What Is Mental Effort: A Clinical Perspective

Noham Wolpe*, Richard Holton, Paul C. Fletcher

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Although mental effort is a frequently used term, it is poorly defined and understood. Consequently, its usage is frequently loose and potentially misleading. In neuroscience research, the term is used to mean both the cognitive work that is done to meet task demands and the subjective experience of performing that work. We argue that conflating these two meanings hampers progress in understanding cognitive impairments in neuropsychiatric conditions because cognitive work and the subjective experience of it have distinct underlying mechanisms. We suggest that the most coherent and clinically useful perspective on mental effort is that it is a subjective experience. This makes a clear distinction between cognitive impairments that arise from changes in the cognitive apparatus, as in dementia and brain injury, and those that arise from subjective difficulties in carrying out the cognitive work, as in attention-deficit/hyperactivity disorder, depression, and other motivational disorders. We review recent advances in neuroscience research that suggests that the experience of effort has emerged to control task switches so as to minimize costs relative to benefits. We consider how these advances can contribute to our understanding of the experience of increased effort perception in clinical populations. This more specific framing of mental effort will offer a deeper understanding of the mechanisms of cognitive impairments in differing clinical groups and will ultimately facilitate better therapeutic interventions.

Original languageEnglish
Pages (from-to)1030-1037
Number of pages8
JournalBiological Psychiatry
Issue number11
StateAccepted/In press - 2024


FundersFunder number
Bernard Wolfe Health Neuroscience Fund
Israel Science Foundation1603/22
Israel Science Foundation
National Institute for Health and Care ResearchACF-2019-14-013
National Institute for Health and Care Research
Wellcome Trust206368/Z/17/Z
Wellcome Trust
NIHR Cambridge Biomedical Research CentreNIHR203312
NIHR Cambridge Biomedical Research Centre


    • Apathy
    • Cognitive control
    • Cognitive effort
    • Demotivation
    • Mental effort
    • Opportunity cost


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