Effort-based decision making in psychopathology: A transdiagnostic multilevel meta-analysis and systematic review of behavioral patterns and mechanisms underlying amotivational psychopathology.

= -0.01). Altered effort allocation patterns were marked by reduced effort exertion across increasing reward and probability conditions, with schizophrenia spectrum disorders showing the most pronounced deficits. The most robust moderators were the number of probability conditions, ethnicity, gender, and the severity of positive and negative symptoms. A narrative synthesis of computational modeling studies indicated that maladaptive EBDM may reflect increased effort sensitivity, reduced reward sensitivity, and cognitive impairment, with variations across disorders. Whereas schizophrenia spectrum disorders are associated with unsystematic effort allocation and cognitive deficits, major depressive disorder and bipolar disorder show heightened effort sensitivity. Overall, findings point to both shared and disorder-specific mechanisms of EBDM, offering directions for targeted interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).