Green Michael F, Horan William P, Barch Deanna M, Gold James M
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA;
Departments of Psychology, Psychiatry and Radiology, Washington University, St. Louis, MO;
Schizophr Bull. 2015 Sep;41(5):1035-44. doi: 10.1093/schbul/sbv071. Epub 2015 Jun 18.
Because negative symptoms, including motivational deficits, are a critical unmet need in schizophrenia, there are many ongoing efforts to develop new pharmacological and psychosocial interventions for these impairments. A common challenge of these studies involves how to evaluate and select optimal endpoints. Currently, all studies of negative symptoms in schizophrenia depend on ratings from clinician-conducted interviews. Effort-based decision-making tasks may provide a more objective, and perhaps more sensitive, endpoint for trials of motivational negative symptoms. These tasks assess how much effort a person is willing to exert for a given level of reward. This area has been well-studied with animal models of effort and motivation, and effort-based decision-making tasks have been adapted for use in humans. Very recently, several studies have examined physical and cognitive types of effort-based decision-making tasks in cross-sectional studies of schizophrenia, providing evidence for effort-related impairment in this illness. This article covers the theoretical background on effort-based decision-making tasks to provide a context for the subsequent articles in this theme section. In addition, we review the existing literature of studies using these tasks in schizophrenia, consider some practical challenges in adapting them for use in clinical trials in schizophrenia, and discuss interpretive challenges that are central to these types of tasks.
由于包括动机缺陷在内的阴性症状是精神分裂症中尚未得到满足的关键需求，因此目前有许多正在进行的工作致力于为这些损害开发新的药物和心理社会干预措施。这些研究的一个共同挑战涉及如何评估和选择最佳终点。目前，所有关于精神分裂症阴性症状的研究都依赖于临床医生进行访谈的评分。基于努力的决策任务可能为动机性阴性症状试验提供一个更客观、或许也更敏感的终点。这些任务评估一个人为了给定水平的奖励愿意付出多少努力。这一领域已经在努力和动机的动物模型方面得到了充分研究，并且基于努力的决策任务已经被改编用于人类。最近，几项研究在精神分裂症的横断面研究中考察了基于努力的决策任务的身体和认知类型，为该疾病中与努力相关的损害提供了证据。本文涵盖基于努力的决策任务的理论背景，为该主题部分的后续文章提供背景。此外，我们回顾了在精神分裂症中使用这些任务的现有研究文献，考虑在将它们改编用于精神分裂症临床试验时的一些实际挑战，并讨论这些类型任务核心的解释性挑战。
