title: Effort-Based Decision Making: A Novel Approach for Assessing Motivation in Schizophrenia.
abstract: Because negative symptoms, including motivational deficits, are a critical unmet need in schizophrenia, there are many ongoing efforts to develop new pharmacological and psychosocial interventions for these impairments. A common challenge of these studies involves how to evaluate and select optimal endpoints. Currently, all studies of negative symptoms in schizophrenia depend on ratings from clinician-conducted interviews. Effort-based decision-making tasks may provide a more objective, and perhaps more sensitive, endpoint for trials of motivational negative symptoms. These tasks assess how much effort a person is willing to exert for a given level of reward. This area has been well-studied with animal models of effort and motivation, and effort-based decision-making tasks have been adapted for use in humans. Very recently, several studies have examined physical and cognitive types of effort-based decision-making tasks in cross-sectional studies of schizophrenia, providing evidence for effort-related impairment in this illness. This article covers the theoretical background on effort-based decision-making tasks to provide a context for the subsequent articles in this theme section. In addition, we review the existing literature of studies using these tasks in schizophrenia, consider some practical challenges in adapting them for use in clinical trials in schizophrenia, and discuss interpretive challenges that are central to these types of tasks.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; mgreen@ucla.edu.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Green
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA;
authors.forename: William P
authors.initials: WP
authors.lastname: Horan
authors.affiliation: Departments of Psychology, Psychiatry and Radiology, Washington University, St. Louis, MO;
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Barch
authors.affiliation: Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MA.
authors.forename: James M
authors.initials: JM
authors.lastname: Gold
mesh_terms: D003657:Decision Making / Q000502:physiology*; D006801:Humans; D009042:Motivation / Q000502:physiology*; D009483:Neuropsychological Tests; D012201:Reward; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D013647:Task Performance and Analysis
keywords: clinical trials; effort-based decision making; motivation; negative symptoms; schizophrenia