investigation of objective cognitive effort in neuropsychological evaluation of psychotic disorders

Conditions: Schizophrenia; Psychotic Disorders; Cognitive Impairment; Motivation

Summary: psychotic disorders are characterised by a heterogeneity of symptoms, including cognitive disorders, which predict functional outcome. to date, the evaluation of cognitive functions essentially measures performance. cognitive effort and the influence of psychological factors are rarely considered. based on the principle of energy conservation, the motivational intensity theory (mit) allows to test cognitive effort independently of performance, by measuring cardiovascular reactivity, as well as controlling for psychological factors (e.g., mood, fatigue, anxiety). the main aim of this study is to investigate in a memory task the interaction between cognitive effort, performance and psychological factors in individuals with psychotic disorders compared to a non-clinical group, based on the predictions of the mit. this study will provide insights into the nature of cognitive impairment in psychotic disorders: primary or secondary to motivational (effort) or psychological (mood, fatigue, anxiety) difficulties.

the study will be proposed to patients with psychotic disorders (n=50) and non clinical participants (n = 50) aged 18 to 60. this is a non-interventional, randomized, prospective experimental study with mixed design: 2 groups (psychotic disorders vs. non-clinical) with 2 repeated measures of difficulty (easy vs. difficult). the study comprises a single visit with memory tests recording cardiovascular, and performance data, as well as participants' perceptions of the task (effort invested, difficulty, motivation to perform the task), followed by a psychological assessment using questionnaires and a semi-structured interview. the study of these different measures (cardiovascular, performance, perception) will enable us to refine the understanding of cognitive deficits in psychotic disorders, taking psychopathological variables into account. will provide better direction for the care of this population: cognitive remediation for primary cognitive disorders vs. cognitive and behavioral therapies for cognitive disorders secondary to psychopathological variables (mood, fatigue, defeatist beliefs, motivational deficits).

Eligibility criteria:
inclusion criteria in both groups - age ≥ 18 years and ≤60 years inclusion criteria for the psychotic disorders group: - patients with a diagnosis within the schizophrenia spectrum and other psychotic disorders according to the criteria of the diagnostic and statistical manual of mental disorders (dsm-5; apa, 2015). inclusion criterion for the non-clinical group: - absence of any psychiatric disorder. non-inclusion criteria in both groups * neurological disorder or history of head trauma; * cardiovascular disease or treatment for hypertension; * substance abuse or dependence disorder; * individuals who cannot understand or speak french; * non-affiliation with a social security system; * individuals participating in another study that includes an ongoing exclusion period; * individuals who have not provided written informed consent to participate in the study; * pregnant or breastfeeding women; * absence of written consent from the legal guardian for patients under guardianship; * absence of notification to the curator for patients under curatorship.

Keywords: memory effort cardiovascular reactivity