Research article

Incentive motivation in first-episode psychosis: A behavioural study

Graham K Murray^1,2,3 , Luke Clark³ , Philip R Corlett^1,3 , Andrew D Blackwell^1,4 , Roshan Cools³ , Peter B Jones^1,2 , Trevor W Robbins³ and Luise Poustka^1,2,5

¹Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK

²CAMEO, Cambridgeshire and Peterborough Mental Health Partnership NHS Trust, Cambridge, UK

³Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK

⁴Cambridge Cognition Limited, Cambridge, UK

⁵Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim, Germany

author email corresponding author email

BMC Psychiatry 2008, 8:34doi:10.1186/1471-244X-8-34

Published:	8 May 2008

Abstract

Background:

It has been proposed that there are abnormalities in incentive motivational processing in psychosis, possibly secondary to subcortical dopamine abnormalities, but few empirical studies have addressed this issue.

Methods:

We studied incentive motivation in 18 first-episode psychosis patients from the Cambridge early psychosis service CAMEO and 19 control participants using the Cued Reinforcement Reaction Time Task, which measures motivationally driven behaviour. We also gathered information on participants' attentional, executive and spatial working memory function in order to determine whether any incentive motivation deficits were secondary to generalised cognitive impairment.

Results:

We demonstrated the anticipated "reinforcement-related speeding" effect in controls (17 out of 19 control participants responded faster during an "odd-one-out" task in response to a cue that indicated a high likelihood of a large points reward). Only 4 out of 18 patients showed this effect and there was a significant interaction effect between reinforcement probability and diagnosis on reaction time (F_1,35 = 14.2, p = 0.001). This deficit was present in spite of preserved executive and attentional function in patients, and persisted even in antipsychotic medication free patients.

Conclusion:

There are incentive motivation processing abnormalities in first-episode psychosis; these may be secondary to dopamine dysfunction and are not attributable to generalised cognitive impairment.