A new study published in Psychological Medicine sheds light on how specific depression symptoms are related to decisions about how much effort people are willing to put into tasks. Higher anxiety was linked to a greater willingness to exert cognitive effort, while anhedonia and apathy increased physical effort avoidance. Those with more severe depression were less likely to leave tasks for better opportunities, potentially reflecting altered perceptions of the value of time.
The researchers aimed to better understand how depression affects decision-making about effort. Individuals with depression often struggle with goal-directed behavior due to symptoms like apathy, anergia (low energy), and anhedonia (reduced pleasure), as well as cognitive difficulties. These symptoms can make it harder to pursue and achieve goals, which often involves weighing the rewards of an action against the effort it requires.
“I identify as neurodivergent and once experienced pronounced cognitive function changes (e.g., slowed thinking) during a period of low mood. Ever since that experience, I puzzled over what drove these changes,” said study author Laura Ana Bustamante, a postdoctoral fellow at Washington University in St. Louis.
“As a neuroscientist, I was in a position to try and find out, but I felt hesitant about learning ‘too much’ about my own mental health. I knew reduced cognitive function was reported in many mental health conditions, and the common explanation was a decrease in cognitive ‘ability’ or ‘capacity.’ As a senior graduate student at the Princeton Neuroscience Institute, I was inspired when I read a theoretical paper on cognitive function in major depressive disorder (Grahek et al., 2021). It suggested that reduced cognitive function, experienced by some individuals with depression, might stem from a reduced ‘willingness’ to exert cognitive control. This idea excited me because motivation is dynamic and, I reasoned, more changeable than ability.”
“I was in the perfect position to test this account,” Bustamante explained. “At the Princeton Neuroscience Institute, I had developed the Effort Foraging Task—a tool to measure the willingness to exert effort, grounded in robust theoretical and computational foundations. Then the Rutgers-Princeton Center for Neuropsychiatry, was established as a hub for clinical collaborations. Furthermore, I had enough distance to be comfortable with the research topic, having not experienced major depression firsthand.”
“So, I embarked on my first ever clinical research project. I assembled a team of collaborators, and we applied for a grant from the New Jersey Alliance for Clinical and Translational Science. I was absolutely thrilled when we were awarded the grant. Working on this project ignited a passion for computational psychiatry and spurred me to complete a clinically oriented postdoctoral position at Washington University in St. Louis, where I carried out data analysis and manuscript preparation. All of this to say, it’s very special to see it in print.”
The study included 97 participants, 67 of whom were diagnosed with major depressive disorder. The remaining 30 participants served as a comparison group with no psychiatric diagnoses. Participants completed the Effort Foraging Task, a decision-making exercise that evaluates how people balance effort and reward. The task required participants to “harvest” rewards from patches that provided diminishing returns or decide to leave the patch and move to a new one. Moving to a new patch required time and effort, with both cognitive and physical effort manipulated across conditions.
In the cognitive effort condition, participants performed a working memory task of varying difficulty (simple versus demanding). In the physical effort condition, they had to press keys repeatedly, with the number of presses required adjusted for difficulty. The researchers used computational models to analyze participants’ decisions, including the threshold at which they stopped harvesting rewards and moved to a new patch. These thresholds revealed participants’ tolerance for effort and their perceptions of the opportunity cost of time.
Symptom severity was measured using clinical interviews and self-reported questionnaires. Participants’ depression symptoms were analyzed across dimensions such as anhedonia, anxiety, behavioral apathy, and overall depression severity. By linking these symptom profiles to participants’ performance on the Effort Foraging Task, the researchers aimed to identify how different symptoms influence effort-based decisions.
The researchers found that participants with higher anxiety symptoms were more willing to exert cognitive effort. This finding challenges traditional assumptions that depression universally reduces cognitive motivation. The researchers suggested that anxiety might act as a compensatory mechanism, motivating individuals to engage in effortful tasks as a way to manage worry or maintain performance in the face of perceived threats.
“Our analyses allowed us to see that anxiety symptom severity was selectively related to increased willingness to exert effort,” Bustamante told PsyPost. “Although this was unexpected, it does make some sense, since anxiety can involve engaging cognitive effort to avoid potential threats (i.e., worrying). So it may be that being more willing to exert cognitive effort is a mechanism underlying anxiety. This could potentially be leveraged as a strength, embracing the tendency to exert cognitive effort, but exploring ways to change the thoughts to be less distressing (i.e., fantasizing).”
“This effect hadn’t been reported before, so it should be replicated, and we need more studies to understand the causality of this relationship. Another possibility is that cognitive effort was a welcome distraction from participants’ thoughts. If that were the case, people could try engaging with cognitively demanding tasks as a way to modulate their anxiety. I would be curious if any of your readers already do so!”
Greater anhedonia and behavioral apathy, on the other hand, were associated with higher physical effort costs, meaning individuals with these symptoms were more likely to avoid physically demanding tasks. This aligns with the idea that physical symptoms, such as fatigue and low energy, contribute to reduced motivation in depression.
Interestingly, participants with more severe depression exhibited lower thresholds for leaving a patch, suggesting that they perceived time as less valuable or were less likely to seek better opportunities. This finding supports theories that depression may reduce perceptions of reward in one’s environment, leading to decreased goal-directed behavior.
“We expected that individuals with greater depression symptom severity would exhibit decreased willingness to exert cognitive effort, but we found the opposite,” Bustamante said.
No significant differences were found between the depression and comparison groups in terms of overall effort costs, suggesting that the relationship between effort-based decisions and depression is driven by individual symptom patterns rather than the diagnosis as a whole. This highlights the importance of examining symptom-specific relationships in major depressive disorder, rather than relying solely on diagnostic labels.
However, as with all research, there are a few limitations to consider. The study’s cross-sectional design cannot establish causal relationships between symptoms and effort-based decision-making. In addition, the study’s findings may not generalize to other measures of effort-based decision-making or to real-world contexts. The Effort Foraging Task is a laboratory-based task that relies on specific manipulations of effort and reward, and its results may differ from those of more explicit decision-making tasks.
Nevertheless, by identifying distinct patterns of cognitive and physical effort costs associated with symptoms like anxiety, anhedonia, and apathy, the researchers offer new perspectives on how depression affects decision-making.
“My broadest research goal is to use computational cognitive neuroscience to help people reach their goals,” Bustamante said. “This is one of many studies linking mental health and effortful behavior. Understanding the dynamic interplay between affect, anxiety, effort, and cognitive function will put us in a better position to find effective solutions. I’m passionate about bringing neurodiversity and disability perspectives into clinical psychology. I always have an eye out for how to play to people’s strengths, and how environmental and contextual factors help or hinder goal achievement.”
The study, “Major depression symptom severity associations with willingness to exert effort and patch foraging strategy,” was authored by Laura A. Bustamante, Deanna M. Barch, Johanne Solis, Temitope Oshinowo, Ivan Grahek, Anna B. Konova, Nathaniel D. Daw, and Jonathan D. Cohen.
