This is a competitive renewal of an R01 supporting a program of research delineating the psychological and neural mechanisms of impairments in motivation and goal-oriented behavior in psychosis, which will extend our work transdiagnostically. Motivational impairments are a key feature of both psychotic and mood pathology, and are included in the Research Domain Criteria (RDoC) Positive Valence System. Decreases in motivation impair work and social function transdiagnostically, reduce quality of life, and increase public health demands. Current treatments are not sufficiently effective at reducing impairments in motivation in every day life, in part due to the need to better understand the mechanisms that give rise to these symptoms. Our prior research provides strong evidence that abnormal effort-cost decision-making (ECDM; Effort valuation/Willingness to work in the RDoC Positive Valence System) may be a key contributor to motivational deficits in both psychotic and mood pathology. ECDM refers to calculations that individuals perform to estimate the amount of physical or cognitive ?work? required to obtain a reward. Individuals with schizophrenia, schizoaffective, bipolar disorder and depression are less motivated than healthy individuals to exert effort to obtain rewards on experimental tasks, and these deficits are related to symptoms of amotivation and function in every day life. Here we bring together a team with complimentary expertise for an innovative transdiagnostic study that would determine the similarities and differences in the psychological and neural mechanisms that contribute to impaired ECDM across forms of psychopathology. We will integrate state-of-the art functional neuroimaging methods developed in the Human Connectome Project, novel behavioral and imaging paradigms derived from the affective science literature (Consultants Treadway & Westbrook), and innovative mobile technologies to assess motivated behavior in everyday life (Co-Is Ben-Zeev, Campbell, & Moran). This study will address NIMH Strategic Objective #1 (Define the Mechanisms of Complex Behaviors) and inform novel targets for future interventions.
Aim 1 will test the hypothesis that impairments in cognitive and/or physical ECDM cut across the spectrum of psychotic and mood disorders, and relate to each other.
Aim 2 will test the hypothesis that altered ECDM in psychosis may be more associated with impairments in the RDoC construct of cognitive control, while altered ECDM related to depression may be more related to the RDoC constructs of reward responsiveness and learning.
Aim 3 will test the hypothesis that altered ECDM in psychosis may be more associated with impairments in dorsal anterior cingulate and dorsolateral prefrontal cortex activity and connectivity, while altered ECDM in depression may be more related to impairments striatal, anterior insula, and ventral-medical prefrontal activity and connectivity.
Aim 4 will test the hypothesis that ECDM predicts amotivation and function in every day life across the spectrum of psychotic and mood disorders, using ecological momentary assessment, mobile sensing (geo-location and actigraphy) and informant report.
Our prior research provides strong evidence that abnormal effort-cost decision-making (calculations that individuals perform to estimate the amount of physical or cognitive ?work? required to obtain a reward) may be a key contributor to motivational deficits in both psychotic and mood pathology. Individuals with schizophrenia, schizoaffective, bipolar disorder and depression are less motivated than healthy individuals to exert effort to obtain rewards on experimental tasks, and these deficits are related to symptoms of amotivation and function in every day life. Here we bring together a team with complimentary expertise for an innovative transdiagnostic study that would determine the similarities and differences in the psychological and neural mechanisms that contribute to impaired effort-cost decision making across forms of psychopathology to better identify optimal treatment targets.
