title: Effort-Based Decision-Making Paradigms for Clinical Trials in Schizophrenia: Part 1—Psychometric Characteristics of 5 Paradigms.
abstract: Impairments in willingness to exert effort contribute to the motivational deficits characteristic of the negative symptoms of schizophrenia. The current study evaluated the psychometric properties of 5 new or adapted paradigms to determine their suitability for use in clinical trials of schizophrenia. This study included 94 clinically stable participants with schizophrenia and 40 healthy controls. The effort-based decision-making battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 5 paradigms included 1 that assesses cognitive effort, 1 perceptual effort, and 3 that assess physical effort. Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure (ie, practice effects), and (4) tolerability. The 5 paradigms showed varying psychometric strengths and weaknesses. The Effort Expenditure for Rewards Task showed the best reliability and utility as a repeated measure, while the Grip Effort Task had significant patient-control group differences, and superior tolerability and administration duration. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting effort and motivation paradigms for use in clinical trials.
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, Los Angeles, CA; lenafelice@ucla.edu.
authors.forename: L Felice
authors.initials: LF
authors.lastname: Reddy
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, 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, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD;
authors.forename: Robert W
authors.initials: RW
authors.lastname: Buchanan
authors.affiliation: Amgen, Inc., Thousand Oaks, CA;
authors.forename: Eduardo
authors.initials: E
authors.lastname: Dunayevich
authors.affiliation: Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD;
authors.forename: James M
authors.initials: JM
authors.lastname: Gold
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA;
authors.forename: Naomi
authors.initials: N
authors.lastname: Lyons
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, Los Angeles, CA;
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Marder
authors.affiliation: Department of Psychology, Emory University, Atlanta, GA;
authors.forename: Michael T
authors.initials: MT
authors.lastname: Treadway
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, Los Angeles, CA;
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Wynn
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA; Research Service, VA San Diego Healthcare System, San Diego, CA.
authors.forename: Jared W
authors.initials: JW
authors.lastname: Young
authors.affiliation: Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, Los Angeles, CA;
authors.forename: Michael F
authors.initials: MF
authors.lastname: Green
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D003657:Decision Making / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D009483:Neuropsychological Tests / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D011597:Psychomotor Performance / Q000502:physiology*; D015203:Reproducibility of Results; D012201:Reward; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology
keywords: effort; motivation; psychometric; schizophrenia