A Transdiagnostic Study of Effort-Cost Decision-Making in Psychotic and Mood Disorders.
Adam J Culbreth, Erin K Moran, Wasita Mahaphanit, Molly A Erickson, Megan A Boudewyn, Michael J Frank, Deanna M Barch, Angus W MacDonald, J Daniel Ragland, Steven J Luck, Steven M Silverstein, Cameron S Carter, James M Gold
Author Information
Adam J Culbreth: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, USA. ORCID
Erin K Moran: Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, USA. ORCID
Wasita Mahaphanit: Department of Psychological and Brain Sciences, Dartmouth College, Hanover, USA.
Molly A Erickson: Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, USA.
Megan A Boudewyn: Department of Psychology, University of California, Santa Cruz, USA.
Michael J Frank: Department of Cognitive, Linguistics, and Psychological Sciences, Brown University, Providence, USA.
Deanna M Barch: Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, USA. ORCID
Angus W MacDonald: Department of Psychology, University of Minnesota, Minneapolis, USA.
J Daniel Ragland: Department of Psychiatry, University of California, Davis, School of Medicine, Davis, USA.
Steven J Luck: Center for Mind and Brain, University of California, Davis, Davis, USA. ORCID
Steven M Silverstein: Department of Psychiatry, University of Rochester Medical Center, Rochester, USA. ORCID
Cameron S Carter: Department of Psychiatry, University of California, Davis, School of Medicine, Davis, USA.
James M Gold: Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Baltimore, USA. ORCID
BACKGROUND: Research suggests that effort-cost decision-making (ECDM), the estimation of work required to obtain reward, may be a relevant framework for understanding motivational impairment in psychotic and mood pathology. Specifically, research has suggested that people with psychotic and mood pathology experience effort as more costly than controls, and thus pursue effortful goals less frequently. This study examined ECDM across psychotic and mood pathology. HYPOTHESIS: We hypothesized that patient groups would show reduced willingness to expend effort compared to controls. STUDY DESIGN: People with schizophrenia (N���=���33), schizoaffective disorder (N���=���28), bipolar disorder (N���=���39), major depressive disorder (N���=���40), and controls (N���=���70) completed a physical ECDM task. Participants decided between completing a low-effort or high-effort option for small or larger rewards, respectively. Reward magnitude, reward probability, and effort magnitude varied trial-by-trial. Data were analyzed using standard and hierarchical logistic regression analyses to assess the subject-specific contribution of various factors to choice. Negative symptoms were measured with a clinician-rated interview. STUDY RESULTS: There was a significant effect of group, driven by reduced choice of high-effort options in schizophrenia. Hierarchical logistic regression revealed that reduced choice of high-effort options in schizophrenia was driven by weaker contributions of probability information. Use of reward information was inversely associated with motivational impairment in schizophrenia. Surprisingly, individuals with major depressive disorder and bipolar disorder did not differ from controls. CONCLUSIONS: Our results provide support for ECDM deficits in schizophrenia. Additionally, differences between groups in ECDM suggest a seemingly similar behavioral phenotype, reduced motivation, could arise from disparate mechanisms.
