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Abstract
Anhedonia and avolition are core negative symptoms of schizophrenia (SZ) and among the strongest predictors of functional disability for individuals with the disorder. Current psychosocial and pharmacological interventions are ineffective at treating negative symptoms, largely due to limited mechanistic understanding. Leading conceptual frameworks of anhedonia and avolition implicate dysfunctional cortico-striatal interactions and abnormalities in reward processing; however, these models all assume that the hedonic response is intact in schizophrenia, a theory that may be immature based on the affective science literature. The current work applied Cacioppo’s Evaluative Space Model across multiple methods and different phases of psychosis to test the novel mechanistic hypothesis that hedonic abnormalities in the form of a diminished positivity offset contribute to anhedonia and avolition across the psychosis continuum. The positivity offset is an adaptive function characterized by a greater balance of positive than negative emotion at low levels of arousal, which promotes motivated behaviors. Previous laboratory evidence indicates that the positivity offset is reduced in SZ compared to healthy controls and is associated with clinically rated negative symptoms. Here, we extend these findings through three separate studies designed to explore the overarching hypothesis that reductions in the positivity offset predict anhedonia and avolition throughout the continuum of psychotic disorders. Study 1 aimed to determine if the positivity offset is also reduced in the context of daily life and whether it is associated with anhedonia and avolition measured via active and passive digital phenotyping. Study 2 aimed to replicate prior laboratory evidence for the reduced positivity offset in SZ and its association with negative symptoms. Additionally, Study 2 aimed to determine if the pattern of positivity offset abnormalities previously observed in SZ extend to individuals at clinical high-risk (CHR) for psychosis, as well as determine how mood symptoms influence the positivity offset and its relationship with negative symptoms across the psychosis continuum. Study 3 aimed to determine whether the positivity offset is reduced in individuals at CHR for psychosis and associated with anhedonia and avolition in the context of daily life using active and passive digital phenotyping. Collectively, findings have the potential to identify affective processes underlying anhedonia and avolition that may be novel targets for prevention and intervention.