Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-05T21:10:43.929Z Has data issue: false hasContentIssue false

Delay discounting in youth at clinical high-risk for psychosis and adults with schizophrenia

Published online by Cambridge University Press:  06 April 2020

Lisa A. Bartolomeo
Affiliation:
Department of Psychology, University of Georgia, USA
Hannah C. Chapman
Affiliation:
Department of Psychology, University of Georgia, USA
Ian M. Raugh
Affiliation:
Department of Psychology, University of Georgia, USA
Gregory P. Strauss*
Affiliation:
Department of Psychology, University of Georgia, USA
*
Author for correspondence: Gregory P. Strauss, E-mail: gstrauss@uga.edu

Abstract

Background

Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and highly predictive of conversion to illness. Mechanisms underlying negative symptoms in the CHR population are unclear. Two studies were conducted to evaluate whether abnormalities in a reward processing mechanism thought to be core to negative symptoms in SZ, value representation, also exist in CHR individuals and whether they are associated with negative symptoms transphasically.

Methods

Study 1 included 33 individuals in the chronic phase of illness who have been diagnosed with schizophrenia or schizoaffective disorder (SZ) and 40 healthy controls (CN). Study 2 included 37 CHR participants and 45 CN. In both studies, participants completed the delay discounting (DD) task as a measure of value representation and the Brief Negative Symptom Scale was rated to measure negative symptoms.

Results

Results indicated that patients with SZ had steeper discounting rates than CN, indicating impairments in value representation. However, CHR participants were unimpaired on the DD task. In both studies, steeper discounting was associated with greater severity of negative symptoms.

