Learning to Expect Less: An Ecological Momentary Assessment Study of Prediction Errors, Reward Anticipation, and Negative Symptoms in Daily Lives of People with Schizophrenia

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Abstract
Background and Hypotheses: The brain continuously generates predictions about future experiences. When outcomes deviate from expectations, positive (+RPE) and negative (-RPE) reward prediction errors recalibrate predictions. Neuroimaging evidence indicates that amotivation in schizophrenia-spectrum disorders (SSD) is linked to blunted processing of +RPEs. Yet the nature of RPEs and their processing in the everyday lives of people with SSD remains unknown. Study Design: This preregistered analysis pooled data from two studies (N = 147; SSD = 68, healthy controls [HC] = 79) to quantify daily-life +RPEs and -RPEs and test their association with subsequent updating of anticipatory pleasure. Participants completed six days of ecological momentary assessment capturing current and anticipated pleasure. +RPEs were defined as EMA assessments in which current pleasure exceeded anticipated pleasure at the previous prompt, –RPEs were defined as occasions in which current pleasure fell short of prior anticipation. Linear mixed-effects models tested group differences in RPE frequency and magnitude; time-lagged models assessed updating of anticipatory pleasure. Study Results: Individuals with SSD reported fewer +RPEs (β = –0.05, p = .025), with no group difference in -RPEs or RPE magnitude. Within SSD, higher baseline amotivation was associated with smaller +RPEs (β = –0.08, p = .019). Time-lagged analyses revealed that in SSD, larger +RPEs predicted reduced subsequent anticipatory pleasure (β = –.171, p < .001), unlike in HCs (β = –.038, p = .26). Conclusions: Findings indicate that in everyday life, individuals with SSD experience fewer positive surprises and show maladaptive updating of reward expectations, potentially driving negative symptoms.

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