Does effort-cost decision-making relate to real-world motivation in people living with HIV?. Issue 10 (26th November 2021)

• Record Type: Journal Article
• Authors: Castaneda, Gloria; Fernandez Cruz, Ana Lucia; Sefranek, Marcus; Yau, Yvonne H.C.; Brouillette, Marie-Josée; Mayo, Nancy E.; Fellows, Lesley K
• Is Part Of: Journal of clinical and experimental neuropsychology. Volume 43:Issue 10(2021)
• Page Start: 1032
• Page End: 1043
• Publication Date: 2021-11-26
• Subjects: Reward -- effort -- apathy -- motivation -- measurement -- human; Neuropsychology -- Periodicals; Psychophysiology -- Periodicals; Neurosciences -- Periodicals; Psychophysiology -- Periodicals; Societies, Medical -- Periodicals; 616.89
• DOI: 10.1080/13803395.2022.2058464
• Languages: English
• ISSNs: 1380-3395

Abstract

ABSTRACT: Introduction: Low motivation is frequent in older people with HIV, yet poorly understood. Effort-cost decision-making (ECDM) tasks inspired by behavioral economics have shown promise as indicators of motivation or apathy. These tasks assess the willingness to exert effort to earn a monetary reward, providing an estimate of the subjective "cost" of effort for each participant. Here we sought evidence for a relationship between ECDM task performance and self-reported motivation in a cross-sectional study involving 80 middle-aged and older people with well-controlled HIV infection, a chronic health condition with a high burden of mental and cognitive health challenges. Methods: Participants attending a regular follow-up visit for a Canadian longitudinal study of brain health in HIV completed a computerized ECDM task and a self-report measure of motivation. Other brain health measures were available, collected for the parent study (cognition, depression, anxiety, and vitality, as well as self-reported time spent on real-world leisure activities). Results: Contrary to our hypothesis, we found no relationship between ECDM performance and self-reported motivation. However, those willing to accept higher effort in the ECDM task also reported more time engaged in real-world activities. This association had a small-to-moderate effect size. Conclusions: The behavioral economics construct of subjective cost of effort, measured with a laboratory ECDM task, does not relate to motivation in people living with chronic HIV. However, the task shows some relationship with real-world goal-directed behavior, suggesting this construct has potential clinical relevance. More work is needed to understand how the subjective cost of effort plays out in clinical symptoms and everyday activities.