Mehta Marishka M, Butler Grace, Ahn Christopher, Whitaker Yolanda Irini, Bachi Keren, Jacob Yael, Treadway Michael, Murrough James W, Morris Laurel S
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Laureate Institute for Brain Research, Tulsa, OK, USA.
Psychol Med. 2024 Dec 27;54(16):1-10. doi: 10.1017/S0033291724002022.
Motivated behaviors vary widely across individuals and are controlled by a range of environmental and intrinsic factors. However, due to a lack of objective measures, the role of intrinsic extrinsic control of motivation in psychiatric disorders remains poorly understood.
We developed a novel multi-factorial behavioral task that separates the distinct contributions of intrinsic extrinsic control, and determines their influence on motivation and outcome sensitivity in a range of contextual environments. We deployed this task in two independent cohorts (final in-person = 181 and final online = 258), including individuals with and without depression and anxiety disorders.
There was a significant interaction between group (controls, depression, anxiety) and control-condition (extrinsic, intrinsic) on motivation where participants with depression showed lower extrinsic motivation and participants with anxiety showed higher extrinsic motivation compared to controls, while intrinsic motivation was broadly similar across the groups. There was also a significant group-by-valence (rewards, losses) interaction, where participants with major depressive disorder showed lower motivation to avoid losses, but participants with anxiety showed higher motivation to avoid losses. Finally, there was a double-dissociation with anhedonic symptoms whereby anticipatory anhedonia was associated with reduced extrinsic motivation, whereas consummatory anhedonia was associated with lower sensitivity to outcomes that modulated intrinsic behavior. These findings were robustly replicated in the second independent cohort.
Together this work demonstrates the effects of intrinsic and extrinsic control on altering motivation and outcome sensitivity, and shows how depression, anhedonia, and anxiety may influence these biases.
动机性行为在个体间差异很大，受一系列环境和内在因素控制。然而，由于缺乏客观测量方法，动机的内在与外在控制在精神疾病中的作用仍知之甚少。
我们开发了一种新颖的多因素行为任务，该任务区分了内在与外在控制的不同作用，并确定它们在一系列情境环境中对动机和结果敏感性的影响。我们在两个独立队列（最终面对面 = 181人，最终在线 = 258人）中部署了此任务，包括患有和未患有抑郁和焦虑症的个体。
在动机方面，组（对照组、抑郁症组、焦虑症组）和控制条件（外在、内在）之间存在显著交互作用，与对照组相比，抑郁症患者表现出较低的外在动机，焦虑症患者表现出较高的外在动机，而内在动机在各组中大致相似。在组与效价（奖励、损失）之间也存在显著交互作用，其中重度抑郁症患者避免损失的动机较低，但焦虑症患者避免损失的动机较高。最后，在快感缺失症状方面存在双重分离，即预期性快感缺失与外在动机降低有关，而 consummatory 快感缺失与调节内在行为的结果的较低敏感性有关。这些发现在第二个独立队列中得到了有力的重复验证。
这项工作共同证明了内在和外在控制对改变动机和结果敏感性的影响，并展示了抑郁症、快感缺失和焦虑症如何可能影响这些偏差。
