title: Motivational deficits in individuals at-risk for psychosis and across the course of schizophrenia.
abstract: Motivational impairment is a critical factor that contributes to functional disability in schizophrenia and undermines an individual's ability to engage in and adhere to effective treatment. However, little is known about the developmental trajectory of deficits in motivation and whether these deficits are present prior to the onset of psychosis. We assessed several components of motivation including anticipatory versus consummatory pleasure (using the Temporal Experience of Pleasure Scale (TEPS)), and behavioral drive, behavioral inhibition, and reward responsivity (using the Behavioral Inhibition Scale/Behavioral Activation Scale (BIS/BAS)). A total of 234 participants completed study measures, including 60 clinical high risk (CHR) participants, 60 recent-onset schizophrenia participants (RO), 78 chronic schizophrenia participants (SZ) and 29 healthy controls (HC) age matched to the CHR group. CHR participants endorsed greater deficits in anticipatory pleasure and reward responsivity, relative to HC comparison participants and individuals diagnosed with schizophrenia. Motivational deficits were not more pronounced over the course of illness. Depressed mood was uniquely associated with impairments in motivation in the CHR sample, but not the schizophrenia participants. The results suggest that CHR individuals experience multiple contributors to impaired motivation, and thus multiple leverage points for treatment.
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA. Electronic address: danielle.schlosser@ucsf.edu.
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Schlosser
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA; San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fisher
authors.affiliation: San Francisco State University, San Francisco, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gard
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA; Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fulford
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Loewy
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA; San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Vinogradov
mesh_terms: D000293:Adolescent; D000328:Adult; D059031:Anticipation, Psychological; D002908:Chronic Disease; D003863:Depression; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D012201:Reward; D012306:Risk; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Anticipatory Pleasure; Avolition; Duration of illness; Motivation; Psychosis; Reward; Schizophrenia