Effort-cost decision-making in psychotic and mood disorders

Avolition and anhedonia are core symptoms across psychosis and mood disorders. One important mechanism thought to relate to these symptoms is effort-cost decision-making (ECDM), the valuation and estimation of work required to obtain a given reward. While recent work suggests impairments in ECDM in both mood disorders and psychosis relative to controls, limited work has taken a transdiagnostic approach to examine how these deficits relate to different symptom profiles across disorders. The present study investigated ECDM across schizophrenia/schizoaffective disorder (N = 33), bipolar disorder (N = 47), unipolar depression (N = 61), and healthy controls (N = 58) to examine willingness to expend physical effort. Moreover, we examined the relationship between ECDM and motivation and pleasure symptoms across participants. We found that people with schizophrenia and bipolar disorder showed a reduced willingness to expend physical effort at high reward values relative to controls, while as a group, those with depression showed no differences relative to controls. However, individual differences in self-reported motivation and pleasure predicted reduced ECDM, particularly at high reward values, suggesting that both severity of symptoms and diagnostic categories are important for understanding altered ECDM in psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).