Achievement motivation in early schizophrenia

Relationship with symptoms, cognition and functional outcome

Gagan Fervaha, Hiroyoshi Takeuchi, George Foussias, Margaret K. Hahn, Ofer Agid, Gary Remington

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Individuals with schizophrenia engage in goal-directed activities significantly less often compared to healthy individuals in the community. There is ample evidence documenting the presence of motivational deficits in schizophrenia using observer-based ratings; however, purely self-reported accounts of patients' motivation are less well understood. This study examined subjective accounts of trait achievement motivation among relatively young, clinically stable, early-course outpatients with schizophrenia. Methods: Thirty-nine early-course patients and 39 healthy comparison subjects completed clinical and cognitive assessments in addition to a self-report inventory measuring achievement motivation. Results: Patients were found to endorse significantly lower levels of motivation, a mean difference which translated to a large effect size (Cohen's d=1.1). Patients' self-reported motivation was significantly related to clinician ratings of motivational deficits which were based on behavioural output, and to vocational functioning. Within the patient sample, 33.3% of individuals were found to experience prominent or clinically significant levels of amotivation based on patients' own self-report. Self-reported achievement motivation was not associated with other clinical variables such as positive symptom severity or expressive negative symptoms. Conclusions: Our results serve to highlight the occurrence and prevalence of motivational deficits in patients with schizophrenia who are in the early stages of their illness. Subjective accounts of motivation in this population were found to be related to important outcomes such as community functioning, highlighting the importance of this domain of illness. Targeting these deficits early in the course of the illness offers the potential to curb potential prospective poor outcomes and sets the stage for recovery.

Original languageEnglish
JournalEarly Intervention in Psychiatry
DOIs
Publication statusAccepted/In press - 2017
Externally publishedYes

Fingerprint

Cognition
Motivation
Schizophrenia
Self Report
Healthy Volunteers
Outpatients
Equipment and Supplies
Population

Keywords

  • Apathy
  • Dopamine
  • Intrinsic motivation
  • Psychosis
  • Reward
  • Schizophrenia

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Achievement motivation in early schizophrenia : Relationship with symptoms, cognition and functional outcome. / Fervaha, Gagan; Takeuchi, Hiroyoshi; Foussias, George; Hahn, Margaret K.; Agid, Ofer; Remington, Gary.

In: Early Intervention in Psychiatry, 2017.

Research output: Contribution to journalArticle

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abstract = "Background: Individuals with schizophrenia engage in goal-directed activities significantly less often compared to healthy individuals in the community. There is ample evidence documenting the presence of motivational deficits in schizophrenia using observer-based ratings; however, purely self-reported accounts of patients' motivation are less well understood. This study examined subjective accounts of trait achievement motivation among relatively young, clinically stable, early-course outpatients with schizophrenia. Methods: Thirty-nine early-course patients and 39 healthy comparison subjects completed clinical and cognitive assessments in addition to a self-report inventory measuring achievement motivation. Results: Patients were found to endorse significantly lower levels of motivation, a mean difference which translated to a large effect size (Cohen's d=1.1). Patients' self-reported motivation was significantly related to clinician ratings of motivational deficits which were based on behavioural output, and to vocational functioning. Within the patient sample, 33.3{\%} of individuals were found to experience prominent or clinically significant levels of amotivation based on patients' own self-report. Self-reported achievement motivation was not associated with other clinical variables such as positive symptom severity or expressive negative symptoms. Conclusions: Our results serve to highlight the occurrence and prevalence of motivational deficits in patients with schizophrenia who are in the early stages of their illness. Subjective accounts of motivation in this population were found to be related to important outcomes such as community functioning, highlighting the importance of this domain of illness. Targeting these deficits early in the course of the illness offers the potential to curb potential prospective poor outcomes and sets the stage for recovery.",
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