Conclusions

These findings suggest that deficits in value representation are associated with negative symptoms transphasically.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J., & Heinssen, R. (2012). Prediction and prevention of psychosis in youth at clinical high risk. Annual Review of Clinical Psychology, 8, 269289. doi:10.1146/annurev-clinpsy-032511-143146.CrossRefGoogle ScholarPubMed
Addington, J., Piskulic, D., Liu, L., Lockwood, J., Cadenhead, K. S., Cannon, T. D., … Woods, S. W. (2017). Comorbid diagnoses for youth at clinical high risk of psychosis. Schizophrenia Research, 190, 9095. doi:10.1016/j.schres.2017.03.043.CrossRefGoogle ScholarPubMed
Ahn, W.-Y., Rass, O., Fridberg, D. J., Bishara, A. J., Forsyth, J. K., Breier, A., … O'donnell, B. F. (2011). Temporal discounting of rewards in patients with bipolar disorder and schizophrenia. Journal of Abnormal Psychology, 120(4), 911921. doi:10.1037/a0023333.CrossRefGoogle Scholar
Amlung, M., Petker, T., Jackson, J., Balodis, I., & MacKillop, J. (2016). Steep discounting of delayed monetary and food rewards in obesity: A meta-analysis. Psychological Medicine, 46(11), 24232434. doi:10.1017/s0033291716000866.CrossRefGoogle ScholarPubMed
Avsar, K. B., Weller, R. E., Cox, J. E., Reid, M. A., White, D. M., & Lahti, A. C. (2013). An fMRI investigation of delay discounting in patients with schizophrenia. Brain and Behavior, 3(4), 384401. doi:10.1002/brb3.135.CrossRefGoogle ScholarPubMed
Barch, D. M., & Dowd, E. C. (2010). Goal representations and motivational drive in schizophrenia: The role of prefrontal-striatal interactions. Schizophrenia Bulletin, 36(5), 919934. doi:10.1093/schbul/sbq068.CrossRefGoogle ScholarPubMed
Bickel, W. K., Odum, A. L., & Madden, G. J. (1999). Impulsivity and cigarette smoking: Delay discounting in current, never, and ex-smokers. Psychopharmacology (Berl), 146(4), 447454. doi:10.1007/pl00005490.CrossRefGoogle ScholarPubMed
Brewer, W. J., Wood, S. J., Phillips, L. J., Francey, S. M., Pantelis, C., Yung, A. R., … McGorry, P. D. (2006). Generalized and specific cognitive performance in clinical high-risk cohorts: A review highlighting potential vulnerability markers for psychosis. Schizophrenia Bulletin, 32(3), 538555. doi:10.1093/schbul/sbj077.CrossRefGoogle Scholar
Brown, H. E., Hart, K. L., Snapper, L. A., Roffman, J. L., & Perlis, R. H. (2018). Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders. npj Schizophrenia, 4, 9. doi:10.1038/s41537-018-0050-z.CrossRefGoogle Scholar
Cai, X.-L., Weigl, M., Liu, B.-H., Cheung, E. F., Ding, J.-H., & Chan, R. C. (2018). Delay discounting and affective priming in individuals with negative schizotypy. Schizophrenia Research, 210, 180187. doi:10.1016/j.schres.2018.12.040.CrossRefGoogle ScholarPubMed
Carrión, R. E., Demmin, D., Auther, A. M., McLaughlin, D., Olsen, R., Lencz, T., … Cornblatt, B. A. (2016). Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome. Journal of Psychiatric Research, 81, 95101. doi:10.1016/j.jpsychires.2016.06.021.CrossRefGoogle ScholarPubMed
Ceaser, A. E., Goldberg, T. E., Egan, M. F., McMahon, R. P., Weinberger, D. R., & Gold, J. M. (2008). Set-shifting ability and schizophrenia: A marker of clinical illness or an intermediate phenotype? Biological Psychiatry, 64(9), 782788. doi:10.1016/j.biopsych.2008.05.009.CrossRefGoogle ScholarPubMed
Collins, A. G., Brown, J. K., Gold, J. M., Waltz, J. A., & Frank, M. J. (2014). Working memory contributions to reinforcement learning impairments in schizophrenia. Journal of Neuroscience, 34(41), 1374713756. doi:10.1523/JNEUROSCI.0989-14.2014.CrossRefGoogle Scholar
Cornblatt, B. A., Auther, A. M., Niendam, T., Smith, C. W., Zinberg, J., Bearden, C. E., & Cannon, T. D. (2007). Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia. Schizophrenia Bulletin, 33(3), 688702. doi:10.1093/schbul/sbm029.CrossRefGoogle ScholarPubMed
