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Article: Abnormal cognitive effort allocation and its association with amotivation in first-episode psychosis

TitleAbnormal cognitive effort allocation and its association with amotivation in first-episode psychosis
Authors
KeywordsEffort discounting
effort-based decision-making
effort-cost computation
motivational deficits
negative symptoms
Issue Date2019
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2019, Epub 2019-10-02, p. 1-11 How to Cite?
AbstractBackground: Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP). Method: Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored. Results: Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits. Conclusion: This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
Persistent Identifierhttp://hdl.handle.net/10722/282955
ISSN
2020 Impact Factor: 7.723
2020 SCImago Journal Rankings: 2.857
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChang, WC-
dc.contributor.authorWestbrook, A-
dc.contributor.authorStrauss, GP-
dc.contributor.authorChu, AOK-
dc.contributor.authorChong, CSY-
dc.contributor.authorSiu, CMW-
dc.contributor.authorChan, SKW-
dc.contributor.authorLee, EHM-
dc.contributor.authorHui, CLM-
dc.contributor.authorSuen, YM-
dc.contributor.authorLo, TL-
dc.contributor.authorChen, EYH-
dc.date.accessioned2020-06-05T06:23:28Z-
dc.date.available2020-06-05T06:23:28Z-
dc.date.issued2019-
dc.identifier.citationPsychological Medicine, 2019, Epub 2019-10-02, p. 1-11-
dc.identifier.issn0033-2917-
dc.identifier.urihttp://hdl.handle.net/10722/282955-
dc.description.abstractBackground: Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP). Method: Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored. Results: Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits. Conclusion: This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.-
dc.languageeng-
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM-
dc.relation.ispartofPsychological Medicine-
dc.rightsPsychological Medicine. Copyright © Cambridge University Press.-
dc.rightsThis article has been published in a revised form in [Journal] [http://doi.org/XXX]. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © copyright holder.-
dc.subjectEffort discounting-
dc.subjecteffort-based decision-making-
dc.subjecteffort-cost computation-
dc.subjectmotivational deficits-
dc.subjectnegative symptoms-
dc.titleAbnormal cognitive effort allocation and its association with amotivation in first-episode psychosis-
dc.typeArticle-
dc.identifier.emailChang, WC: changwc@hku.hk-
dc.identifier.emailChan, SKW: kwsherry@hku.hk-
dc.identifier.emailLee, EHM: edwinlhm@hku.hk-
dc.identifier.emailHui, CLM: christyh@hku.hk-
dc.identifier.emailSuen, YM: suenyn@hku.hk-
dc.identifier.emailChen, EYH: eyhchen@hku.hk-
dc.identifier.authorityChang, WC=rp01465-
dc.identifier.authorityChan, SKW=rp00539-
dc.identifier.authorityLee, EHM=rp01575-
dc.identifier.authorityHui, CLM=rp01993-
dc.identifier.authoritySuen, YM=rp02481-
dc.identifier.authorityChen, EYH=rp00392-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1017/S0033291719002769-
dc.identifier.pmid31576787-
dc.identifier.hkuros310156-
dc.identifier.volumeEpub 2019-10-02-
dc.identifier.spage1-
dc.identifier.epage11-
dc.identifier.isiWOS:000598412500012-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0033-2917-

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