Cognitive effort-based decision-making in major depressive disorder
Cognitive effort-based decision-making in major depressive disorder
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DOI：
10.1017/s0033291722000964
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发表时间：
2022-04-25
影响因子：
6.9
通讯作者：
Pizzagalli, Diego A.
中科院分区：
文献类型：
--
作者：
Ang, Yuen-Siang;Gelda, Steven E.;Pizzagalli, Diego A.
背景 重度抑郁症与投入认知努力以获得奖励的动机之间的关联尚不清楚。原因之一可能是基于认知努力的决策的先前任务受到潜在混杂因素的限制，例如体力努力和时间延迟折扣。方法为了解决这些解释性挑战，我们开发了一项新任务——认知努力动机任务——来评估一个人为获得奖励而付出认知努力的意愿。认知努力是通过改变空间工作记忆中保存的项目数量（1、2、3、4、5）来控制的。 26 名抑郁症患者和 44 名健康对照者参加了广泛的学习课程，其中他们对每种可能的努力水平进行了 10 次。然后，他们被要求在任务期间执行固定的低努力低回报或可变的高努力高回报选项之间做出一系列选择。结果 两组都发现，当努力水平增加时，任务在认知上（而非身体上）更加费力，但他们在训练期间每个努力水平的准确率仍然达到 > 80%，在实际任务期间总体准确率 > 95%。计算模型显示，抛物线模型最能解释受试者的数据，这表明较高的努力水平比较低的努力水平对贬值奖励的影响更大。这些程序还表明，与健康参与者相比，重度抑郁症患者对努力的回报的折扣更大，并且不太愿意为奖励付出认知努力。结论 这些发现提供了经验证据，表明在不混淆其他变量的情况下，与普通人群相比，抑郁症患者的认知努力动机受损。
Background The association between major depressive disorder and motivation to invest cognitive effort for rewards is unclear. One reason might be that prior tasks of cognitive effort-based decision-making are limited by potential confounds such as physical effort and temporal delay discounting. Methods To address these interpretive challenges, we developed a new task - the Cognitive Effort Motivation Task - to assess one's willingness to exert cognitive effort for rewards. Cognitive effort was manipulated by varying the number of items (1, 2, 3, 4, 5) kept in spatial working memory. Twenty-six depressed patients and 44 healthy controls went through an extensive learning session where they experienced each possible effort level 10 times. They were then asked to make a series of choices between performing a fixed low-effort-low-reward or variable higher-effort-higher-reward option during the task. Results Both groups found the task more cognitively (but not physically) effortful when effort level increased, but they still achieved > 80% accuracy on each effort level during training and >95% overall accuracy during the actual task. Computational modelling revealed that a parabolic model best accounted for subjects' data, indicating that higher-effort levels had a greater impact on devaluing rewards than lower levels. These procedures also revealed that MDD patients discounted rewards more steeply by effort and were less willing to exert cognitive effort for rewards compared to healthy participants. Conclusions These findings provide empirical evidence to show, without confounds of other variables, that depressed patients have impaired cognitive effort motivation compared to the general population.