Temporal and Effort cost Decision-making in Healthy Individuals with Subclinical Psychotic Symptoms

Terenzi, Damiano; Mainetto, Elena; Barbato, Mariapaola; Rumiati, Raffaella I.; Aiello, Marilena

doi:10.1038/s41598-018-38284-x

Cited by 13 publications

(17 citation statements)

References 62 publications

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“…A range of studies have found that individuals with psychotic disorders or schizophrenia have effort-related impairments (Barch et al, 2014;Whitton et al, 2015) and that there is an association between the degree of negative symptoms and these impairments (Bergé et al, 2018). In healthy populations similar findings have been reported for negative symptom-like phenomena (Stefanis et al, 2002;Terenzi et al, 2019).…”

Section: Motivation Vigor and Effort-based Decision Making In Psychmentioning

confidence: 52%

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

et al. 2020

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Background and Objective: Goal-directed behavior is a central feature of human functioning. It requires goal appraisal and implicit cost-benefit analyses, i.e., how much effort to invest in the pursuit of a certain goal, against its value and a confidence judgment regarding the chance of attainment. Persons with severe mental illness such as psychosis often struggle with reaching goals. Cognitive deficits, positive symptoms restricting balanced judgment, and negative symptoms such as anhedonia and avolition may compromise goal attainment. The objective of this study was to investigate to what degree symptom severity is related to cognitive abilities, metacognition, and effort-based decision-making in a visual search task. Methods: Two studies were conducted: study 1: N = 52 (healthy controls), and study 2: N = 46 (23 patients with psychosis/23 matched healthy controls). Symptoms were measured by the CAPE-42 (study 1) and the PANSS (study 2). By using a visual search task, we concomitantly measured (a) accuracy in short-term memory, (b) perceived accuracy by participants making a capture area or confidence interval, and (c) effort by measuring how long one searched for the target. Perseverance was assessed in trials in which the target was omitted and search had to be abandoned. Results: Higher levels of positive symptoms, and having a diagnosis of psychosis, were associated with larger errors in memory. Participants adjusted both their capture area and their search investment to the error of their memory. Perseverance was associated with negative symptoms in study 1 but not in study 2. Conclusion: By simultaneously assessing error and confidence in one's memory, as well as effort in search, we found that memory was affected by positive, not negative, symptoms in healthy controls, and was reduced in patients with psychosis. However, impaired memory did not concur with overconfidence or less effort in search, i.e., goal directed behavior was unrelated to symptoms or diagnosis. Metacognition and motivation were neither affected by cognitive abilities nor by negative symptoms. Clinically, this could indicate that struggles with goal directed behavior in psychosis may not solely be dependent on primary illness factors.

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Section: Motivation Vigor and Effort-based Decision Making In Psychmentioning

confidence: 52%

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

et al. 2020

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“…Overall, these findings suggest that not all subdimensions of PLEs are associated with conspiratorial beliefs and that both the positive (possibly through cognitive processes such as the jump to conclusion bias) and negative (reduced motivation) dimensions of PLEs may contribute to believing in conspiracy theories. In line with these findings, a study by Ståhl and colleagues (2018) proposed that skepticism towards conspiratorial beliefs requires sufficient cognitive and motivational abilities, which are both altered in individuals with high levels of PLEs 9,28,29 .…”

Section: Discussionmentioning

confidence: 90%

“…The Community Assessment of Psychic Experience (CAPE) is a 42-item questionnaire that measures self-reported subclinical psychotic symptoms in the general population based on three dimensions: positive symptoms, negative symptoms, and depression 44,45 . Several studies have shown that the CAPE can be a screening tool to identify people who might be at risk for psychosis 9,10,46 .…”

