Informationally administered reward enhances intrinsic motivation in schizophrenia

Lee, Hyeon Seung; Jang, Seon Kyeong; Lee, Ga Young; Park, Seon Cheol; Medalia, Alice; Choi, Kee Hong

doi:10.1016/j.psychres.2017.06.049

Cited by 6 publications

(3 citation statements)

References 47 publications

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“…Nonetheless, the Low Activity cluster’s skewed composition towards SZ participants potentially implicates schizophrenia-specific susceptibility to competence-based intrinsic motivation deficits. Indeed, previous investigations have stressed the importance of competency beliefs in schizophrenia for everyday goal setting 48 and emotional experience 49 , alongside intrinsically motivated task performance 17 , 50 .…”

Section: Discussionmentioning

confidence: 99%

Behavioural phenotypes of intrinsic motivation in schizophrenia determined by cluster analysis of objectively quantified real-world performance

et al. 2022

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Intrinsic motivation deficits are a prominent feature of schizophrenia that substantially impacts functional outcome. This study used cluster analysis of innate real-world behaviours captured during two open-field tasks to dimensionally examine heterogeneity in intrinsic motivation in schizophrenia patients (SZ) and healthy controls (HC). Wireless motion capture quantified participants’ behaviours aligning with distinct aspects of intrinsic motivation: exploratory behaviour and effortful activity in the absence of external incentive. Cluster analysis of task-derived measures identified behaviourally differentiable subgroups, which were compared across standard clinical measures of general amotivation, cognition, and community functioning. Among 45 SZ and 47 HC participants, three clusters with characteristically different behavioural phenotypes emerged: low exploration (20 SZ, 19 HC), low activity (15 SZ, 8 HC), and high exploration/activity (10 SZ, 20 HC). Low performance in either dimension corresponded with similar increased amotivation. Within-cluster discrepancies emerged for amotivation (SZ > HC) within the low exploration and high performance clusters, and for functioning (SZ < HC) within all clusters, increasing from high performance to low activity to low exploration. Objective multidimensional characterization thus revealed divergent behavioural expression of intrinsic motivation deficits that may be conflated by summary clinical measures of motivation and overlooked by unidimensional evaluation. Deficits in either aspect may hinder general motivation and functioning particularly in SZ. Multidimensional phenotyping may help guide personalized remediation by discriminating between intrinsic motivation impairments that require amelioration versus unimpaired tendencies that may facilitate remediation.

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Section: Discussionmentioning

confidence: 99%

Behavioural phenotypes of intrinsic motivation in schizophrenia determined by cluster analysis of objectively quantified real-world performance

et al. 2022

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“…After about 50 min of computer-based CR training, the group members gathered for a bridging group (Medalia et al, 2009 ), in which they discussed the connections between their goals and the cognitive training and exchanged strategies. The therapists used motivational interviewing techniques to enhance the participants' intrinsic motivation toward the CR (Fiszdon et al, 2016 ; Lee et al, 2017 ). All CR sessions were reviewed by K. H. Choi in a weekly supervision meeting or in vivo training sessions to confirm the consistency of the CR protocol.…”

Section: Methodsmentioning

confidence: 99%

Cognitive Remediation in Middle-Aged or Older Inpatients with Chronic Schizophrenia: A Randomized Controlled Trial in Korea

et al. 2018

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Background: Accumulating evidence indicates that cognitive remediation (CR) is effective for improving various cognitive deficits in adult patients with schizophrenia. Although reports of brain plasticity in older adults and the service needs for chronic patients with schizophrenia are increasing, very few randomized controlled trials of CR have been conducted in middle-aged or older inpatients with chronic schizophrenia. We investigated the efficacy of individualized CR on the cognitive impairments of middle-aged or older inpatients with chronic schizophrenia within the context of comprehensive psychiatric rehabilitation (PR) by comparing the results obtained with PR only and treatment as usual (TAU).Method: Fifty-seven middle-aged and older individuals with chronic schizophrenia and mild to moderate cognitive deficits were enrolled. Thirty-eight who were undergoing PR were randomly assigned to CR + PR (N = 19) or PR-only (N = 19) groups. Nineteen participants who were undergoing TAU without CR or PR were evaluated pre- and post-treatment.Results: CR was easily provided and well received (drop-out rates = 5.3%) by middle-aged or older psychiatric inpatients. Compared to the PR-Only or TAU patients, patients in the CR + PR group showed greater improvement in executive functioning. Compared to TAU patients, CR + PR and PR-only patients showed greater improvement in logical memory. More patients in the CR + PR group improved clinically significantly in executive functioning and logical memory, compared with the PR-only and TAU patients.Conclusions: These results suggested that CR improved some cognitive deficits in middle-aged or older inpatients with chronic schizophrenia and that it was effective as an adjunctive treatment to the usual PR services provided in inpatient settings.Clinical Registration: KCT0002609

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“…Impaired motivation is also a core feature and very strong predictor of functional outcome in early stages of psychosis [38,49,50]. Some studies have shown positive effects in improving motivation immediately after the intervention (e.g., [51][52][53]), but treatments that induce enduring J Psychiatry Brain Sci. 2020;5:e200023.…”

Section: Aim 2b: Cognitive Dysfunction and Impaired Motivation Improvmentioning

confidence: 99%

Targeting Cognition and Motivation in Coordinated Specialty Care for Early Psychosis: A Grant Report

Roisum

Jenkins

Fisher

et al. 2020

J Psychiatry Brain Sci

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In this grant report, we describe our project to expand measurementbased psychiatric care across 6 early psychosis treatment teams in Minnesota, and to provide a neuroscience-informed cognitive training and motivation enhancement program for individuals with early psychosis. This project is part of the NIMH Early Psychosis Intervention Network (EPINET) initiative which seeks to link data from treatment centers nationally that offer evidence-based specialty care to persons experiencing early psychosis. Systematic analyses of pooled data collected in EPINET will help inform methods for early psychosis care, psychosis risk factors, and pre-emptive interventions. As part of the national EPINET, our hub (Early Psychosis Intervention-Minnesota, EPI-MINN), will: (1) provide measurement-based care in coordinated specialty care programs for early psychosis, (2) determine whether a structured feedback report provides benefit to stakeholders-service users, family members, and primary clinicians, and (3) explore whether deficits in cognition and motivated behavior-two domains that significantly impact functioning and overall quality of life in early psychosis-can be addressed as key treatment goals by implementing a 12-week mobile intervention. Using a regression discontinuity design, participants will be randomized to the cognitive training and motivational enhancement intervention or to treatment as usual. The intervention consists of neuroscience-informed, computerized auditory and social cognitive training exercises, as well as a mobile app where participants interact with each other and with a motivational coach. Participants will complete assessments at 4 time points: baseline and post-intervention (i.e., at 6 months), and again at 12 and 18 months to test the long-term effects of the intervention. All assessments and interventions in this project can be completed entirely remotely.

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Informationally administered reward enhances intrinsic motivation in schizophrenia

Cited by 6 publications

References 47 publications

Behavioural phenotypes of intrinsic motivation in schizophrenia determined by cluster analysis of objectively quantified real-world performance

Behavioural phenotypes of intrinsic motivation in schizophrenia determined by cluster analysis of objectively quantified real-world performance

Cognitive Remediation in Middle-Aged or Older Inpatients with Chronic Schizophrenia: A Randomized Controlled Trial in Korea

Targeting Cognition and Motivation in Coordinated Specialty Care for Early Psychosis: A Grant Report

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