Psychotic disorders are characterized by a generalized neurocognitive deficit (i.e., performance 1.5 SD below controls across neuropsychological domains with no specific profile of differential deficits). A motivational account of the generalized neurocognitive deficit has been proposed, which attributes poor neuropsychological testing performance to low effort. However, findings are inconsistent regarding effort test failure rate in individuals with psychotic disorders across studies (0–72%), and moderators are unclear, making it difficult to know whether the motivational explanation is viable. To address these issues, a meta-analysis was performed on data from 2205 individuals with psychotic disorders across 19 studies with 24 independent effects. Effort failure rate was examined along with moderators of effort test type, forensic status, IQ, positive symptoms, negative symptoms, diagnosis, age, gender, education, and antipsychotic use. The pooled weighted effort test failure rate was 18% across studies and there was a moderate pooled association between effort failure rate and global neurocognitive performance (r = .57). IQ and education significantly moderated failure rate. Collectively, these findings suggest that a nontrivial proportion of individuals with a psychotic disorder fail effort testing, and failure rate is associated with global neuropsychological impairment. However, given that effort tests are not immune to the effects of IQ in psychotic disorders, these results cannot attest to the viability of the motivational account of the generalized neurocognitive deficit. Furthermore, the significant moderating effect of IQ and education on effort test performance suggests that effort tests have questionable validity in this population and should be interpreted with caution.

中文翻译：

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精神障碍神经心理学努力测试表现的元分析。

精神病性障碍的特征在于广泛的神经认知缺陷（即，跨神经心理学领域的表现比对照低 1.5 SD，没有特定的差异缺陷概况）。已经提出了广义神经认知缺陷的动机解释，这将神经心理学测试表现不佳归因于低努力。然而，关于精神病患者努力测试失败率的研究结果不一致（0-72%），并且主持人不清楚，因此很难知道动机解释是否可行。为了解决这些问题，对 19 项研究中的 2205 名精神病患者的数据进行了荟萃分析，具有 24 个独立的影响。努力失败率与努力测试类型、法医状态、智商、阳性症状、阴性症状、诊断、年龄、性别、教育和抗精神病药的使用。跨研究的汇总加权努力测试失败率为 18%，努力失败率与整体神经认知表现之间存在中等汇总关联 (r = .57)。智商和教育显着降低了失败率。总的来说，这些发现表明，相当一部分患有精神障碍的个体未能通过努力测试，并且失败率与整体神经心理障碍有关。然而，考虑到努力测试对智商在精神病中的影响没有免疫力，这些结果不能证明广义神经认知缺陷的动机解释的可行性。此外，