***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Recent work has suggested that anhedonia in schizophrenia can be understood as involving two separate constructs : deficits in anticipatory and consummatory pleasure . Little is known about the relative stability of these different constructs and their links with clinical features and social function over time . To examine these questions , 51 participants with a diagnosis of schizophrenia or schizoaffective disorder in a non-acute phase of illness were administered the  Temporal Experience of Pleasure Scale , the Positive and Negative Syndrome Scale , and Quality of Life Scale at two time points six months apart . Results revealed that baseline scores of both anticipatory and consummatory pleasure were significantly correlated with follow-up scores six months later , suggesting each construct is stable in the short term . The association of anticipatory pleasure at baseline and six months was significantly higher than the relationship between consummatory pleasure at baseline and at six months . Anticipatory pleasure predicted concurrent and prospect i ve levels of positive symptoms , emotional discomfort , and interpersonal function , but not emotion recognition . Consummatory pleasure predicted only concurrent positive symptoms . The link of baseline anticipatory pleasure with emotional discomfort at six months persisted even after controlling for baseline emotional discomfort . Implication s for the measurement and conceptualization of anhedonia in schizophrenia are discussed BACKGROUND Negative symptoms may be associated with dysfunction of the brain reward system in schizophrenia . We used functional magnetic resonance imaging ( fMRI ) to assess the BOLD response in the ventral striatum of unmedicated schizophrenics during presentation of reward-indicating and loss-indicating stimuli . METHODS A total of 10 schizophrenic men ( 7 never medicated , 3 unmedicated for at least 2 years ) and 10 age-matched healthy male volunteers participated in an incentive monetary delay task , in which visual cues predicted that a rapid response to a subsequent target stimulus would result either in monetary gain or loss or would have no consequence . RESULTS Compared to healthy controls , unmedicated schizophrenics showed reduced ventral striatal activation during the presentation of reward-indicating cues . Decreased activation of the left ventral striatum was inversely correlated with the severity of negative ( and trendwise positive ) symptoms . DISCUSSION Reduced activation in one of the central areas of the brain reward system , the ventral striatum , was correlated with the severity of negative symptoms in medication-free schizophrenics . In unmedicated schizophrenic patients , a high striatal dopamine turnover may increase the " noise " in the reward system , thus interfering with the neuronal processing of reward-predicting cues by phasic dopamine release . This , in turn , may contribute to negative symptoms as such as anhedonia , apathy , and loss of drive and motivation Background The  Temporal Experience of Pleasure Scale  ( TEPS ) is a measure specifically design ed to capture the anticipatory and consummatory facets of pleasure . However , few studies have examined the structure of the measure in non-Western sample s. The current study aim ed to evaluate the factor structure and psychometric properties of the TEPS in a Chinese sample . Methods We administered the Chinese version of the TEPS to 2275 healthy Chinese college students . They were r and omly split into two sub- sample s. The first sub- sample was used for exploratory factor analysis ( EFA ) to examine the structure of the TEPS in a Chinese sample . The second sub- sample was used as a validation sample for the identified structure from the EFA and confirmatory factor analysis ( CFA ) was adopted . Results Results of the EFA suggested a four-factor model ( consummatory context ual , consummatory abstract , anticipatory context ual , and anticipatory abstract factors ) instead of the original two-factor model ( consummatory and anticipatory factors ) ascertained from Western sample s in the United States . The CFA results confirmed these results in the second sub- sample . Internal consistency and test-retest stability of the TEPS factors were good . Conclusions The TEPS has four factors among Chinese participants . Possible reasons for cultural difference and potential applications of the TEPS for cross-cultural comparison are discussed Research on emotional processing in schizophrenia suggests relatively intact subjective responses to affective stimuli " in the moment . " However , neuroimaging evidence suggests diminished activation in brain regions associated with emotional processing in schizophrenia . We asked whether given a more vulnerable cognitive system in schizophrenia , individuals with this disorder would show increased or decreased modulation of working memory ( WM ) as a function of the emotional content of stimuli compared with healthy control subjects . In addition , we examined whether higher anhedonia levels were associated with a diminished impact of emotion on behavioral and brain activation responses . In the present study , 38 individuals with schizophrenia and 32 healthy individuals completed blocks of a 2-back WM task in a functional magnetic resonance imaging scanning session . Blocks contained faces displaying either only neutral stimuli or neutral and emotional stimuli ( happy or fearful faces ) , r and omly intermixed and occurring both as targets and non-targets . Both groups showed higher accuracy but slower reaction time for negative compared to neutral stimuli . Individuals with schizophrenia showed intact amygdala activity in response to emotionally evocative stimuli , but demonstrated altered dorsolateral prefrontal cortex ( DLPFC ) and hippocampal activity while performing an emotionally loaded WM-task . Higher levels of social anhedonia were associated with diminished amygdala responses to emotional stimuli and increased DLPFC activity in individuals with schizophrenia .  