A Transdiagnostic Study of Effort-Cost Decision-Making in Psychotic and Mood Disorders
Open accessAbstract
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.
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A transdiagnostic study investigating effort-cost-decision-making in schizophrenia, schizoaffective disorder, MDD, and bipolar disorder reported that use of reward information was negatively associated with motivational impairments in schizophrenia, whereas the other patient groups did not differ from healthy people.
“A transdiagnostic study investigating effort–cost–decision-making in schizophrenia, schizoaffective disorder, MDD, and bipolar disorder reported that use of reward information was negatively associated with motivational impairments in schizophrenia, whereas the other patient groups did not differ from healthy people.83”
From Investigating disorder-specific and transdiagnostic alterations in model-based and model-free decision-making (2024) · cites this paper as [83]
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Knolle, F., Sen, P., Culbreth, A., Koch, K., Schmitz-Koep, B., Gürsel, D. A., Wunderlich, K., Avram, M., Berberich, G., Sorg, C., et al. (2024) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.240020 · Cited by 9 · see citing works
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- Authors
- Culbreth, A. J., Moran, E. K., Mahaphanit, W., Erickson, M. A., Boudewyn, M. A., Frank, M. J., Barch, D. M., MacDonald, A. W., Ragland, J. D., Luck, S. J., Silverstein, S. M., Carter, C. S., & Gold, J. M.
- Affiliations
- University of Maryland, Baltimore (US)
- Washington University in St. Louis (US)
- Dartmouth College (US)
- University of Chicago (US)
- University of California, Santa Cruz (US)
- Brown University (US)
- University of Minnesota (US)
- University of California, Davis (US)
- University of Rochester Medicine (US)
- Corresponding author
- Culbreth, Adam J
- ORCID
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2023-10-30
- Volume
- 50
- Issue
- 2
- Pages
- 339-348
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC10919776
- OpenAlex
- W4388014055
- Cited by
- 19
- References
- 44
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 4
- FWCI
- 3.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R01 MH084821, K23 MH126986)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- effort-based decision making
- MeSH terms
- Decision Making, Depressive Disorder, Major, Major Depressive Disorder, Humans, Motivation, Psychotic Disorders, Reward, Schizophrenia, Mood Disorders
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