Probabilistic reversal learning in schizophrenia: Stability of deficits and potential causal mechanisms

Lena Felice Reddy, James A. Waltz, Michael F. Green, Jonathan K. Wynn, William P. Horan

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Although individuals with schizophrenia show impaired feedback-driven learning on probabilistic reversal learning (PRL) tasks, the specific factors that contribute to these deficits remain unknown. Recent work has suggested several potential causes including neurocognitive impairments, clinical symptoms, and specific types of feedback-related errors. To examine this issue, we administered a PRL task to 126 stable schizophrenia outpatients and 72 matched controls, and patients were retested 4 weeks later. The task involved an initial probabilistic discrimination learning phase and subsequent reversal phases in which subjects had to adjust their responses to sudden shifts in the reinforcement contingencies. Patients showed poorer performance than controls for both the initial discrimination and reversal learning phases of the task, and performance overall showed good test-retest reliability among patients. A subgroup analysis of patients (n = 64) and controls (n = 49) with good initial discrimination learning revealed no between-group differences in reversal learning, indicating that the patients who were able to achieve all of the initial probabilistic discriminations were not impaired in reversal learning. Regarding potential contributors to impaired discrimination learning, several factors were associated with poor PRL, including higher levels of neurocognitive impairment, poor learning from both positive and negative feedback, and higher levels of indiscriminate response shifting. The results suggest that poor PRL performance in schizophrenia can be the product of multiple mechanisms.

Original languageEnglish
Pages (from-to)942-951
Number of pages10
JournalSchizophrenia Bulletin
Issue number4
StatePublished - Jul 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.


FundersFunder number
National Institutes of Health
National Institute of Mental HealthR01MH094460


    • Motivation
    • Negative symptoms
    • Probabilistic reversal learning
    • Schizophrenia


    Dive into the research topics of 'Probabilistic reversal learning in schizophrenia: Stability of deficits and potential causal mechanisms'. Together they form a unique fingerprint.

    Cite this