<qa>  What is the first step in a drug trial?The demonstration of improvements in negative symptoms in medication trials has been elusive. Even an agent capable of improving reward processing might not produce detectable decreases in rating scales designed to measure negative symptoms over the short term. This is because patients with chronic deficit states have compromised functioning due to the cumulative effects of social and occupational dysfunction. In patients such as these, the normalization of reward processing circuits by a medication such as aripiprazole would only be the first step. These patients are likely to require considerable psychosocial rehabilitation to recoup occupational and social functioning and achieve meaningful gains in negative symptom rating scales. However, normalization of reward circuitry function would strongly suggest that aripiprazole has potential to improve chronic negative symptoms when combined with a supporting rehabilitative program. Significant changes in reward circuit function would also strongly support the early intervention potential for aripiprazole to prevent chronic deterioration in function if first break patients were treated with this agent early in their course. 