Frustrative Non-reward and Lab-Based Paradigms for Advancing the Study of Aggression in Persons with Psychosis

Purpose of Review: Prior research and assessment of aggression in schizophrenia and other psychotic conditions has focused on one or two levels of measurement (third-party observation and self-report) identified by the NIMH Research Domain Criteria (RDoC), while frequently neglecting a third (laboratory behavioral paradigms). We review aggression in psychosis using the RDoC conceptualization of frustrative non-reward; describe how lab-based behavioral paradigms, particularly, the Point Subtraction Aggression Paradigm (PSAP), can help to better understand aggression in individuals with psychosis; and suggest directions for future research. Recent Findings: Many studies of violence in psychosis focus on field observations of behavior and self-report. However, laboratory behavioral paradigms such as the PSAP, which have not been widely adopted, hold conceptual promise for the study of aggression in schizophrenia. Summary: The RDoC represent a neurobehavioral approach for advancing behavioral health research that recommends multilevel investigations to include laboratory behavioral paradigms. The PSAP is one such behavioral measure with particular relevance to a frustrative non-reward conceptualization of aggression. The PSAP and its adaptations offer a promising methodology for future research of aggression in schizophrenia and other psychotic conditions. The method may likewise prove useful in individual cases, to enhance the incremental validity of violence risk assessment.