Effort–cost computation in a transdiagnostic psychiatric sample: Differences among patients with schizophrenia, bipolar disorder, and major depressive disorder

Abstract

Amotivational symptoms are observed in schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD).Effort-cost computation may be a potential contributor to amotivation transdiagnostically. This study examined effort-cost computation in these three diagnostic groups. This study recruited 141 outpatients (49 SCZ, 52 non-psychotic BD, and 40 non-psychotic MDD) and 57 healthy controls (HCs). We administered the Effort-Expenditure for Reward Task (EEfRT), which manipulated different levels of reward magnitude and probability relating to a high and low physical effort task. There were significant interactions between group and reward magnitude, group and reward probability, and group and expected value on the percentage of high-effort choices. SCZ, BD, and MDD patients made comparably fewer high-effort choices than HCs in the high-reward magnitude, high-reward probability, and highexpected-value conditions. Self-reported amotivation did not correlate with decision-making on the EEfRT. Our findings suggest that reduced effort expenditure for reward is a transdiagnostic phenotype in SCZ, BD, and MDD.

Motivational differences in unipolar and bipolar depression, manic bipolar, acute and stable phase schizophrenia

“…Reward wanting in healthy people is an ability to balance costs and benefits when selecting from multiple options (Treadway et al, 2009). However, it has been reported that patients with major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia display reduced effort to gain reward and fail to respond optimally to uncertain rewards (Barch et al, 2014;Treadway et al, 2012;Wang et al, 2015;Yang et al, 2014;Zou et al, 2020).…”

Factor structure and sex invariance of the temporal experience of pleasure scale (TEPS) in Chinese university students and clinical population

“…impaired anticipatory pleasure and consummatory pleasure in MDD [32], but bias toward impairment in anticipatory pleasure in schizophrenia [20,[29][30][31]). Furthermore, recent studies employing reward task-choice behavioral analyses have suggested that there may be distinct clinically important motivation impairments in relation to anhedonia in patients with schizophrenia, bipolar disorder, and MDD [65,66]. Hence, measurement invariance provides confidence that TEPS score differences reflect authentic differences across the wellestablishedanticipatory-consummatory pleasure dimension as well as across a newly exposed motivationnonmotivation dimension in future research.…”

Pleasure, reward value and prediction error in anhedonia

“…Several studies using such "value-based choice" tasks have found that, compared to healthy controls, people with depression and schizophrenia are less willing to expend greater effort for larger or more probable rewards. While in some studies depressed participants expended less effort overall (Treadway et al 2012;Hershenberg et al 2016), in most studies participants with depression (Cléry-Melin et al, 2011;Yang et al, 2014;Zou et al, 2020) and schizophrenia (Barch et al, 2014;Chang et al, 2019;Fervaha et al, 2013;Gold et al, 2013;McCarthy et al, 2016;Treadway et al, 2015;Yang et al, 2021;Zou et al, 2020) did not differ from healthy controls in their overall willingness to expend effort; instead, anhedonic individuals were less willing to expend greater effort when the magnitude or probability of reward were high. Although some studies in depression (Yang et al, 2021) and schizophrenia (Docx et al 2015) reported divergent results, overall the pattern is remarkably consistent (although this may be due in part to publication bias; Halahakoon et al, 2020).…”