THE EFFECT OF A METACOGNITIVE TRAINING PROGRAM ON EFFORT COMPUTING IN INDIVIDUALS DIAGNOSED WITH SCHIZOPHRENIA

Abstract

Although traditional approaches to schizophrenia have long focused on positive symptoms such as hallucinations and delusions, modern literature emphasizes that the components causing long-term disability are motivational deficits within the negative symptoms, asserting them as a core feature of the illness. Furthermore, the lack of an effective treatment for these deficits highlights the significance of research in this field and increases interest in supportive intervention methods. This study aims to measure the impact of the Metacognitive Training (MCT) program on effort-cost computation, which plays a critical role in the emergence of motivational deficits and is an integral part of reward-related processes. The EEfRT task was utilized to measure effort-cost computation. In this pretest-posttest experimental study conducted with 42 individuals diagnosed with schizophrenia (25 intervention, 17 control) receiving inpatient care at a care center in Istanbul, the participants in the intervention group underwent an 8-week, 8-module MCT program. Baseline findings revealed that both groups exhibited initial impairments in effort-cost computation, making choices independent of reward probability and magnitude. Following the intervention, although both groups showed an increased tendency to select difficult tasks overall, the intervention group demonstrated superior effort-cost computation compared to the control group. Unlike the controls, individuals who received MCT significantly reduced their selection rate of high-effort tasks in trials with a low reward probability (12%) and low reward magnitude (p<0,05). Consequently, it was demonstrated that intervention programs such as metacognitive training can be effective in reward/decision-making processes and effort optimization associated with amotivation by reducing patients' cognitive biases.