Culbreth, A. J., Gold, J. M., Cools, R., & Barch, D. M. (2016). Impaired activation in cognitive control regions predicts reversal learning in schizophrenia. Schizophrenia Bulletin, 42(2), 484493. doi:10.1093/schbul/sbv075.CrossRefGoogle Scholar
Demjaha, A., Valmaggia, L., Stahl, D., Byrne, M., & McGuire, P. (2010). Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophrenia Bulletin, 38(2), 351359. doi:10.1093/schbul/sbq088%J.CrossRefGoogle ScholarPubMed
Elliott, R., Agnew, Z., & Deakin, J. F. (2010). Hedonic and informational functions of the human orbitofrontal cortex. Cerebral Cortex, 20(1), 198204. doi:10.1093/cercor/bhp092.CrossRefGoogle ScholarPubMed
Elliott, R., McKenna, P. J., Robbins, T. W., & Sahakian, B. J. (1995). Neuropsychological evidence for frontostriatal dysfunction in schizophrenia. Psychological Medicine, 25(3), 619630. doi:10.1017/s0033291700033523.CrossRefGoogle Scholar
First, M., Williams, J., Benjamin, L., & Spitzer, R. (2015). User's guide for the SCID-5-PD (structured clinical interview for DSM-5 personality disorder). Arlington, VA: American Psychiatric Association.Google Scholar
First, M., Williams, J., Karg, R., & Spitzer, R. (2015). Structured clinical interview for DSM-5-research version (SCID-5 for DSM-5, research version; SCID-5-RV). Arlington, VA: American Psychiatric Association.Google Scholar
Fusar-Poli, P., Papanastasiou, E., Stahl, D., Rocchetti, M., Carpenter, W., Shergill, S., & McGuire, P. (2015). Treatments of negative symptoms in schizophrenia: Meta-analysis of 168 randomized placebo-controlled trials. Schizophrenia Bulletin, 41(4), 892899. doi:10.1093/schbul/sbu170.CrossRefGoogle ScholarPubMed
Gard, D. E., Cooper, S., Fisher, M., Genevsky, A., Mikels, J. A., & Vinogradov, S. (2011). Evidence for an emotion maintenance deficit in schizophrenia. Psychiatry Research, 187(1–2), 2429. doi:10.1016/j.psychres.2010.12.018.CrossRefGoogle Scholar
Gold, J. M., Waltz, J. A., Prentice, K. J., Morris, S. E., & Heerey, E. A. (2008). Reward processing in schizophrenia: A deficit in the representation of value. Schizophrenia Bulletin, 34(5), 835847. doi:10.1093/schbul/sbn068.CrossRefGoogle ScholarPubMed
Häfner, H., Löffler, W., Maurer, K., Hambrecht, M., & Heiden, W. A. D. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica, 100(2), 105118. doi:10.1111/j.1600-0447.1999.tb10831.x.CrossRefGoogle ScholarPubMed
Hawk, A. B., Carpenter, W. T., & Strauss, J. S. (1975). Diagnostic criteria and five-year outcome in schizophrenia: A report from the international pilot study of schizophrenia. Archives of General Psychiatry, 32(3), 343347. doi:10.1001/archpsyc.1975.01760210077005.CrossRefGoogle ScholarPubMed
Heerey, E. A., Matveeva, T. M., & Gold, J. M. (2011). Imagining the future: Degraded representations of future rewards and events in schizophrenia. Journal of Abnormal Psychology, 120(2), 483489. doi:10.1037/a0021810.CrossRefGoogle Scholar
Heerey, E. A., Robinson, B. M., McMahon, R. P., & Gold, J. M. (2007). Delay discounting in schizophrenia. Cognitive Neuropsychiatry, 12(3), 213221. doi:10.1080/13546800601005900.CrossRefGoogle Scholar
Ho, B.-C., Barry, A. B., & Koeppel, J. A. (2018). Impulsivity in unaffected adolescent biological relatives of schizophrenia patients. Journal of Psychiatric Research, 97, 4753. doi:10.1016/j.jpsychires.2017.11.008.CrossRefGoogle ScholarPubMed
Horan, W. P., Johnson, M. W., & Green, M. F. (2017). Altered experiential, but not hypothetical, delay discounting in schizophrenia. Journal of Abnormal Psychology, 126(3), 301311. doi:10.1037/abn0000249.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Ebmeier, K. P., Miller, P., Owens, D. G., & Lawrie, S. M. (2005). Predicting schizophrenia: Findings from the Edinburgh high-risk study. The British Journal of Psychiatry, 186(1), 1825. doi:10.1192/bjp.186.1.18.CrossRefGoogle ScholarPubMed
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261276. doi:10.1093/schbul/13.2.261.CrossRefGoogle Scholar
