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Motivation and Social Cognition in Patients with Schizophrenia

Published online by Cambridge University Press:  02 July 2015

Gagan Fervaha ,
Ishraq Siddiqui ,
George Foussias ,
Ofer Agid  and
Gary Remington
Gagan Fervaha*
Affiliation:
Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada
Ishraq Siddiqui
Affiliation:
Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada
George Foussias
Affiliation:
Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
Ofer Agid
Affiliation:
Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
Gary Remington
Affiliation:
Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
*
Correspondence and reprint requests to: Gagan Fervaha, Schizophrenia Division, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, Ontario, Canada M5T 1R8. E-mail: [email protected]
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Abstract

Social cognition, referring to one’s ability to perceive and process social cues, is an important domain in schizophrenia. Numerous studies have demonstrated that patients with schizophrenia have poorer performance on tests assessing social cognition relative to healthy comparison participants. However, whether variables such as motivation are related to performance on these tests in patients with schizophrenia is unclear. One thousand three-hundred and seventy-eight patients with schizophrenia completed the Facial Emotion Discrimination Task as a measure of emotional processing, a key facet of social cognition. Level of motivation was also evaluated in these patients using a derived measure from the Quality of Life Scale. The relationship between motivation and task performance was examined using bivariate correlations and logistic regression modeling, controlling for the impact of age and overall severity of psychopathology, the latter evaluated using the Positive and Negative Syndrome Scale. Motivation was positively related to performance on the social cognition test, and this relationship remained significant after controlling for potential confounding variables such as age and illness severity. Social cognition was also related to functioning, and the relationship was mediated by level of motivation. The present study found a significant relationship between motivation and performance on a test of social cognition in a large sample of patients with schizophrenia. These findings suggest that amotivation undermines task performance, or alternatively that poor social cognitive ability impedes motivation. Future studies evaluating social cognition in patients with schizophrenia should concurrently assess for variables such as effort and motivation. (JINS, 2015, 21, 436–443)

Keywords

SchizophreniaIntrinsic motivationEmotion processingCognitive performanceInterpersonal relationsAvolition-apathy
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 6 , July 2015 , pp. 436 - 443
Copyright
Copyright © The International Neuropsychological Society 2015 

