title: Motivated to do well: an examination of the relationships between motivation, effort, and cognitive performance in schizophrenia.
abstract: The uncertain relationship between negative symptoms, and specifically motivational deficits, with cognitive dysfunction in schizophrenia is in need of further elucidation as it pertains to the interpretation of cognitive test results. Findings to date have suggested a possible mediating role of motivational deficits on cognitive test measures, although findings from formal examinations of effort using performance validity measures have been inconsistent. The aim of this study was to examine the relationships between motivation, effort exerted during cognitive testing, and cognitive performance in schizophrenia. Sixty-nine outpatients with schizophrenia or schizoaffective disorder were evaluated for psychopathology, severity of motivational deficits, effort exerted during cognitive testing, and cognitive performance. Motivation and degree of effort exerted during cognitive testing were significantly related to cognitive performance, specifically verbal fluency, verbal and working memory, attention and processing speed, and reasoning and problem solving. Further, effort accounted for 15% of the variance in cognitive performance, and partially mediated the relationship between motivation and cognitive performance. Examining cognitive performance profiles for individuals exerting normal or reduced effort revealed significant differences in global cognition, as well as attention/processing speed and reasoning and problem solving. These findings suggest that cognitive domains may be differentially affected by impairments in motivation and effort, and highlight the importance of understanding the interplay between motivation and cognitive performance deficits, which may guide the appropriate selection of symptom targets for promoting recovery in patients.
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada. Electronic address: george.foussias@camh.ca.
authors.forename: G
authors.initials: G
authors.lastname: Foussias
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Siddiqui
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Fervaha
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Mann
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: K
authors.initials: K
authors.lastname: McDonald
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: O
authors.initials: O
authors.lastname: Agid
authors.affiliation: Department of Psychology, University of Toronto Scarborough, Toronto, Ontario M1C 1A4, Canada.
authors.forename: K K
authors.initials: KK
authors.lastname: Zakzanis
authors.affiliation: Campbell Family Research Institute and Schizophrenia Division, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Remington
mesh_terms: D000293:Adolescent; D000328:Adult; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000523:psychology*; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Apathy; Cognition; Effort; Motivation; Negative symptoms; Performance validity; Schizophrenia