaller +RPEs (β = -0.08, p = .019). Time-lagged analyses revealed that in SSD, larger +RPEs predicted reduced subsequent anticipatory pleasure (β = -.171, p < .001), unlike in HCs (β = -.038, p = .26).

Conclusions: Findings indicate that in everyday life, individuals with SSD experience fewer positive surprises and show maladaptive updating of reward expectations, potentially driving negative symptoms.