Kirby, K. N. (2000). Instructions for inferring discount rates from choices between immediate and delayed rewards. Williams College, Williamstown, MA. Unpublished manuscriptGoogle Scholar
Kirby, K. N., & Marakovic, N. N. (1996). Delay-discounting probabilistic rewards: Rates decrease as amounts increase. Psychonomic Bulletin and Review, 3(1), 100104. doi:10.3758/bf03210748.CrossRefGoogle ScholarPubMed
Kirby, K. N., Petry, N. M., & Bickel, W. K. (1999). Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls. Journal of Experimental Psychology: General, 128(1), 7887. doi:10.1037//0096-3445.128.1.78.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Strauss, G. P., Nguyen, L., Fischer, B. A., Daniel, D. G., Cienfuegos, A., & Marder, S. R. (2010). The brief negative symptom scale: Psychometric properties. Schizophrenia Bulletin, 37(2), 300305. doi:10.1093/schbul/sbq059.CrossRefGoogle ScholarPubMed
Kirschner, M., Hager, O. M., Muff, L., Bischof, M., Hartmann-Riemer, M. N., Kluge, A., … Kaiser, S. (2016). Ventral striatal dysfunction and symptom expression in individuals with schizotypal personality traits and early psychosis. Schizophrenia Bulletin, 44(1), 147157. doi:10.1093/schbul/sbw142.Google Scholar
Kline, E. R., Seidman, L. J., Cornblatt, B. A., Woodberry, K. A., Bryant, C., Bearden, C. E., … Addington, J. (2018). Depression and clinical high-risk states: Baseline presentation of depressed vs. non-depressed participants in the NAPLS-2 cohort. Schizophrenia Research, 192, 357363. doi:10.1016/j.schres.2017.05.032.CrossRefGoogle ScholarPubMed
Kring, A. M., & Barch, D. M. (2014). The motivation and pleasure dimension of negative symptoms: Neural substrates and behavioral outputs. European Neuropsychopharmacology, 24(5), 725736. doi:10.1016/j.euroneuro.2013.06.007.CrossRefGoogle ScholarPubMed
Kring, A. M., Germans Gard, M., & Gard, D. E. (2011). Emotion deficits in schizophrenia: Timing matters. Journal of Abnormal Psychology, 120(1), 7987. doi:10.1037/a0021402.CrossRefGoogle ScholarPubMed
Lee, Y., Kim, Y. T., Seo, E., Park, O., Jeong, S. H., Kim, S. H., & Lee, S. J. (2007). Dissociation of emotional decision-making from cognitive decision-making in chronic schizophrenia. Psychiatry Research, 152(2–3), 113120. doi:10.1016/j.psychres.2006.02.001.CrossRefGoogle ScholarPubMed
Lencz, T., Smith, C. W., Auther, A., Correll, C. U., & Cornblatt, B. (2004). Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophrenia Research, 68(1), 3748. doi:10.1016/S0920-9964(03)00214-7.CrossRefGoogle ScholarPubMed
MacKillop, J., Amlung, M. T., Few, L. R., Ray, L. A., Sweet, L. H., & Munafò, M. R. (2011). Delayed reward discounting and addictive behavior: A meta-analysis. Journal of Psychopharmacology, 216(3), 305321. doi:10.1007/s00213-011-2229-0.CrossRefGoogle ScholarPubMed
MacKillop, J., & Tidey, J. W. (2011). Cigarette demand and delayed reward discounting in nicotine-dependent individuals with schizophrenia and controls: An initial study. Journal of Psychopharmacology, 216(1), 9199. doi:10.1007/s00213-011-2185-8.CrossRefGoogle Scholar
Mazur, J. E., ML., Mazur, J., & Nevin, J. (1987). An adjusting procedure for studying delayed reinforcement. In Commons, M. L., Mazur, J. E., Nevin, J. A., & Rachlin, H. (Eds.), The effect of delay and of intervening events on reinforcement value (Vol. 5, pp. 5573). Hillside, NJ: Erlbaum.Google Scholar
McGorry, P. D., Hickie, I. B., Yung, A. R., Pantelis, C., & Jackson, H. J. (2006). Clinical staging of psychiatric disorders: A heuristic framework for choosing earlier, safer and more effective interventions. Australian and New Zealand Journal of Psychiatry, 40(8), 616622. doi:10.1080/j.1440-1614.2006.01860.x.CrossRefGoogle ScholarPubMed
McGorry, P. D., Nelson, B., Goldstone, S., & Yung, A. R. (2010). Clinical staging: A heuristic and practical strategy for new research and better health and social outcomes for psychotic and related mood disorders. Canadian Journal of Psyhiatry, 55(8), 486497. doi:10.1177/070674371005500803.CrossRefGoogle ScholarPubMed
