Modification of the Effort Expenditure for Rewards Task (EEfRT) for Motivation Studies in Schizophrenia Patients

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Abstract

Recent evidence indicates a decrease in willingness to exert effort for rewards in patients with schizophrenia. The exact mechanism of this deficit is unknown, which necessitates further research of the issue using adequate experimental procedures to measure willingness to exert efforts. Among the latter, the most widely used paradigm is the Effort Expenditure for Rewards Task (EEfRT). However, the original version of the task cannot be used in all populations because of socio-economic differences between countries. The present study was aimed to adapt the EEfRT for use in the Russian population. We shortened the task and selected levels of rewards enabling the assessment of patterns of effort expenditure in patients and healthy people. To test the psychodiagnostic properties of the modified version, it was administered to 20 young people (including 15 women) with schizophrenia and 20 healthy controls matched to the patients on demographic characteristics. In addition, we assessed clinical symptoms with the Positive and Negative Syndrome Scale (PANSS) in patients and evaluated schizotypal traits with SPQ-74 in healthy controls. The modified version of EEfRT successfully revealed the normal patterns of effort expenditure for a monetary reward. A decrease in willingness to exert effort and an attenuation of moderating effects of reward magnitude and probability in young patients with schizophrenia were demonstrated. The task therefore allows study those motivational deficits in psychiatric patients, which cannot be assessed with clinical psychometric tools.

General Information

Keywords: motivation, experimental method, schizophrenia, schizotypy, negative symptoms

Journal rubric: Methods and Techniques

Article type: scientific article

DOI: https://doi.org/10.17759/cpse.2019080409

Acknowledgements. The authors are grateful to psychiatrists of the Mental Health Research Center for assistance in organizing the research.

For citation: Plakunova V., Tkhostov A.S., Alfimova M. Modification of the Effort Expenditure for Rewards Task (EEfRT) for Motivation Studies in Schizophrenia Patients [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2019. Vol. 8, no. 4, pp. 138–155. DOI: 10.17759/cpse.2019080409. (In Russ., аbstr. in Engl.)