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References

Addington, D., Addington, J., & Maticka-Tyndale, E. (1993). Assessing depression in schizophrenia: The Calgary Depression Scale. British Journal of Psychiatry, 163(22), 39–44.Google Scholar
Addington, D., Addington, J., & Maticka-Tyndale, E. (1994). Specificity of the Calgary Depression Scale for schizophrenics. Schizophrenia Research, 11(3), 239–244.CrossRefGoogle ScholarPubMed
Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia Research, 3(4), 247–251.Google Scholar
Andreasen, N.C., Carpenter, W.T. Jr., Kane, J.M., Lasser, R.A., Marder, S.R., & Weinberger, D.R. (2005). Remission in schizophrenia: Proposed criteria and rationale for consensus. The American Journal of Psychiatry, 162(3), 441–449.Google Scholar
Appelbaum, P.S., & Grisso, T. (2001). MacArthur competence assessment tool for clinical research (MacCAT-CR). Sarasota, FL: Professional Resource Press.Google Scholar
Avery, R., Startup, M., & Calabria, K. (2009). The role of effort, cognitive expectancy appraisals and coping style in the maintenance of the negative symptoms of schizophrenia. Psychiatry Research, 167(1-2), 36–46.Google Scholar
Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.CrossRefGoogle ScholarPubMed
Bellack, A.S., Morrison, R.L., Wixted, J.T., & Mueser, K.T. (1990). An analysis of social competence in schizophrenia. British Journal of Psychiatry, 156, 809–818.CrossRefGoogle ScholarPubMed
Collins, A.A., Remington, G., Coulter, K., & Birkett, K. (1996). Depression in schizophrenia: A comparison of three measures. Schizophrenia Research, 20(1-2), 205–209.Google Scholar
Couture, S.M., Penn, D.L., & Roberts, D.L. (2006). The functional significance of social cognition in schizophrenia: A review. Schizophrenia Bulletin, 32(Suppl. 1), S44–S63.CrossRefGoogle ScholarPubMed
Davis, L., & Brekke, J. (2013). Social support and functional outcome in severe mental illness: The mediating role of proactive coping. Psychiatry Research, 215(1), 39–45.Google Scholar
Fervaha, G., Agid, O., Foussias, G., & Remington, G. (2014). Effect of intrinsic motivation on cognitive performance in schizophrenia: A pilot study. Schizophrenia Research, 152(1), 317–318.Google Scholar
Fervaha, G., Foussias, G., Agid, O., & Remington, G. (2013). Amotivation and functional outcomes in early schizophrenia. Psychiatry Research, 210(2), 665–668.CrossRefGoogle ScholarPubMed
Fervaha, G., Zakzanis, K.K., Foussias, G., Graff-Guerrero, A., Agid, O., & Remington, G. (2014). Motivational deficits and cognitive test performance in schizophrenia. JAMA Psychiatry, 71(9), 1058–1065.CrossRefGoogle ScholarPubMed
Fett, A.K., Viechtbauer, W., Dominguez, M.D., Penn, D.L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis. Neuroscience and Biobehavioral Reviews, 35(3), 573–588.CrossRefGoogle ScholarPubMed
First, M.B. (1997). User’s guide for the Structured clinical interview for DSM-IV axis I disorders SCID-I: Clinician version. Washington, DC: American Psychiatric Publishers Inc.Google Scholar
Foussias, G., Mann, S., Zakzanis, K.K., van Reekum, R., Agid, O., & Remington, G. (2011). Prediction of longitudinal functional outcomes in schizophrenia: The impact of baseline motivational deficits. Schizophrenia Research, 132(1), 24–27.Google Scholar
Gard, D.E., Fisher, M., Garrett, C., Genevsky, A., & Vinogradov, S. (2009). Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophrenia Research, 115(1), 74–81.Google Scholar
Gorissen, M., Sanz, J.C., & Schmand, B. (2005). Effort and cognition in schizophrenia patients. Schizophrenia Research, 78(2-3), 199–208.CrossRefGoogle ScholarPubMed
Green, M.F., Hellemann, G., Horan, W.P., Lee, J., & Wynn, J.K. (2012). From perception to functional outcome in schizophrenia: Modeling the role of ability and motivation. Archives of General Psychiatry, 69(12), 1216–1224.Google Scholar
Green, M.F., Penn, D.L., Bentall, R., Carpenter, W.T., Gaebel, W., Gur, R.C., & Heinssen, R. (2008). Social cognition in schizophrenia: An NIMH workshop on definitions, assessment, and research opportunities. Schizophrenia Bulletin, 34(6), 1211–1220.CrossRefGoogle ScholarPubMed
Harvey, P.D., Koren, D., Reichenberg, A., & Bowie, C.R. (2006). Negative symptoms and cognitive deficits: What is the nature of their relationship? Schizophrenia Bulletin, 32(2), 250–258.CrossRefGoogle ScholarPubMed
Heinrichs, D.W., Hanlon, T.E., & Carpenter, W.T. Jr (1984). The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10(3), 388–398.Google Scholar
Hunt, S., Root, J.C., & Bascetta, B.L. (2014). Effort testing in schizophrenia and schizoaffective disorder: Validity indicator profile and test of memory malingering performance characteristics. Archives of Clinical Neuropsychology, 29(2), 164–172.Google Scholar
Kay, S.R., Fiszbein, A., & Opler, L.A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276.CrossRefGoogle ScholarPubMed
Keefe, R.S., Bilder, R.M., Harvey, P.D., Davis, S.M., Palmer, B.W., Gold, J.M., & Lieberman, J.A. (2006). Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology, 31(9), 2033–2046.Google Scholar
Keefe, R.S., Mohs, R.C., Bilder, R.M., Harvey, P.D., Green, M.F., Meltzer, H.Y., & Sano, M. (2003). Neurocognitive assessment in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project schizophrenia trial: Development, methodology, and rationale. Schizophrenia Bulletin, 29(1), 45–55.Google Scholar
Kerr, S.L., & Neale, J.M. (1993). Emotion perception in schizophrenia: Specific deficit or further evidence of generalized poor performance? Journal of Abnormal Psychology, 102(2), 312–318.CrossRefGoogle ScholarPubMed