Section: Psychotic-like Experiencesmentioning

confidence: 99%

“…In view of these detrimental consequences, recent studies have found that a greater endorsement of conspiracy theories is associated with psychotic-like experiences (PLEs) 7,8 . More in detail, PLEs refer to subclinical psychotic events (e.g., subthreshold forms of paranoid delusions) experienced by healthy individuals in the general population in the absence of a clear psychotic disorder 9,10 . Studies on the general adult population have found that approximately 8% of individuals who reported PLEs will become clinically psychotic after 2 years 11 , suggesting that PLEs may represent a risk factor for developing psychotic disorders.…”

Section: Introductionmentioning

confidence: 99%

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Psychotic-like experiences in the lonely predict conspiratorial beliefs and are associated with the diet during COVID-19

Terenzi¹,

Muth²,

Vermeer³

et al. 2022

Preprint

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The Covid-19 pandemic has increased the occurrence of conspiracy theories. It has been suggested that a greater endorsement of these theories may be associated with psychotic-like experiences (PLEs), as well as with social isolation. In this preregistered study, we investigated whether both PLEs and measures of social isolation (e.g., loneliness) can predict conspiratorial beliefs and, if so, which of these variables can mediate the association with conspiratorial beliefs. Furthermore, based on previous studies on schizophrenia, we explored whether the diet is associated with PLEs and conspiratorial beliefs. Participants (N=142) completed online questionnaires measuring PLEs, social isolation, mental well-being, and conspiratorial beliefs. They also submitted their daily food intake for a week using a smartphone app.We found that loneliness predicted the endorsement of conspiracy theories during the Covid-19 lockdown. Strikingly, the proneness to experience subclinical psychotic symptoms played an underlying mediating role. In addition, these subclinical symptoms were associated with lower fruit, carbohydrate and iron intakes, as well as with higher fat intake.Our results add insights into how conspiratorial beliefs can affect individuals’ mental health and relationships. Moreover, these results open the avenue for potential novel intervention strategies to optimize food intake in individuals with psychotic-like experiences.

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“…A better understanding of specific impairments in effort-based decision-making will ultimately lead to better strategies for treating disabling amotivation. As clinical amotivation and reduced willingness to exert effort in behavioral tasks are also observed in first episode psychosis and clinical high risk for psychosis [77][78][79] neurobehavioral biomarkers of amotivation may also provide targets for early detection and intervention.…”

Section: Discussionmentioning

confidence: 99%

Relationship of ventral striatum activation during effort discounting to clinical amotivation severity in schizophrenia

et al. 2021

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Motivational deficits play a central role in disability due to negative symptoms of schizophrenia (SZ), but limited pathophysiological understanding impedes critically needed therapeutic development. We applied an fMRI Effort Discounting Task (EDT) that quantifies motivation using a neuroeconomic decision-making approach, capturing the degree to which effort requirements produce reductions in the subjective value (SV) of monetary reward. An analyzed sample of 21 individuals with SZ and 23 group-matched controls performed the EDT during fMRI. We hypothesized that ventral striatum (VS) as well as extended brain motivation circuitry would encode SV, integrating reward and effort costs. We also hypothesized that VS hypoactivation during EDT decisions would demonstrate a dimensional relationship with clinical amotivation severity, reflecting greater suppression by effort costs. As hypothesized, VS as well as a broader cortico-limbic network were activated during the EDT and this activation correlated positively with SV. In SZ, activation to task decisions was reduced selectively in VS. Greater VS reductions correlated with more severe clinical amotivation in SZ and across all participants. However, these diagnosis and amotivation effects could not be explained by the response to parametric variation in reward, effort, or model-based SV. Our findings demonstrate that VS hypofunction in schizophrenia is manifested during effort-based decisions and reflects dimensional motivation impairment. Dysfunction of VS impacting effort-based decision-making can provide a target for biomarker development to guide novel efforts to assess and treat disabling amotivation.

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Temporal and Effort cost Decision-making in Healthy Individuals with Subclinical Psychotic Symptoms

Cited by 13 publications

References 62 publications

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

Psychotic-like experiences in the lonely predict conspiratorial beliefs and are associated with the diet during COVID-19

Relationship of ventral striatum activation during effort discounting to clinical amotivation severity in schizophrenia

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