Effort-based decision-making paradigms for clinical trials in schizophrenia: Part 1 - Psychometric characteristics of 5 paradigms

L. Felice Reddy, William P. Horan, Deanna M. Barch, Robert W. Buchanan, Eduardo Dunayevich, James M. Gold, Naomi Lyons, Stephen R. Marder, Michael T. Treadway, Jonathan K. Wynn, Jared W. Young, Michael F. Green

Research output: Contribution to journalArticlepeer-review

114 Scopus citations


Impairments in willingness to exert effort contribute to the motivational deficits characteristic of the negative symptoms of schizophrenia. The current study evaluated the psychometric properties of 5 new or adapted paradigms to determine their suitability for use in clinical trials of schizophrenia. This study included 94 clinically stable participants with schizophrenia and 40 healthy controls. The effort-based decision-making battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 5 paradigms included 1 that assesses cognitive effort, 1 perceptual effort, and 3 that assess physical effort. Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure (ie, practice effects), and (4) tolerability. The 5 paradigms showed varying psychometric strengths and weaknesses. The Effort Expenditure for Rewards Task showed the best reliability and utility as a repeated measure, while the Grip Effort Task had significant patient-control group differences, and superior tolerability and administration duration. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting effort and motivation paradigms for use in clinical trials.

Original languageEnglish
Pages (from-to)1045-1054
Number of pages10
JournalSchizophrenia Bulletin
Issue number5
StatePublished - Sep 2015
Externally publishedYes

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  • Effort
  • Motivation
  • Psychometric
  • Schizophrenia


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