Effort-based decision making as an objective paradigm for the assessment of motivational deficits in schizophrenia
Effort-based decision making as an objective paradigm for the assessment of motivational deficits in schizophrenia
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DOI：
10.1016/j.schres.2015.07.023
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发表时间：
2015-10-01
影响因子：
4.5
通讯作者：
Remington, Gary
中科院分区：
文献类型：
--
作者：
Fervaha, Gagan;Duncan, Mark;Remington, Gary
背景资料：阴性症状和动机缺陷是精神分裂症的普遍特征，代表了现实世界功能结局的可靠预测因素。这些症状的评估标准是临床访谈和标准化评定量表上的严重程度评级。在本研究中，我们探讨了精神分裂症患者的动机缺陷的绩效为基础的措施的心理测量学特性。方法：97例精神分裂症患者被列入本次调查。患者愿意付出努力以获得奖励（即，动机）进行了评估，使用基于努力的决策范例，其中参与者选择了一系列的试验是否花费更大的努力，以获得更大的金钱奖励，而不是更少的努力，以获得更小的奖励。努力的表现进行了两次评估，分开了两个星期intervation.Results：精神分裂症患者选择花费更大的努力，更高的奖励价值和更大的可能性，奖励收据的试验。患者没有发现任务过于困难，并报告有动力表现良好，强调了患者对任务的耐受性。重测一致性良好，随着时间的推移，分数变化很小。努力表现与社会人口统计学或临床变量无关（例如，阳性症状）;然而，赤字综合征患者付出的努力奖励在一个显着较低的利率比nondeficit patients.Conclusions：在本研究中使用的基于努力的决策任务代表了一个客观的范式，可用于评估精神分裂症患者的动机障碍。这种基于绩效的激励措施也可以作为临床试验的可行终点。(C)2015 Elsevier B. V.版权所有。
Background: Negative symptoms and motivational deficits are prevalent features of schizophrenia, and represent robust predictors of real-world functional outcomes. The standard for assessment of these symptoms is clinical interview and severity ratings on standardized rating scales. In the present study we examined the psychometric properties of a performance-based measure of motivational deficits in patients with schizophrenia.Methods: Ninety-seven patients with schizophrenia were included in this investigation. Patients' willingness to expend effort for reward (i.e., motivation) was evaluated using an effort-based decision making paradigm where participants chose over a series of trials whether to expend a greater amount of effort for a larger monetary reward versus less effort for a smaller reward. Effort performance was evaluated twice, separated by a two-week interval.Results: Patients with schizophrenia opted to expend greater effort for trials with higher reward value and greater likelihood of reward receipt. Patients did not find the task overly difficult and reported being motivated to perform well, underscoring the tolerability of the task for patients. Test-retest consistency was good and there was only minimal change in scores over time. Effort performance was not related to sociodemographic or clinical variables (e.g., positive symptoms); however, deficit syndrome patients exerted effort for reward at a significantly lower rate than nondeficit patients.Conclusions: The effort-based decision making task used in the present study represents an objective paradigm that can be used to evaluate motivational impairments in patients with schizophrenia. Such performance-based measures of motivation may also serve as viable endpoints in clinical trials. (C) 2015 Elsevier B.V. All rights reserved.