Miller, T. J., McGlashan, T. H., Rosen, J. L., Cadenhead, K., Cannon, T., Ventura, J., … Woods, S. W. (2003). Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: Predictive validity, interrater reliability, and training to reliability. Schizophrenia Bulletin, 29(4), 703715. doi:10.1093/oxfordjournals.schbul.a007040.CrossRefGoogle ScholarPubMed
Nuechterlein, K. H., Green, M. F., Kern, R. S., Baade, L. E., Barch, D. M., Cohen, J. D., … Gold, J. M. (2008). The MATRICS consensus cognitive battery, part 1: Test selection, reliability, and validity. American Journal of Psychiatry, 165(2), 203213. doi:10.1176/appi.ajp.2007.07010042.CrossRefGoogle ScholarPubMed
Pantelis, C., Barber, F. Z., Barnes, T. R., Nelson, H. E., Owen, A. M., & Robbins, T. W. (1999). Comparison of set-shifting ability in patients with chronic schizophrenia and frontal lobe damage. Schizophrenia Research, 37(3), 251270. doi:10.1016/s0920-9964(98)00156-x.CrossRefGoogle ScholarPubMed
Pelletier-Baldelli, A., Strauss, G. P., Visser, K. H., & Mittal, V. A. (2017). Initial development and preliminary psychometric properties of the Prodromal Inventory of Negative Symptoms (PINS). Schizophrenia Research, 189, 4349. doi:10.1016/j.schres.2017.01.055.CrossRefGoogle Scholar
Piskulic, D., Addington, J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Heinssen, R., … Walker, E. F. (2012). Negative symptoms in individuals at clinical high risk of psychosis. Psychiatry Research, 196(2–3), 220224. doi:10.1016/j.psychres.2012.02.018.CrossRefGoogle ScholarPubMed
Schlosser, D. A., Jacobson, S., Chen, Q., Sugar, C. A., Niendam, T. A., Li, G., … Cannon, T. D. (2012). Recovery from an at-risk state: Clinical and functional outcomes of putatively prodromal youth who do not develop psychosis. Schizophrenia Bulletin, 38(6), 12251233. doi:10.1093/schbul/sbr098.CrossRefGoogle Scholar
Sevy, S., Burdick, K. E., Visweswaraiah, H., Abdelmessih, S., Lukin, M., Yechiam, E., & Bechara, A. (2007). Iowa gambling task in schizophrenia: A review and new data in patients with schizophrenia and co-occurring cannabis use disorders. Schizophrenia Research, 92(1–3), 7484. doi:10.1016/j.schres.2007.01.005.CrossRefGoogle ScholarPubMed
Shamosh, N. A., DeYoung, C. G., Green, A. E., Reis, D. L., Johnson, M. R., Conway, A. R. A., … Gray, J. R. (2008). Individual differences in delay discounting: Relation to intelligence, working memory, and anterior prefrontal cortex. Psychological Science, 19(9), 904911. doi:10.1111/j.1467-9280.2008.02175.x.CrossRefGoogle ScholarPubMed
Shamosh, N. A., & Gray, J. R. (2008). Delay discounting and intelligence: A meta-analysis. Intelligence, 36(4), 289305. doi:10.1016/j.intell.2007.09.004.CrossRefGoogle Scholar
Shurman, B., Horan, W. P., & Nuechterlein, K. H. (2005). Schizophrenia patients demonstrate a distinctive pattern of decision-making impairment on the iowa gambling task. Schizophrenia Research, 72(2–3), 215224. doi:10.1016/j.schres.2004.03.020.CrossRefGoogle ScholarPubMed
Strauss, G. P., & Chapman, H. C. (2018). Preliminary psychometric properties of the brief negative symptom scale in youth at clinical high-risk for psychosis. Schizophrenia Research, 193, 435437. doi:10.1016/j.schres.2017.07.051.CrossRefGoogle ScholarPubMed
Strauss, G. P., Harrow, M., Grossman, L. S., & Rosen, C. (2010). Periods of recovery in deficit syndrome schizophrenia: A 20-year multi-follow-up longitudinal study. Schizophrenia Bulletin, 36(4), 788799. doi:10.1093/schbul/sbn167.CrossRefGoogle ScholarPubMed
Strauss, G. P., Robinson, B. M., Waltz, J. A., Frank, M. J., Kasanova, Z., Herbener, E. S., & Gold, J. M. (2011). Patients with schizophrenia demonstrate inconsistent preference judgments for affective and nonaffective stimuli. Schizophrenia Bulletin, 37(6), 12951304. doi:10.1093/schbul/sbq047.CrossRefGoogle ScholarPubMed