Emotional arousal may challenge dorsal-frontal control systems , which may have both beneficial and detrimental influences . Our findings suggest that disturbances in emotional processing in schizophrenia relate to alterations in emotion-cognition interactions rather than to the perception and subjective experience of emotion per se CONTEXT Low-functioning patients with chronic schizophrenia have high direct treatment costs and indirect costs incurred due to lost employment and productivity and have a low quality of life ; antipsychotic medications and psychosocial interventions have shown limited efficacy to promote improved functional outcomes . OBJECTIVE To determine the efficacy of an 18-month recovery-oriented cognitive therapy program to improve psychosocial functioning and negative symptoms ( avolition-apathy , anhedonia-asociality ) in low-functioning patients with schizophrenia . Design , Setting , and PARTICIPANTS A single-center , 18-month , r and omized , single-blind , parallel group trial enrolled 60 low-functioning , neurocognitively impaired patients with schizophrenia ( mean age , 38.4 years ; 33.3 % female ; 65.0 % African American ) . INTERVENTIONS Cognitive therapy plus st and ard treatment vs st and ard treatment alone . MAIN OUTCOME MEASURES The primary outcome measure was the Global Assessment Scale score at 18 months after r and omization . The secondary outcomes were scores on the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms at 18 months after r and omization . RESULTS Patients treated with cognitive therapy showed a clinical ly significant mean improvement in global functioning from baseline to 18 months that was greater than the improvement seen with st and ard treatment ( within-group Cohen d , 1.36 vs 0.06 , respectively ; adjusted mean [ SE ] , 58.3 [ 3.30 ] vs 47.9 [ 3.60 ] , respectively ; P = .03 ; between-group d = 0.56 ) . Patients receiving cognitive therapy as compared with those receiving st and ard treatment also showed a greater mean reduction in avolition-apathy ( adjusted mean [ SE ] , 1.66 [ 0.31 ] vs 2.81 [ 0.34 ] , respectively ; P = .01 ; between-group d = -0.66 ) and positive symptoms ( hallucinations , delusions , disorganization ) ( adjusted mean [ SE ] , 9.4 [ 3.3 ] vs 18.2 [ 3.8 ] , respectively ; P = .04 ; between-group d = -0.46 ) at 18 months . Age was controlled in the analyses , and there were no meaningful group differences in baseline antipsychotic medications ( class or dosage ) or in medication changes during the course of the trial . CONCLUSION Cognitive therapy can be successful in promoting clinical ly meaningful improvements in functional outcome , motivation , and positive symptoms in low-functioning patients with significant cognitive impairment . Trial Registration clinical trials.gov Identifier : NCT00350883 BACKGROUND Cognitive difficulties are prevalent in people with a diagnosis of schizophrenia and are associated with poor long-term functioning . AIMS To evaluate the effectiveness of cognitive remediation therapy on cognitive difficulties experienced by people with schizophrenia . METHOD Participants with a diagnosis of schizophrenia , a social behaviour problem and a cognitive difficulty ( n=85 ) were r and omised to 40 sessions  of cognitive remediation or treatment as usual in a single-blind r and omised controlled trial . Working memory , cognitive flexibility and planning , were measured at weeks 0,14 and 40 . RESULTS There were durable improvements in working memory ( advantage 1.33 points , 95 % CI 0.43 - 2.16 , st and ardised effect size 0.34 ) as well as an indication of improvement in cognitive flexibility . Memory improvement predicted improvement in social functioning . Costs were lower in the cognitive remediation group following therapy but rose at follow-up . However , cost-effectiveness analyses showed that improvements in memory were achieved at little additional cost . CONCLUSIONS Cognitive remediation therapy is associated with durable improvements in memory , which in turn are associated with social functioning improvements in people with severe mental illness Startle-elicited blinks were measured during the presentation of affective slides in order to investigate emotional responsiveness in 24 male healthy subjects and 34 male schizophrenic patients . Although the two groups did not differ with regard to their subjective and autonomic responses to the slide stimuli , there was a significant difference between the groups in their responses to the startle probes . Patients rated low in affective expression showed a linear response pattern comparable to that of normal controls with largest amplitudes during unpleasant slides and smallest during pleasant slides . Patients without apparent deficit in affective expression showed a quadratic relationship with smaller blink amplitudes during both pleasant and unpleasant slides . Diminished affective expression rated on the basis of a clinical interview is not associated with a general attenuation of the blink reflex or of its modulation by exposure to emotional slides . Thus , we found no indication of an impairment in the perception of affective stimuli nor of reduced appreciation of pleasant stimuli ( anhedonia ) in these patients A dysfunction of central dopaminergic neurotransmission has been found in various neuropsychiatric diseases , and may be associated with a common psychopathological correlate . One hypothesis suggests that dopaminergic stimulation of the brain reward system reinforces behavior because it is experienced as pleasurable , and that dopaminergic dysfunction leads to anhedonia , the inability to experience pleasure . An alternative hypothesis assumes that dopaminergic stimulation does not promote pleasure or " liking " of a reward but rather mediates " wanting " of a reward , and suggests that dopaminergic dysfunction is associated with a failure to be motivated by stimuli that indicate reward . We measured negative symptoms , psychomotor slowing and dopamine receptor sensitivity in twelve drug-free patients with major depression , seventeen alcohol-dependent and sixteen opiate-dependent patients , ten schizophrenics with neuroleptic medication , and ten healthy controls . The sensitivity of central dopamine receptors was assessed with the growth hormone response to apomorphine application . Psychomotor slowing was measured in a reaction-time test and anhedonia and other negative symptoms were assessed with self-rating scales and the Scale for the Assessment of Negative Symptoms . Patients with major depression , alcohol dependence and neuroleptic medication displayed a reduced sensitivity of central dopamine receptors compared to control subjects . Anhedonia was not a common correlate of dopamine receptor dysfunction . Instead , affective flattening was associated with both dopamine receptor sensitivity and psychomotor slowing . Our findings thus do not support the anhedonia hypothesis of central dopaminergic dysfunction . Rather , affective flattening may result from the lack of an emotional response towards reward-indicating stimuli . These findings indicate that patients with dopaminergic dysfunction are not unable to experience pleasure , but may fail to be motivated by environmental stimuli to seek reward 
    Output:
    
RESULTS 80 independent studies were review ed and executive functions , emotional memory and the translation of motivation into actions are highlighted as key deficits with a strong evidence base in people with schizophrenia .