Too much or too little? Exploring effort perception in schizophrenia within the framework of motivational intensity theory

Décombe, Amandine; Brunel, Lionel; Capdevielle, Delphine; Raffard, Stéphane

doi:10.1080/13546805.2020.1798220

Cited by 10 publications

(7 citation statements)

References 69 publications

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“…Abnormal effort-cost computations have been associated with abnormal orbitofrontal cortex-driven reward magnitude representation, update, and maintenance. 4,52 In parallel, an eventrelated functional magnetic resonance imaging experiment found weaker neural response in the nucleus accumbens associated with lower probability to expend high level of effort in participants with schizophrenia compared with controls during EEfRT. 6 Other mechanisms, such as disruption of prefrontal-mediated action invigoration and selection and impairments in reinforcement learning, may be involved in effort-cost decision-making deficits.…”

Section: Discussionmentioning

confidence: 97%

Effort-Cost Decision-making Among Individuals With Schizophrenia

et al. 2023

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ImportanceMotivational impairments in schizophrenia are by definition associated with poor outcome. It is postulated that the reduction of goal-directed behavior arises from abnormal trade-offs between rewards and efforts.ObjectiveTo examine whether schizophrenia is associated with impairments in effort-cost decision-making.Data SourcesFor this systematic review and meta-analysis, the PubMed, ScienceDirect, PsycINFO, Embase, and ClinicalTrials.gov databases were searched from inception to July 2022 for studies that investigated effort-cost decision-making in schizophrenia. Search terms included effort, cost, and schizophrenia.Study SelectionConsensual criteria for inclusion were peer-reviewed studies published in English that used a computerized effort-cost decision-making behavioral paradigm and compared individuals with schizophrenia with control individuals.Data Extraction and SynthesisThe Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was used for abstracting data. Data were extracted independently by 2 authors and then pooled using random-effects sizes and bayesian approaches.Main Outcomes and MeasuresThe main outcomes were performance on effort-cost decision-making tasks requiring an effort-reward trade-off, measured by Hedges g effect size. Effects of moderators were tested with meta-regressions and subgroup analyses.ResultsTwenty studies involving 1503 participants were included: 837 individuals with schizophrenia (541 [64.6%] male; mean [SD] age, 35.89 [6.70] years) and 666 control individuals without schizophrenia (360 [54.1%] male; mean [SD] age, 34.16 [5.92] years). Participants with schizophrenia had significantly reduced willingness to expend effort for rewards compared with controls (k = 20; effect size, 0.43; 95% CI, 0.30-0.56; P &lt; .001; I2 = 33.1%; Q test P = .08). The magnitude of the deficit was significantly greater for high-reward trials. The severity of negative symptoms was negatively associated with effort-cost decision-making (k = 8; effect size, −0.33; 95% CI, −0.50 to −0.15; P &lt; .001), while participants with a high number of negative symptoms had a significantly larger impairment in effort-cost decision-making (k = 5; effect size, 0.47; 95% CI, 0.10-0.84; P = .01).Conclusions and RelevanceIn this systematic review and meta-analysis, schizophrenia was associated with deficits in effort allocation as indexed by effort-cost decision-making tasks. Understanding the cognitive and neurobiological mechanisms driving effort allocation impairments may assist in developing novel interventions.

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Section: Discussionmentioning

confidence: 97%

Effort-Cost Decision-making Among Individuals With Schizophrenia

et al. 2023

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“…Hence, future studies on effort allocation should consider to apply ESM for more refined assessment of amotivation in schizotypy individuals. In addition, recent research has proposed the need to take into consideration participants’ perception of task difficulty and effort in evaluating effort-based decision-making, and revealed that schizophrenia patients might be able to mobilize more effort to maintain performance despite their higher perceived task demands relative to controls ( 56 ). Further research is required to explore the relationships between effort allocation, perceived difficulty and effort, and amotivation in schizotypy individuals.…”

Section: Discussionmentioning

confidence: 99%

Effort-based decision making in schizotypy and its relationship with amotivation and psychosocial functioning

