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155. Talk Isn’t Cheap: The Role of Monetary Incentives on Social Cognitive Task Performance in Early Episode Psychosis
Impairments in social cognition remain a significant barrier to functional recovery across all phases of psychosis, yet the factors that contribute to and maintain such impairments are poorly understood. Motivational difficulties are pervasive in psychosis, and involve abnormalities in reward processing and effort expenditure, which may be implicated in social cognitive task performance. In the present study, early psychosis patients (n=35) and demographically-matched controls (n=35) were randomized to either receive performance-contingent incentives ($0.25/correct response) on a theory of mind (ToM) task, or a non-reward condition in which they completed the task without any incentives. A significant Group x Condition interaction emerged after covarying for premorbid intelligence and neurocognition, F(1,63)=7.76, p=.007. Post-hoc analyses revealed that controls displayed similar ToM performance across conditions; however, patients who received monetary reinforcement displayed significantly higher ToM performance relative to patients who were not incentivized. Based on these results, ToM performance may not accurately represent actual ToM abilities for those in the early stages of psychosis. Findings from this study underscore the therapeutic potential of addressing motivational deficits during efforts to remediate social cognition. Additional research is warranted to determine whether this pattern of performance is unique to patients in the early stages of psychosis.