Strauss, G. P., Ruiz, I., Visser, K. H., Crespo, L. P., & Dickinson, E. K. (2018). Diminished hedonic response in neuroleptic-free youth at ultra high-risk for psychosis. Schizophrenia Research: Cognition, 12, 17. doi:10.1016/j.scog.2017.12.001.Google ScholarPubMed
Strauss, G. P., Sandt, A. R., Catalano, L. T., & Allen, D. N. (2012). Negative symptoms and depression predict lower psychological well-being in individuals with schizophrenia. Comprehensive Psychiatry, 53(8), 11371144. doi:10.1016/j.comppsych.2012.05.009.CrossRefGoogle ScholarPubMed
Strauss, G. P., Waltz, J. A., & Gold, J. M. (2014). A review of reward processing and motivational impairment in schizophrenia. Schizophrenia Bulletin, 40(Suppl 2), S107S116. doi:10.1093/schbul/sbt197.CrossRefGoogle Scholar
Tyson, P. J., Laws, K. R., Roberts, K. H., & Mortimer, A. M. (2004). Stability of set-shifting and planning abilities in patients with schizophrenia. Psychiatry Research, 129(3), 229239. doi:10.1016/j.psychres.2004.09.007.CrossRefGoogle ScholarPubMed
Ursu, S., Kring, A. M., Gard, M. G., Minzenberg, M. J., Yoon, J. H., Ragland, J. D., … Carter, C. S. (2011). Prefrontal cortical deficits and impaired cognition-emotion interactions in schizophrenia. American Journal of Psychiatry, 168(3), 276285. doi:10.1176/appi.ajp.2010.09081215.CrossRefGoogle Scholar
Valmaggia, L. R., Stahl, D., Yung, A. R., Nelson, B., Fusar-Poli, P., McGorry, P. D., & McGuire, P. K. (2013). Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: A latent class cluster analysis study. Psychological Medicine, 43(11), 23112325. doi:10.1017/s0033291713000251.CrossRefGoogle ScholarPubMed
Wallis, J. D. (2007). Orbitofrontal cortex and its contribution to decision-making. Annual Review of Neuroscience, 30, 3156. doi:10.1146/annurev.neuro.30.051606.094334.CrossRefGoogle ScholarPubMed
Wallwork, R. S., Fortgang, R., Hashimoto, R., Weinberger, D. R., & Dickinson, D. (2012). Searching for a consensus five-factor model of the positive and negative syndrome scale for schizophrenia. Schizophrenia Research, 137(1–3), 246250. doi:10.1016/j.schres.2012.01.031.CrossRefGoogle Scholar
Waltz, J. A., Frank, M. J., Wiecki, T. V., & Gold, J. M. (2011). Altered probabilistic learning and response biases in schizophrenia: Behavioral evidence and neurocomputational modeling. Neuropsychology, 25(1), 8697. doi:10.1037/a0020882.CrossRefGoogle ScholarPubMed
Wang, L., Jin, S., He, K., Chen, X., Ji, G., Bai, X., … Wang, K. (2018). Increased delayed reward during intertemporal decision-making in schizophrenic patients and their unaffected siblings. Psychiatry Research, 262, 246253. doi:10.1016/j.psychres.2017.12.040.CrossRefGoogle ScholarPubMed
Weller, R. E., Avsar, K. B., Cox, J. E., Reid, M. A., White, D. M., & Lahti, A. C. (2014). Delay discounting and task performance consistency in patients with schizophrenia. Psychiatry Research, 215(2), 286293. doi:10.1016/j.psychres.2013.11.013.CrossRefGoogle ScholarPubMed
Wing, V. C., Moss, T. G., Rabin, R. A., & George, T. P. (2012). Effects of cigarette smoking status on delay discounting in schizophrenia and healthy controls. Addictive Behaviors, 37(1), 6772. doi:10.1016/j.addbeh.2011.08.012.CrossRefGoogle ScholarPubMed
Yu, L. Q., Lee, S., Katchmar, N., Satterthwaite, T. D., Kable, J. W., & Wolf, D. H. (2017). Steeper discounting of delayed rewards in schizophrenia but not first-degree relatives. Psychiatry Research, 252, 303309. doi:10.1016/j.psychres.2017.02.062.CrossRefGoogle Scholar
Yung, A. R., & McGorry, P. D. (1996). The initial prodrome in psychosis: Descriptive and qualitative aspects. Australian and New Zealand Journal of Psychiatry, 30(5), 587599. doi:10.3109/00048679609062654.CrossRefGoogle ScholarPubMed
Zhang, T., Xu, L., Tang, Y., Li, H., Tang, X., Cui, H., … Liu, X. (2018). Prediction of psychosis in prodrome: Development and validation of a simple, personalized risk calculator. Psychological Medicine, 49(12), 19. doi:10.1017/S0033291718002738.Google ScholarPubMed