Patients with schizophrenia demonstrate dissociation between affective experience and motivated behavior

Self-reported emotional experience does not differ between patients with schizophrenia and healthy individuals, suggesting that the anhedonia in schizophrenia instead reflects decoupling of affect from motivated behavior. In 2 behavioral conditions, participants with schizophrenia and healthy participants were able to prolong or decrease exposure to stimuli while stimuli were present or alter the likelihood of future exposure to stimuli on the basis of internal representations. They also provided self-reports of affective experience. Patients showed weaker correspondence between behavior and ratings than did comparison participants. The effect was amplified when patients responded on the basis of internal rather than evoked stimulus representations. These data suggest that the motivational deficits in schizophrenia reflect problems in the ability to translate experience into action.