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Cognitive effort-based decision-making in major depressive disorder

Published online by Cambridge University Press:  25 April 2022

Yuen-Siang Ang Open the ORCID record for Yuen-Siang Ang [Opens in a new window] ,
Steven E. Gelda  and
Diego A. Pizzagalli
Yuen-Siang Ang*
Affiliation:
McLean Hospital, Belmont MA, USA Department of Psychiatry, Harvard Medical School, Boston MA, USA Social and Cognitive Computing Department, Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
Steven E. Gelda
Affiliation:
McLean Hospital, Belmont MA, USA
Diego A. Pizzagalli
Affiliation:
McLean Hospital, Belmont MA, USA Department of Psychiatry, Harvard Medical School, Boston MA, USA
*
Author for correspondence: Yuen-Siang Ang, E-mail: angys@ihpc.a-star.edu.sg
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Abstract

Background

The association between major depressive disorder and motivation to invest cognitive effort for rewards is unclear. One reason might be that prior tasks of cognitive effort-based decision-making are limited by potential confounds such as physical effort and temporal delay discounting.

Methods

To address these interpretive challenges, we developed a new task – the Cognitive Effort Motivation Task – to assess one's willingness to exert cognitive effort for rewards. Cognitive effort was manipulated by varying the number of items (1, 2, 3, 4, 5) kept in spatial working memory. Twenty-six depressed patients and 44 healthy controls went through an extensive learning session where they experienced each possible effort level 10 times. They were then asked to make a series of choices between performing a fixed low-effort-low-reward or variable higher-effort-higher-reward option during the task.

Results

Both groups found the task more cognitively (but not physically) effortful when effort level increased, but they still achieved ⩾80% accuracy on each effort level during training and >95% overall accuracy during the actual task. Computational modelling revealed that a parabolic model best accounted for subjects' data, indicating that higher-effort levels had a greater impact on devaluing rewards than lower levels. These procedures also revealed that MDD patients discounted rewards more steeply by effort and were less willing to exert cognitive effort for rewards compared to healthy participants.

Conclusions

These findings provide empirical evidence to show, without confounds of other variables, that depressed patients have impaired cognitive effort motivation compared to the general population.

Keywords

Cognitive effort-based decision-makingcomputational modellingdepressionmotivation

Information

Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 9 , July 2023 , pp. 4228 - 4235
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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