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The Relationship Between Effort Cost Decision Making, Pleasure, and Health Behaviors in Schizotypy

Adriann Lai MA 1, Olivia McGough PhD 2, and Thomas Dinzeo PhD 1

1 Rowan University

2 North Carolina State University

Schizotypy traits and consummatory pleasure, not effort on a lab task, predicted students’ health behaviors.

BACKGROUND

  • Avolition and anhedonia are core negative symptoms of schizophrenia-spectrum disorders (SSDs) 1, 2 and drive poor real-world functioning, including health behaviors 3.
  • People with SSDs tend to “like” rewards in the moment (consummatory pleasure) but struggle with “wanting” them ahead of time (anticipatory pleasure) 4.
  • The Effort Expenditure for Rewards Task (EEfRT) measures whether people will work harder for bigger rewards.
  • Studying schizotypy (subclinical schizophrenia traits) shows these processes before illness or medication.

HYPOTHESES

1: Higher negative schizotypy → less effort for greater rewards, via reduced anticipatory pleasure.

2: Negative schizotypy, low pleasure, and low effort → poorer health behaviors.

METHODS

247

undergraduates

19.8

mean age (yrs)

53%

female

Effort Expenditure for Rewards Task (EEfRT)

Adapted from Treadway et al. (2012). 5

  • Schizotypy: SPQ-BR (positive, disorganized, negative) 6; WSS Social & Physical Anhedonia 7
  • Pleasure: TEPS Anticipatory & Consummatory 8
  • Health Behaviors: PSQI 9; LHQ-B 10
  • Analysis: Poisson regressions (effort × expected value); hierarchical regressions (health); age, sex and race controlled

RESULTS

DISCUSSION

1

Social anhedonia may flag early motivation problems. High scorers worked hard regardless of payoff, an inefficient pattern also seen in schizophrenia. It may be a scalable early screening target.

2

SPQ Negative alone may miss motivation problems. It mostly measures social anxiety and flat affect; the WSS Social Anhedonia scale captured effects SPQ Negative did not.

3

Disorganization hurt health behaviors. Disorganization, but not effort, was associated with poorer sleep and worse physical health and exercise, suggesting possible planning and executive difficulties.

4

More in-the-moment pleasure, worse sleep. Students who enjoy social life more may keep later, irregular hours.

5

Lab effort did not predict real-world health behaviors. EEfRT performance explained no variance in sleep or physical health and exercise.

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  • Higher social anhedonia → more hard choices overall (b = 0.63, p = .005), but fewer as rewards grew (b = −0.005, p = .005).
  • SPQ Negative, Positive, and Disorganized as well as WSS Physical Anhedonia did not predict effort.
  • Consummatory (not anticipatory) pleasure improved model fit (Bayes factor = 37), but its direct effect was only marginal; no mediation.

Social anhedonia showed inefficient effort

Schizotypy traits linked to poorer sleep &

physical health and exercise

1. Faerden et al. (2010). Schizophr Res, 116, 20–26.

2. Foussias et al. (2011). Schizophr Res, 132, 24–27.

3. Kalinowska et al. (2021). J Clin Med, 10, 165.

4. Gard et al. (2007). Schizophr Res, 93, 253–260.

5. Treadway et al. (2012). J Abnorm Psychol, 121, 553–558.

6. Cohen et al. (2010). J Pers Disord, 24, 516–537.

7. Chan et al. (2015). Psychiatry Res, 228, 143–149.

8. Gard et al. (2006). J Res Pers, 40, 1086–1102.

9. Buysse et al. (1989). Psychiatry Res, 28, 193–213.

10. Dinzeo et al. (2014). Prev Sci, 15, 103–114.

WERE THE HYPOTHESES SUPPORTED?

1: Partially supported. Social Anhedonia, but not SPQ Negative or Physical Anhedonia, predicted less effort as rewards increased. Anticipatory pleasure played no role.

2: Partially supported. SPQ Negative predicted poorer sleep, and WSS Physical Anhedonia predicted worse physical health and exercise. However, EEfRT predicted neither, and more (not less) consummatory pleasure predicted poorer sleep.

Key Findings

  • Poorer sleep: SPQ Negative, SPQ Disorganized, and consummatory pleasure (all p < .02).
  • Poorer physical health and exercise: SPQ Disorganized (p < .01) and WSS Physical Anhedonia (p = .04).
  • EEfRT performance predicted neither health behavior.

References

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