Reduced willingness to expend effort for rewards is associated with risk for conversion and negative symptom severity in youth at clinical high-risk for psychosis

Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and pred...

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Bibliographic Details
Published in:Psychological medicine 2023-02, Vol.53 (3), p.714-721
Main Authors: Strauss, Gregory P., Bartolomeo, Lisa A., Luther, Lauren
Format: Article
Language:English
Subjects:
Adolescent
Amphetamines
Conversion disorder
Cross-Sectional Studies
Dopamine
Emotional behavior
High risk
Humans
Illnesses
Mental disorders
Negative symptoms
Original Article
Population studies
Prevention
Prodromal Symptoms
Psychiatrists
Psychosis
Psychotic Disorders
Reward
Rewards
Risk Factors
Schizophrenia
Schizophrenia - diagnosis
Symptoms
Willingness
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Summary:Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and predictive of conversion to illness. Mechanisms underlying negative symptoms are unclear in the CHR population. The current study evaluated whether CHR participants demonstrated deficits in the willingness to expend effort for rewards and whether these impairments are associated with negative symptoms and greater risk for conversion. Participants included 44 CHR participants and 32 healthy controls (CN) who completed the Effort Expenditure for Reward Task (EEfRT). Compared to CN, CHR participants displayed reduced likelihood of exerting high effort for high probability and magnitude rewards. Among CHR participants, reduced effort expenditure was associated with greater negative symptom severity and greater probability of conversion to a psychotic disorder on a cross-sectional risk calculator. Findings suggest that effort-cost computation is a marker of illness liability and a transphasic mechanism underlying negative symptoms in the SZ spectrum.
ISSN:0033-2917
1469-8978
DOI:10.1017/S003329172100204X