Intrinsic motivation and learning in a schizophrenia spectrum sample

Abstract

Amotivation is a telling hallmark of negative symptomatology in schizophrenia, and it impacts nearly every facet of behavior, including inclination to attempt the difficult cognitive tasks involved in cognitive remediation therapy. Experiences of external reward, reinforcement, and hedonic anticipatory enjoyment are diminished in psychosis, so therapeutics which instead target intrinsic motivation for cognitive tasks may enhance task engagement, and subsequently, remediation outcome. We examined whether outpatients could attain benefits from an intrinsically motivating instructional approach which (a) presents learning materials in a meaningful game-like context, (b) personalizes elements of the learning materials into themes of high interest value, and (c) offers choices so patients can increase their control over the learning process. We directly compared one learning method that incorporated the motivational paradigm into an arithmetic learning program against another method that carefully manipulated out the motivational variables in the same learning program. Fifty-seven subjects with schizophrenia or schizoaffective disorder were randomly assigned to one of the two learning programs for 10 thirty-minute sessions while an intent-to-treat convenience subsample (n=15) was used to account for practice effect. Outcome measures were arithmetic learning, attention, motivation, self competency, and symptom severity. Results showed the motivational group (a) acquired more arithmetic skill, (b) possessed greater intrinsic motivation for the task, (c) reported greater feelings of self competency post-treatment, and (d) demonstrated better post-test attention. Interestingly, baseline perception of self competency was a significant predictor of post-test arithmetic scores. Results demonstrated that incorporating intrinsically motivating instructional techniques into a difficult cognitive task promoted greater learning of the material, higher levels of intrinsic motivation to attempt the demanding task, and greater feelings of self efficacy and achievement to learn.

The Prospective Relationships Among Intrinsic Motivation, Neurocognition, and Psychosocial Functioning in Schizophrenia

“…In addition, the aggregate change in all variables was in the direction of improvement, which indicates that prospective improvement in all of these areas is not only possible but are also associated in ways that should guide how we assess and treat deficits in any or all of these areas. Distinct interventions are available that seek to improve neurocognition, 18,[108][109][110][111][112][113] IM, 18,108,114 , and psychosocial functioning. 115,116 Our findings suggest that recent efforts to blend these interventions (eg, McGurk et al 12 ) should focus on ways to include strategies for impacting all 3 domains.…”

“…Providers may also give choices to consumers by structuring the demands of the environment to match the client's feelings of effectiveness, making sure that the environment is meaningful for the individual and ensuring the individual experiences feelings of personal control and competence. 132,133 Choi and Medalia 114 recently integrated the 3 pronged motivational enhancement approach 134 that has been found to increase IM to learn: context, personalizing, and choices. Their results illustrated that incorporating intrinsically motivating instructional methods into a difficult cognitive task increased learning of the material, yielded higher IM and better levels of self-efficacy and achievement to learn.…”

“…Their results illustrated that incorporating intrinsically motivating instructional methods into a difficult cognitive task increased learning of the material, yielded higher IM and better levels of self-efficacy and achievement to learn. 114 Socio-contextual variables that pertain to enhancing autonomy and motivation 20 such as personalization, choice, goal setting, and self-efficacy must be examined longitudinally alongside neurocognition and psychosocial functioning for persons with schizophrenia. These theoretical propositions should be integrated into future efforts to link cognition, motivation, and functional change in rehabilitation models for schizophrenia.…”

An unusual complication of a long-acting injectable antipsychotic: deep venous thrombosis caused by olanzapine pamoate

“…It is also known that there are several risk factors in schizophrenia patients related to DVT and PE. Patients with schizophrenia may present with a long-term, negative cognitive or affective symptoms such as alogia, flat affect, apathy, asociality, anticipatory anhedonia, or avolition [23]. However, avolition was found to be mostly related to motor activity among the schizophrenia patients [24].…”

Resilience Improves Neurocognition and Treatment Outcomes in Schizophrenia: A Hypothesis

“…Learning impairments have been consistently reported in schizophrenia while there is still a debate over impairments to implicit learning. For example, some studies report that implicit learning is intact for tasks such as probabilistic classification learning [107], weather prediction and artificial grammar learning [108], while others report an impairment in color pattern learning but not in letter string learning [109]. The impact of metacognition on awareness of illness and social functioning seems to be partially independent of neurocognitive functioning [110].…”