References

  1. Efremov A.G., Enikolopov S.N. Aprobacija biosocial'noj metodiki Klonindzhera – struktura haraktera i temperamenta (TCI-125) i metodiki vyrazhennosti shizotipicheskih chert (SPQ-74) [Approbation of the Cloninger’s biosocial Temperament and Character Inventory (TCI-125) and Schizotypal Personality Questionnaire (SPQ-74)]. Vestnik MGU. Ser. 14. Psihologija [Bulletin of Moscow State University. Ser. 14. Psychology], 2002, no. 1,
    pp. 92–93. (In Russ.; abstr. in Engl.).
  2. Zvereva N.V. Podhody k issledovaniju motivacii u detej i podrostkov pri narushenijah psihicheskogo razvitija [Approaches to investigation of motivation in children and adolescents with disturbance of mental development]. In Zvereva N.V., Roshhina I.F. (eds.), Metodologicheskie i prikladnye problemy medicinskoj (klinicheskoj) psihologii: K 90-letiju Ju.F. Poljakova. Kollektivnaja monografija [Methodological and applied problems of medical (clinical) psychology: To the 90th anniversary of Yu.F. Polyakov. Collective monograph]. Moscow: Sam Poligrafist, 2018, pp. 190–203. (In Russ.; abstr. in Engl.).
  3. Zejgarnik B.V. Lichnost' i patologija dejatel'nosti [Personality and pathology of activity]. Moscow: Publ. of Moscow State University, 1971. 98 p. (In Russ.)
  4. Kochenov M.M., Nikolaeva V.V. Motivacija pri shizofrenii [Motivation in schizophrenia]. Moscow: Publ. of Moscow State University, 1978. 88 p.  (In Russ.)
  5. Kritskaja V.P., Meleshko T.K., Poljakov Ju.F. Patologija psihicheskoj dejatel'nosti pri shizofrenii: motivacija, obshhenie, poznanie [Pathology of mental activity in schizophrenia: motivation, communication, cognition]. Moscow: Publ. of Moscow State University, 1991. 256 p. (In Russ.; abstr. in Engl.).  
  6. Leontieva E.M. Osobennosti myshlenija bol'nyh shizofreniej ob abstraktnyh ponjatijah – cennostnyh kategorijah [Features of thinking of patients with schizophrenia about abstract concepts – value categories]. Jeksperimental'naja psihologija [Experimental Psychology (Russia)], 2017, vol. 10, no. 4, pp. 46–55. doi:10.17759/exppsy.2017100404.
    (In Russ.; abstr. in Engl.). 
  7. Semenova N.D., Gurovich I.Ja. Modul' formirovanija motivacii k reabilitacii bol'nyh shizofreniej i rasstrojstvami shizofrenicheskogo spectra [A module of motivational enhancement for rehabilitation in schizophrenia and schizophrenia spectrum disorders patients]. Social'naja i klinicheskaja psihiatrija [Social and Clinical Psychiatry], 2014, vol. 24, no. 4, pp. 31–36. (In Russ.; abstr. in Engl.).
  8. Semenova N.D., Fursov B.B. K voprosu o psihodiagnostike motivacii v psihosocial'noj terapii i psihosocial'noj reabilitacii shizofrenii. Chast' I [Psychodiagnosis of motivation in the psychosocial treatment and rehabilitation of schizophrenia. Part I]. Social'naja i klinicheskaja psihiatrija [Social and Clinical Psychiatry], 2013, vol. 23, no. 1, pp. 34–39. (In Russ.; abstr. in Engl.).
  9. Thostov A.Sh. et al. Psihologicheskie mehanizmy reakcii otkaza u bol'nyh shizofreniej [Psychological mechanisms of refusal reactions in schizophrenic patients] // Zhurnal nevrologii i psihiatrii im. S.S. Korsakova [S.S. Korsakov Journal of Neurology and Psychiatry], 2005, vol. 105, no. 4, pp. 9–16. (In Russ.; abstr. in Engl.).
  10. Barch D.M., Treadway M.T., Schoen N. Effort, anhedonia and function in schizophrenia: reduced effort allocation predicts amotivation and functional impairment. Abnormal Psychology, 2014, vol. 123, no. 2, pp. 387–397. doi: 10.1037/a0036299
  11. Chang W.C., Chu A.O.K., Treadway M.T., et al. Effort-based decision-making impairment in patients with clinically-stabilized first-episode psychosis and its relationship with amotivation and psychosocial functioning. European Neuropsychopharmacology, 2019, vol. 29, no. 5, pp. 629–642. doi: 10.1016/j.euroneuro.2019.03.006
  12. Culbreth A.J., Moran E.K., Barch D.M. Effort-based decision-making in schizophrenia. Current Opinion in Behavioral Sciences, 2018, vol. 22, pp. 1–6.
    doi: 10.1016/j.cobeha.2017.12.003
  13. Da Silva S., Apatsidou A., Saperia S., et al. An Examination of the Multi-Faceted Motivation System in Healthy Young Adults. Frontiers in Psychiatry, 2018, vol. 9, article 191. doi:10.3389/fpsyt.2018.00191
  14. Fervaha G., Graff-Guerrero A., Zakzanis K.K., et al. Incentive motivation deficits in schizophrenia reflect effort computation impairments during cost-benefit decision-making. Journal of Psychiatry Research, 2013, vol. 47, no. 11, pp. 1590–1596. doi: 10.1016/j.jpsychires.2013.08.003
