Motivational impairments in psychotic and depressive pathology

The Research Domain Criteria initiative has recognized the importance of studying motivation and hedonic processing in psychopathology and includes a “positive valence system (PVS) domain. Here, we review behavioral and neuroimaging studies examining impairments in these constructs in individuals with psychosis versus depressive pathology. This review indicates that in depression, impairments in the experience of pleasure may propagate forward and lead to impairments in other aspects of the PVS that are reliant on hedonic responses, such as anticipation, learning, effort, and action selection. The existing data indicate relatively intact in-the-moment pleasure experience in psychosis, but disruptions in other components involved in the PVS. Specifically, individuals with schizophrenia exhibit altered reward prediction and associated striatal and prefrontal activation, impaired reward learning, and impaired reward-modulated action selection, which may combine together to disrupt goal-directed behavior and function in everyday life.