Associations Between Negative Symptoms and Effort Discounting in Patients With Schizophrenia and Major Depressive Disorder

Abstract

Deficits in goal-directed decision making and motivation are hallmark characteristics of several neuropsychiatric disorders, including schizophrenia (SZ) and major depressive disorder (MDD). Studies using effort based decision making tasks have shown that both patients with SZ and MDD invest less physical effort in order to obtain rewards. However, how these motivational deficits relate to clinically assessed symptom dimensions such as apathy remains controversial. Using a grip-strength based effort discounting task we assessed effort based decision making behaviour in healthy controls (HC) (N = 18), patients with SZ (N = 42) and MDD (N = 44). We then investigated how effort discounting relates to different symptom dimensions. There were no differences in effort discounting between HC participants and patients with SZ or MDD. In addition, we did not observe a correlation between effort discounting and negative symptoms in patients with SZ or MDD. In conclusion, the current study does not support an association between effort discounting and negative symptoms in SZ or MDD. Further studies are needed to investigate effort discounting and its relation to psychopathological dimensions across different neuropsychiatric disorders.

Major depression symptom severity associations with willingness to exert effort and patch foraging strategy

“…Anhedonia was associated with increased physical effort costs both within the MDD group and across all participants, though only numerically in the current MDD group (consistent with some previous reports, Sherdell et al, 2012; Tran et al, 2021; X.-H. Yang et al, 2014, but not others, Berwian et al, 2017; Cathomas et al, 2021; Cléry-Melin et al, 2011; Vinckier et al, 2022; Wang et al, 2022; X. Yang et al, 2021; Zou et al, 2020).…”

“…Based on previous findings we predicted MDD would be associated with increased effort avoidance for both cognitive (Ang et al, 2023;Hershenberg et al, 2016;Vinckier et al, 2022;Westbrook et al, 2022) and physical (Berwian et al, 2020;Cléry-Melin et al, 2011;Treadway et al, 2012;Vinckier et al, 2022;X.-H. Yang et al, 2014;Zou et al, 2020) effort. Contrary to our hypotheses, there were no group differences in either effort cost, though this is consistent with some null group results in other studies of cognitive (Barch et al, 2023;Tran et al, 2021) and physical effort avoidance (Cathomas et al, 2021;Sherdell et al, 2012;Tran et al, 2021;Wang et al, 2022;X. Yang et al, 2021).…”

“…MDD has been associated with decreased willingness to exert cognitive effort relative to comparison groups in some studies (Ang et al, 2023;Vinckier et al, 2022;Westbrook et al, 2022) though not in others (Barch et al, 2023;Tran et al, 2021). Willingness to exert physical effort has been found to be decreased in MDD relative to comparison groups in some studies (Berwian et al, 2020;Cléry-Melin et al, 2011;Treadway et al, 2012;Vinckier et al, 2022;Wang et al, 2022;X.-H. Yang et al, 2014;Zou et al, 2020) though not in others (Cathomas et al, 2021;Sherdell et al, 2012;Tran et al, 2021;Wang et al, 2022;X. Yang et al, 2021).…”

Negative symptoms and cognitive impairment are associated with distinct motivational deficits in treatment resistant schizophrenia

“…Nevertheless, the authors were also able to demonstrate this association in a sub-group of their patients using a 'nextgeneration' negative symptom questionnaire known as the Clinical Assessment Interview for Negative Symptoms (CAINS) 29 . A recent comparison between this and the BNSS questionnaire, which we used, showed that while both demonstrated good psychometric properties, there was low to moderate convergence between the two questionnaires on motivation and pleasure questions 57 . It is possible there for that the BNSS MAP factor was not able to detect this effect in our patient group.…”

Evaluation of a new intrinsic and extrinsic motivation scale in youth with psychosis spectrum symptoms

“…Studies examining EM based on the incentivizing impact of monetary rewards on effort tasks in schizophrenia and psychosis risk have generally found average reductions in EM correlating with severity of clinical negative symptoms [ 13 , 25 – 27 ]. However, some effort task studies have not found abnormalities [ 28 , 29 ], and studies examining token economies and the impact of monetary incentives on cognitive test performance have shown beneficial effects in schizophrenia consistent with significant EM [ 30 – 34 ]. IM is harder to operationalize in laboratory studies than EM [ 35 ]; however, fMRI studies of putative neural correlates of IM point to reductions in schizophrenia and psychosis risk [ 16 , 36 , 37 ], as does a recent free-choice behavioral study in schizophrenia [ 38 ].…”