Patients with schizophrenia experience motivation deficits

Key message: People with schizophrenia more often refer to their goals as being driven by boredom or a desire to ‘pass time’ and report goals that are more disconnected–disengaged compared with those of healthy controls.^{[Gard et al., 2014]}

• Patients with schizophrenia also have significantly lower intrinsic motivation and extrinsic positive motivation compared with healthy controls.^{[Gard et al., 2014]}

Background

• Agency = ability to act in any given environment.^{[Gard et al., 2014]}
• 47 people with and 41 people without schizophrenia were provided with cell phones and were called four times a day for one week. During each call participants were asked about their goals, and about the most important reason motivating each goal. Each goal/reason was rated on a scale of specific anchors (0–3).^{[Gard et al., 2014]}
• All responses were coded by independent raters (blinded to group and hypotheses) on all Self-Determination Theory (SDT) motivating factors, and ratings were correlated with patient functioning and symptoms.^{[Gard et al., 2014]}
  
• Relative to healthy participants, people with schizophrenia reported goals that were:^{[Gard et al., 2014; Ryan & Deci, 2000]}
• less motivated by filling autonomy (motivated behavior towards agency and self-expression) and competency (motivated behavior towards knowledge, skill or learning) needs, but equivalently motivated by relatedness (interpersonal connection).
• less extrinsically rewarding, but equivalently motivated by punishment
• more disconnected–disengaged (the individual feels that their behavior is not connected to an outcome and that he or she lacks agency, choice, or direction).
• Higher rates of disconnected–disengaged goals were significantly associated with higher negative symptoms and with impairments in patient functioning.^{[Gard et al., 2014]}
• The findings highlight the importance of intervening early and at each level of motivated behavior, with the aim of helping people with schizophrenia avoid over-engagement in disconnected–disengaged behaviors, thereby assisting them to increase their functioning and quality of life.^{[Gard et al., 2014]}

References:
Gard DE et al. Schizophr Res. 2014; 156(2–3): 217–222.

Ryan & Deci. Am Psychol. 2000; 55:68–78.

Other references used on slide:
Deci & Ryan. Psychological Inquiry. 2000; 11(4): 227–268.