Abstract
BackgroundAmotivation is regarded as a core negative symptom in patients with schizophrenia. There are currently no objective methods for assessing and measuring amotivation in the scientific literature, only a trend towards assessing motivation using effort-orientated, decision-making tasks. However, it remains inconclusive as to whether cognitive effort-avoidance in patients with schizophrenia can reflect their amotivation. Therefore, this study aimed to find out whether cognitive effort-avoidance in patients with schizophrenia can reflect their amotivation.MethodsIn total, 28 patients with schizophrenia and 27 healthy controls were selected as participants. The demand selection task (DST) was adapted according to the feedback-based Guilty Knowledge Test (GKT) delayed response paradigm, which was combined with the mean amplitude of contingent negative variation (CNV), considered as the criterion of motivation.ResultsOur results showed that: (1) patients with schizophrenia showed a lower CNV amplitude for the target stimuli compared to the probe stimuli, whereas the control group showed the opposite trend (P < 0.05); (2) among patients with schizophrenia, the high cognitive effort-avoidance group showed a smaller CNV amplitude for the target stimuli compared to the probe stimuli, whereas the low cognitive effort avoidance group showed a higher CNV amplitude for the target stimuli compared to the probe stimuli; the opposite trend was observed in the control group (P < 0.05).ConclusionThese findings support the claim that CNV amplitude can be used as a criterion for detecting amotivation in patients with schizophrenia. Within the context of the DST, the high and low cognitive effort-avoidance of patients with schizophrenia can reflect their state of amotivation; patients with high cognitive effort-avoidance showed severe amotivation.
Highlights
Amotivation is regarded as a core negative symptom in patients with schizophrenia
We propose the following hypotheses: (1) contingent negative variation (CNV) can be used to detect amotivation in patients with schizophrenia, which will manifest as greater CNV amplitudes for target stimuli than probe stimuli in the control group, with the opposite trend manifesting in the patient group; and (2) the selection of high or low cognitive effort-avoidance by patients with schizophrenia in the demand selection task (DST) will reflect their amotivation state, whereby patients with high cognitive effort-avoidance will show severe amotivation and have smaller CNV amplitudes for target stimuli than probe stimuli; and patients with low cognitive effort-avoidance will not show amotivation, having the opposite trend in CNV dissociation
A two-way analysis of variance (ANOVA) was performed on the selection rate of high-effort option, which showed that the main effect of cognitive effort-avoidance was significant, F (1,16) = 182.352, P = 0.000, η2 = 0.919, the main effect of patient condition was not significant, F (1, 16) =0.484, P = 0.497, η2 = 0.029, and the interaction effect between these two factors was not significant, F (1, 16) =0.001, P = 0.973, η2 = 0.000
Summary
There are currently no objective methods for assessing and measuring amotivation in the scientific literature, only a trend towards assessing motivation using effort-orientated, decision-making tasks. This study aimed to find out whether cognitive effort-avoidance in patients with schizophrenia can reflect their amotivation. Schizophrenia patients can present a variety of behavioural and motivational deficits [28], and some researchers have suggested that amotivation is the central negative symptom [13]. Researchers have begun to apply effort-orientated, decision-making tasks in their assessments of symptoms, especially in their assessments of amotivation [11, 17, 38]. Further research is still needed to verify whether the avoidance of cognitive effort in patients can reflect their motive state. ERPs, which have a high temporal resolution, provide us with the possibility of objectively quantifying and revealing amotivation
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