The Associations between Multidimensional Defeatist Performance Beliefs and Anhedonia in Early Psychosis: An Experience Sampling Study

BACKGROUND AND HYPOTHESIS: The cognitive model of negative symptoms posits that defeatist performance beliefs (DPB) contribute to negative symptoms in schizophrenia, such as anhedonia. The associations between specific DPB dimensions (overvaluing success, overvaluing failure, and overvaluing social evaluation) and daily-life pleasure have not been well-studied. Using experience sampling methodology (ESM), we examined associations between multidimensional DPB and momentary consummatory and anticipatory pleasure across daily contexts in early psychosis (EP) patients and healthy controls (HC). STUDY DESIGN: Thirty-three EP and 35 HC completed ESM assessment of momentary consummatory and anticipatory pleasure, as well as current and anticipated activity type (functional vs leisure) and social company (with others vs alone), 10 times daily for 6 days. Multidimensional DPB was assessed at baseline. The associations between DPB dimensions and momentary pleasure in EP and HC, as well as the effects of activity type and social company on the associations, were examined with multilevel modeling. STUDY RESULTS: A total of 2609 ESM responses were analyzed. Across EP and HC, overvaluing success and failure DPB were negatively associated with momentary consummatory and anticipatory pleasure. EP exhibited a more negative association between overvaluing failure DPB and momentary consummatory pleasure when engaging in functional (vs leisure) activities. The same pattern of result emerged for momentary anticipatory pleasure when anticipating to engage in functional (vs leisure) activities. CONCLUSIONS: With a modest sample, specific DPB dimensions showed distinct associations with pleasure in daily-life contexts. Targeting overvaluing failure DPB in patients may help alleviate anhedonia during functional activities, potentially improving patients' functioning.