Major depressive disorder (MDD) is associated with persistent, impaired life functioning. Motivational deficits in physical and cognitive effort expenditure have not been evaluated as contributors to functional impairment in MDD. In this study, we adapted parallel measures of choices to expend physical and cognitive effort and assessed their associations with symptoms, cognition, and life functioning in 44 participants with MDD. Higher anhedonia severity predicted lower motivation for physical effort but not for cognitive effort. Lower cognitive effort motivation was associated with poorer life functioning even after controlling for previously established predictors of symptoms and cognitive impairment. Reduced cognitive effort motivation also had an indirect effect on the relationship between impaired cognitive and life functioning. Findings suggest motivational deficits in MDD present different barriers for recovery depending on the type of effort that is avoided. Physical effort motivation is associated with anhedonia severity, whereas cognitive effort motivation is relevant to life functioning.

中文翻译：

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抑郁症中基于身体和认知努力的决策：与症状和功能的关系

重度抑郁症 (MDD) 与持续的、受损的生活功能有关。身体和认知努力支出的动机缺陷尚未被评估为 MDD 功能障碍的促成因素。在这项研究中，我们调整了平行选择措施来消耗体力和认知努力，并在 44 名 MDD 参与者中评估了它们与症状、认知和生活功能的关联。较高的快感缺失严重程度预示着较低的体力劳动动机，但不是认知努力的动机。即使在控制了先前确定的症状和认知障碍的预测因素之后，较低的认知努力动机也与较差的生活功能有关。认知努力动机的减少也对受损的认知和生活功能之间的关系产生间接影响。研究结果表明，根据避免的努力类型，MDD 中的动机缺陷会为恢复带来不同的障碍。体力劳动动机与快感缺乏严重程度相关，而认知努力动机与生活功能相关。