Understanding Effort-Cost Decision-Making Mechanisms in Mood and Psychotic Disorders: A Computational Modeling Approach Across Physical and Cognitive Effort Paradigms.

BACKGROUND: Effort-cost decision-making (ECDM) is a core component of motivational deficits across diagnostic boundaries, yet mechanisms underlying ECDM deficits are not yet fully understood. Importantly, similar behavioral phenotypes during ECDM paradigms may be associated with distinct underlying cognitive and affective processes across individuals. METHODS: We used a person-centered modeling approach to examine individual decision-making phenotypes (systematic or non-systematic decision-making) during both physical and cognitive ECDM in 5 diagnostic groups: healthy control (N=90), schizophrenia-spectrum disorder (N=67), current major depression (N=70), remitted major depression (N=52), and bipolar I disorder (N=64). We examined the association between ECDM phenotype, cognitive functioning, motivation, and diagnostic group. RESULTS: We found significant diagnostic group differences in ECDM phenotype, such that individuals with a schizophrenia-spectrum disorder, but not current or remitted major depression or bipolar disorder, were less likely to incorporate changing trial-wise reward value information in cognitive effort exertion, with the same trend for physical. Across all diagnostic groups, non-systematic decision-making was associated with lower cognitive functioning, but not lower motivation. In addition, individuals with a schizophrenia-spectrum disorder showed steeper effort discounting during both physical and cognitive ECDM paradigms. CONCLUSIONS: These findings point toward substantial individual differences in ECDM phenotypes both within and across diagnostic boundaries, suggesting that deficits in subjective value representation may be more prevalent in psychosis, compared to in mood disorders.