Abstract
Background and ObjectiveGoal-directed behavior is a central feature of human functioning. It requires goal appraisal and implicit cost-benefit analyses, i.e., how much effort to invest in the pursuit of a certain goal, against its value and a confidence judgment regarding the chance of attainment. Persons with severe mental illness such as psychosis often struggle with reaching goals. Cognitive deficits, positive symptoms restricting balanced judgment, and negative symptoms such as anhedonia and avolition may compromise goal attainment. The objective of this study was to investigate to what degree symptom severity is related to cognitive abilities, metacognition, and effort-based decision-making in a visual search task.MethodsTwo studies were conducted: study 1: N = 52 (healthy controls), and study 2: N = 46 (23 patients with psychosis/23 matched healthy controls). Symptoms were measured by the CAPE-42 (study 1) and the PANSS (study 2). By using a visual search task, we concomitantly measured (a) accuracy in short-term memory, (b) perceived accuracy by participants making a capture area or confidence interval, and (c) effort by measuring how long one searched for the target. Perseverance was assessed in trials in which the target was omitted and search had to be abandoned.ResultsHigher levels of positive symptoms, and having a diagnosis of psychosis, were associated with larger errors in memory. Participants adjusted both their capture area and their search investment to the error of their memory. Perseverance was associated with negative symptoms in study 1 but not in study 2.ConclusionBy simultaneously assessing error and confidence in one’s memory, as well as effort in search, we found that memory was affected by positive, not negative, symptoms in healthy controls, and was reduced in patients with psychosis. However, impaired memory did not concur with overconfidence or less effort in search, i.e., goal directed behavior was unrelated to symptoms or diagnosis. Metacognition and motivation were neither affected by cognitive abilities nor by negative symptoms. Clinically, this could indicate that struggles with goal directed behavior in psychosis may not solely be dependent on primary illness factors.
Highlights
Motivation and goal-directed behaviors are complex phenomena
Hypothesis 1a predicted that neurocognition as measured by the Trail Making Test (TMT) A and B, the Digit Symbol Substitution Task (DSST) and error in the visual short-term memory task would be impaired in participants with high CAPE42 scores
There was no significant relationship between TMT A and CAPE has three subscales: positive (CAPE-P) (β = 0.18, t = 1.07, p = 0.29) or CAPE-ND (β = −0.07, t = −0.42, p = 0.68), but there was a significant relationship of age and TMT A (β = 0.50, t = 3.83, p < 0.001), i.e., younger
Summary
Motivation and goal-directed behaviors are complex phenomena. Consider the following: You meet four students and all tell you that they are motivated to pass an important exam. Student B is smart, and she knows she can pass the exam if she studies all day. Student D is as smart as student C but thinks of herself as being as smart as student A and does not spend all day studying for the exam This example illustrates the interplay of cognitive ability, knowing about one’s ability, and effort (here the amount of learning spent) affecting goal-directed behavior. Goal-directed behavior is a central feature of human functioning. It requires goal appraisal and implicit cost-benefit analyses, i.e., how much effort to invest in the pursuit of a certain goal, against its value and a confidence judgment regarding the chance of attainment. The objective of this study was to investigate to what degree symptom severity is related to cognitive abilities, metacognition, and effort-based decision-making in a visual search task
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