Chu

Tong²,

Wong³

et al. 2023

Front. Psychiatry

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IntroductionSuboptimal effort-based decision-making with reduced willingness to expend effort for high-probability/high-value reward is observed in schizophrenia patients and is related to diminished motivation, but is understudied in schizotypy. This study aimed to examine effort-allocation in schizotypy individuals and its association with amotivation and psychosocial functioning.MethodsWe recruited 40 schizotypy individuals and 40 demographically-matched healthy controls, based on Schizotypal Personality Questionnaire-Brief (SPQ-B) score (top and bottom 10% SPQ-B scores, respectively), from 2400 young people aged 15-24 years participating a population-based mental health survey in Hong Kong and examined effort-allocation using the Effort Expenditure for Reward Task (EEfRT). Negative / amotivation symptoms and psychosocial functioning were assessed by the Brief Negative Symptom Scale (BNSS) and the Social Functioning and Occupational Assessment Scale (SOFAS), respectively. Schizotypy individuals were categorized into high-amotivation and low-amotivation groups based on a median-split of BNSS amotivation domain score.ResultsOur results showed no main group effect (in either two or three-group comparison) on effort task performance. Three-group comparison analyses on selected EEfRT performance indices revealed that high-amotivation schizotypy individuals displayed significantly less increase in effortful options from low-value to high-value reward (reward-difference score) and from low-probability/low-value to high-probability/high-value reward (probability/reward-difference score) than low-amotivation individuals and controls. Correlation analyses demonstrated trend-wise significance between BNSS amotivation domain score and several EEfRT performance indices in schizotypy group. Schizotypy individuals with poorer psychosocial functioning tended to exhibit smaller probability/reward-difference score relative to other two groups.DiscussionOur findings indicate subtle effort-allocation abnormalities in schizotypy individuals with high levels of diminished motivation, and suggest the link between laboratory-based effort-cost measures and real-world functional outcome.

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“…Perception of effort is widely investigated during global locomotor tasks, such as walking or cycling, in both healthy and symptomatic populations ( Horstman et al, 1979 ; Au et al, 2017 ; Zinoubi et al, 2018 ; Décombe et al, 2020 ; Flairty and Scheadler, 2020 ) to prescribe and monitor exercise ( Impellizzeri et al, 2004 ; Azevedo et al, 2016 ; Eston and Parfitt, 2018 ). Perception of effort is also investigated during isolated motor tasks involving the upper or lower limb, in strength training programs ( Miller et al, 2009 ; Zourdos et al, 2016 ), in studies aiming at better understanding the regulation of endurance performance ( Maikala and Bhambhani, 2006 ; Pageaux et al, 2013 ) or the mechanisms associated with the development of muscle fatigue during repetitive tasks ( de Morree et al, 2012 ; Otto et al, 2019 ; Yang et al, 2019 ; Jacquet et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks

et al. 2023

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PurposeThe perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks. The present study examines the validity of PE to prescribe and monitor exercise during upper-limb motor tasks under various loads and speed requirements.MethodsForty participants volunteered in two experiments. In experiment 1, we used four PE intensities to prescribe exercise on a modified version of the box and block test (BBT) and a pointing task. We investigated the possibility of monitoring the exercise intensity by tracking changes in PE rating in response to three different tempos or additional weights. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of additional weights on performance and PE during the standardized version of the BBT. Muscle activation, heart rate, and respiratory frequencies were recorded.ResultsIn experiment 1, increasing the PE intensity to prescribe exercise induced an increased performance between each intensity. Increasing task difficulty with faster movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, participants maintained performance at the cost of a higher PE. In both experiments, changes in PE were associated with changes in muscle activation.ConclusionOur results suggest that PE is a valid tool to prescribe and monitor exercise during upper-limb motor tasks.

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Too much or too little? Exploring effort perception in schizophrenia within the framework of motivational intensity theory

Cited by 10 publications

References 69 publications

Effort-Cost Decision-making Among Individuals With Schizophrenia

Effort-Cost Decision-making Among Individuals With Schizophrenia

Effort-based decision making in schizotypy and its relationship with amotivation and psychosocial functioning

Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks

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