Konstantakopoulos, G., Ploumpidis, D., Oulis, P., Patrikelis, P., Soumani, A., Papadimitriou, G.N., & Politis, A.M. (2011). Apathy, cognitive deficits and functional impairment in schizophrenia. Schizophrenia Research, 133(1-3), 193–198.Google Scholar
Lapierre, Y.D., Angus, C., Awad, A.G., Saxena, B.M., Jones, B., Williamson, P., & Grafford, K. (1999). The treatment of negative symptoms: A clinical and methodological study. International Clinical Psychopharmacology, 14(2), 101–112.Google Scholar
Leifker, F.R., Patterson, T.L., Heaton, R.K., & Harvey, P.D. (2011). Validating measures of real-world outcome: The results of the VALERO expert survey and RAND panel. Schizophrenia Bulletin, 37(2), 334–343.CrossRefGoogle ScholarPubMed
Leucht, S., Kane, J.M., Kissling, W., Hamann, J., Etschel, E., & Engel, R.R. (2005). What does the PANSS mean? Schizophrenia Research, 79(2-3), 231–238.Google Scholar
Lieberman, J.A., Stroup, T.S., McEvoy, J.P., Swartz, M.S., Rosenheck, R.A., Perkins, D.O., & Hsiao, J.K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209–1223.Google Scholar
Lysaker, P.H., Gumley, A., Luedtke, B., Buck, K.D., Ringer, J.M., Olesek, K., & Dimaggio, G. (2013). Social cognition and metacognition in schizophrenia: Evidence of their independence and linkage with outcomes. Acta Psychiatrica Scandinavica, 127(3), 239–247.Google Scholar
Lysaker, P.H., Leonhardt, B.L., Brune, M., Buck, K.D., James, A., Vohs, J., & Dimaggio, G. (2014). Capacities for theory of mind, metacognition, and neurocognitive function are independently related to emotional recognition in schizophrenia. Psychiatry Research, 219(1), 79–85.CrossRefGoogle ScholarPubMed
Mehta, U.M., Thirthalli, J., Bhagyavathi, H.D., Keshav Kumar, J., Subbakrishna, D.K., Gangadhar, B.N., & Keshavan, M.S. (2014). Similar and contrasting dimensions of social cognition in schizophrenia and healthy subjects. Schizophrenia Research, 157(1-3), 70–77.Google Scholar
Mueser, K.T., Doonan, R., Penn, D.L., Blanchard, J.J., Bellack, A.S., Nishith, P., & DeLeon, J. (1996). Emotion recognition and social competence in chronic schizophrenia. Journal of Abnormal Psychology, 105(2), 271–275.Google Scholar
Nakagami, E., Xie, B., Hoe, M., & Brekke, J.S. (2008). Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: Testing mediator and moderator effects. Schizophrenia Research, 105(1-3), 95–104.CrossRefGoogle ScholarPubMed
Penn, D.L., & Combs, D. (2000). Modification of affect perception deficits in schizophrenia. Schizophrenia Research, 46(2-3), 217–229.CrossRefGoogle ScholarPubMed
Penn, D.L., Combs, D.R., Ritchie, M., Francis, J., Cassisi, J., Morris, S., &Townsend, M. (2000). Emotion recognition in schizophrenia: Further investigation of generalized versus specific deficit models. Journal of Abnormal Psychology, 109(3), 512–516.Google Scholar
Pinkham, A.E., Penn, D.L., Green, M.F., Buck, B., Healey, K., & Harvey, P.D. (2014). The Social Cognition Psychometric Evaluation study: Results of the expert survey and RAND panel. Schizophrenia Bulletin, 40(4), 813–823.Google Scholar
Poole, J.H., Tobias, F.C., & Vinogradov, S. (2000). The functional relevance of affect recognition errors in schizophrenia. Journal of the International Neuropsychological Society, 6(6), 649–658.CrossRefGoogle ScholarPubMed
Ryan, R.M., & Deci, E.L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.Google Scholar
Salem, J.E., Kring, A.M., & Kerr, S.L. (1996). More evidence for generalized poor performance in facial emotion perception in schizophrenia. Journal of Abnormal Psychology, 105(3), 480–483.CrossRefGoogle ScholarPubMed
Saperstein, A.M., Fiszdon, J.M., & Bell, M.D. (2011). Intrinsic motivation as a predictor of work outcome after vocational rehabilitation in schizophrenia. Journal of Nervous and Mental Disease, 199(9), 672–677.Google Scholar
Savla, G.N., Vella, L., Armstrong, C.C., Penn, D.L., & Twamley, E.W. (2013). Deficits in domains of social cognition in schizophrenia: A meta-analysis of the empirical evidence. Schizophrenia Bulletin, 39(5), 979–992.Google Scholar
Schemper, M. (1991). Non-parametric partial association revisted. The Statistician, 73–76.Google Scholar
Strauss, G.P., Morra, L.F., Sullivan, S.K., & Gold, J.M. (2015). The role of low cognitive effort and negative symptoms in neuropsychological impairment in schizophrenia. Neuropsychology, 29(2), 282–291.Google Scholar
Stroup, T.S., McEvoy, J.P., Swartz, M.S., Byerly, M.J., Glick, I.D., Canive, J.M., & Lieberman, J.A. (2003). The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project: Schizophrenia trial design and protocol development. Schizophrenia Bulletin, 29(1), 15–31.Google Scholar
Tas, C., Brown, E., Cubukcuoglu, Z., Aydemir, O., Danaci, A.E., & Brune, M. (2013). Towards an integrative approach to understanding quality of life in schizophrenia: The role of neurocognition, social cognition, and psychopathology. Comprehensive Psychiatry, 54(3), 262–268.Google Scholar
Tas, C., Brown, E.C., Esen-Danaci, A., Lysaker, P.H., & Brune, M. (2012). Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia. Journal of Psychiatric Research, 46(8), 1086–1092.Google Scholar
Vohs, J.L., & Lysaker, P.H. (2014). Metacognitive mastery and intrinsic motivation in schizophrenia. Journal of Nervous and Mental Disease, 202(1), 74–77.CrossRefGoogle ScholarPubMed
Vohs, J.L., Lysaker, P.H., & Nabors, L. (2013). Associations of personality with intrinsic motivation in schizophrenia. Psychiatry Research, 208(1), 78–80.Google Scholar
Yamada, A.M., Lee, K.K., Dinh, T.Q., Barrio, C., & Brekke, J.S. (2010). Intrinsic motivation as a mediator of relationships between symptoms and functioning among individuals with schizophrenia spectrum disorders in a diverse urban community. Journal of Nervous and Mental Disease, 198(1), 28–34.Google Scholar