  15. Fervaha G., Foussias G., Agid O., et al. Motivational deficits in early schizophrenia: prevalent, persistent, and key determinants of functional outcome. Schizophrenia Research, 2015, vol. 166, no. 1-3, pp. 9–16. doi: 10.1016/j.schres.2015.04.040
  16. Green M.F., Horan W.P. Effort-based decision making in schizophrenia: evaluation of paradigms to measure motivational deficits. Schizophrenia Bulletin, 2015, vol. 41, no. 5, pp. 1021–1023. doi: 10.1093/schbul/sbv084
  17. Green M. F., Horan W.P., Barch D.M., et al. Effort-based decision making: a novel approach for assessing motivation in schizophrenia. Schizophrenia Bulletin, 2015, vol. 41, no. 5, pp. 1035–1044. doi: 10.1093/schbul/sbv071
  18. Gold J.M., Strauss G.P., Waltz J.A., et al. Negative symptoms of schizophrenia are associated with abnormal effort-cost computations. Biological Psychiatry, 2013, vol. 74,
    no. 2, pp. 130–136. doi: 10.1016/j.biopsych.2012.12.022
  19. Gold J.M., Waltz J.A., Frank M.J. Effort cost computation in schizophrenia:
    a commentary on the recent literature. Biological Psychiatry, 2015, vol. 78, no. 11,
    pp. 747–753. doi: 10.1016/j.biopsych.2015.05.005
  20. Horan W.P., Reddy L.F., Barch D.M., et al. Effort-Based Decision-Making Paradigms for Clinical Trials in Schizophrenia: Part 2 – External Validity and Correlates. Schizophrenia Bulletin, 2015, vol. 41, no. 5, pp. 1055–1065. doi: 10.1093/schbul/sbv090
  21. JASP Team. JASP (Version 0.9.1.0) [Computer software]. 2018. URL: https:.jasp-stats.org/ (Accessed 10.06.2019).
  22. Luther L., Fischer M.W., Firmin R.L., et al. Clarifying the overlap between motivation and negative symptom measures in schizophrenia research: A meta-analysis. Schizophrenia Research, 2019. vol. 206, pp. 27–36. doi: 10.1016/j.schres.2018.10.010
  23. Luther L., Firmin R.L., Lysaker P.H., et al. A meta-analytic review of self-reported, clinician-rated, and performance-based motivation measures in schizophrenia: Are we measuring the same "stuff"? Clinical Psychology Review, 2018, vol. 61, pp. 24–37.
    doi: 10.1016/j.cpr.2018.04.001
  24. Massar S.A.A., Csathó Á., Van der Linden D. Quantifying the Motivational Effects of Cognitive Fatigue Through Effort-Based Decision Making. Frontiers in Psychology, 2018,
    vol. 9, article 843. doi:10.3389/fpsyg.2018.00843
  25. Marder S.R., Galderisi S. The current conceptualization of negative symptoms in schizophrenia. World Psychiatry, 2017, vol. 16, no. 1, pp. 14–24. doi:10.1002/wps.20385
  26. McCarthy J.M., Treadway M.T., Bennett M.E., et al. Inefficient effort allocation and negative symptoms in individuals with schizophrenia. Schizophrenia Research, 2016,
    vol. 170, no. 2-3, pp. 278–284. doi:10.1016/j.schres.2015.12.017
  27. McCarthy J.M., Treadway M.T., Blanchard J.J. Motivation and effort in individuals with social anhedonia. Schizophrenia Research, 2015, vol. 165, no. 1, pp. 70–75. doi:10.1016/j.schres.2015.03.030
  28. Najas-Garcia A., Carmona V.R., Gómez-Benito J. Trends in the Study of Motivation in Schizophrenia: A Bibliometric Analysis of Six Decades of Research (1956–2017). Frontiers in Psychology, 2018, vol. 9, article 63. doi:10.3389/fpsyg.2018.00063
  29. Reddy L.F., Horan W.P., Barch D.M., et al. Effort-based decision-making paradigms for clinical trials in schizophrenia: P. 1 – psychometric characteristics of 5 paradigms. Schizophrenia Bulletin, 2015, vol. 41, no. 5, pp. 1045–1054. doi: 10.1093/schbul/sbv089
  30. Ryan R.M., Deci E.L. Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 2000, vol. 25, no. 1, pp. 54–67.
    doi: 10.1006/ceps.1999.1020
  31. Treadway M.T., Buckholtz J.W., Schwartzman A.N., et al. Worth the 'EEfRT'? The effort expenditure for rewards task as an objective measure of motivation and anhedonia. PLoS One, 2009, vol. 4, e6598. doi: 10.1371/journal.pone.0006598
  32. Treadway M.T., Peterman J.S., Zald D.H., et al. Impaired effort allocation in patients with schizophrenia. Schizophrenia Research, 2015, vol. 161, no. 2-3, pp. 382–385.
    doi: 10.1016/j.schres.2014.11.024

Information About the Authors

Victoria Plakunova, research scientist, Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia, ORCID: https://orcid.org/0000-0001-8690-5422, e-mail: jackfrost14.12@gmail.com

Aleksandr S. Tkhostov, Doctor of Psychology, Professor, Professor, Head of Department of Clinical Psychology, Faculty of Psychology, Moscow State University Lomonosov, Moscow, Russia, ORCID: https://orcid.org/0000-0001-9676-4096, e-mail: tkhostov@gmail.com

Margarita Alfimova, Doctor of Psychology, Principal Investigator, Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia, ORCID: https://orcid.org/0000-0003-0155-8412, e-mail: m.alfimova@gmail.com

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