Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects.
BACKGROUND
This study examined the nature of the relationships among neurocognition, intrinsic motivation, and psychosocial functioning for persons with schizophrenia. Hypotheses concerning both mediator and moderator mechanisms were tested.


METHODS
120 individuals diagnosed with schizophrenia were recruited as they entered outpatient psychosocial rehabilitation programs. Measures of psychosocial functioning and intrinsic motivation were administered at baseline. Measures of neurocognition were administered at baseline by testers blind to scores on other study variables. Data were analyzed using latent construct modeling to test for mediator and moderator effects.


RESULTS
There were strong bivariate relationships between neurocognition, intrinsic motivation, and psychosocial functioning. The results demonstrated that intrinsic motivation strongly mediated the relationship between neurocognition and psychosocial functioning. This mediation was evidenced by: (i) the direct path from neurocognition to functional outcome no longer being statistically significant after the introduction of motivation into the model, (ii) the statistical significance of the indirect path from neurocognition through motivation to functional outcome. There was no support for the two moderation hypotheses: the level of neurocognition did not influence the relationship between intrinsic motivation and psychosocial functioning, nor did the level of intrinsic motivation influence the relationship between neurocognition and psychosocial functioning.


CONCLUSIONS
Neurocognition influences psychosocial functioning through its relationship with intrinsic motivation. Intrinsic motivation is a critical mechanism for explaining the relationship between neurocognition and psychosocial functioning. Implications for the theoretical understanding and psychosocial treatment of intrinsic motivation in schizophrenia are discussed.
Nakagami
Eri
E
University of Southern California, School of Social Work, CA, USA. nakagami@usc.edu
Xie
Bin
B
Hoe
Maanse
M
Brekke
John S
JS
D000223:Adaptation, Psychological; D000328:Adult; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D026684:Personal Autonomy; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D012565:Schizophrenic Psychology; D020377:Self Efficacy; D012917:Social Adjustment; D012938:Social Perception