Non-optimal cognitive offloading in schizophrenia in a prospective memory task: Influence of both metacognitive beliefs and cognitive effort avoidance

Cognitive offloading refers to the use of physical action and the external environment to simplify mental demand. One form of this-intention offloading-involves the use of external reminders to support delayed intentions. Both beliefs of poor memory ability and a preference to avoid cognitive effort lead to offloading intentions rather than using internal memory. Schizophrenia is a population with deficits in prospective memory and to overcome this difficulty, neuropsychological interventions can propose external aids such as reminders. However, it is unknown what motivates individuals with schizophrenia to spontaneously use reminders. Twenty-seven individuals with schizophrenia and twenty-seven non-clinical individuals were recruited to perform a prospective memory task, with two levels of difficulty, by deciding whether to use reminders or their internal memory. The proportion of reminder use, performance (hits and errors), subjective effort and metacognitive beliefs were recorded. The results show a non-optimal use of reminders in the schizophrenia group: this group used more reminders than the non-clinical group when the task was easy but did not increase reminder usage when the task became more difficult. Individuals with schizophrenia perceived the task to be more effortful than the non-clinical individuals in the easy task, but also had a high estimation of their memory ability. Reminder usage in schizophrenia is atypical and non-optimal. This may relate to effort and metacognition but the direct influence of these factors remains to be demonstrated. The overall results open perspectives on the neuropsychological treatment of prospective memory in this population.