title: Metacognition deficits as a risk factor for prospective motivation deficits in schizophrenia spectrum disorders.
abstract: Although motivation deficits are key determinants of functional outcomes, little is known about factors that contribute to prospective motivation in people with schizophrenia. One candidate factor is metacognition, or the ability to form complex representations about oneself, others, and the world. This study aimed to assess whether metacognition deficits were a significant predictor of reduced prospective motivation, after controlling for the effects of baseline motivation, anticipatory pleasure, and antipsychotic medication dose. Fifty-one participants with a schizophrenia spectrum disorder completed measures of metacognition and anticipatory pleasure at baseline; participants also completed a measure of motivation at baseline and six months after the initial assessment. Baseline antipsychotic dose was obtained from medical charts. Hierarchical regression analysis revealed that lower levels of baseline metacognition significantly predicted reduced levels of motivation assessed six months later, after controlling for baseline levels of motivation, anticipatory pleasure, and antipsychotic dose. Higher baseline antipsychotic dose was also a significant predictor of reduced six month motivation. Results suggest that metacognition deficits and higher antipsychotic dose may be risk factors for the development of motivation deficits in schizophrenia. Implications include utilizing interventions to improve metacognition in conjunction with evaluating and possibly lowering antipsychotic dose for people struggling with motivation deficits.
authors.affiliation: Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States. Electronic address: lutherl@iupui.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Luther
authors.affiliation: Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Firmin
authors.affiliation: Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Minor
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, United States; Prevention and Recovery Center for Early Psychosis, Midtown Community Mental Health Centers, Eskenazi Hospital, Indianapolis, IN, United States; Larue D. Carter Memorial Hospital, IU Psychotic Disorders Research Program, Indianapolis, IN, United States.
authors.forename: Jenifer L
authors.initials: JL
authors.lastname: Vohs
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Buck
authors.affiliation: Richard L. Roudebush Veteran's Affairs Medical Center, Indianapolis, IN, United States.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Buck
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, United States; Richard L. Roudebush Veteran's Affairs Medical Center, Indianapolis, IN, United States.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
mesh_terms: D000328:Adult; D059031:Anticipation, Psychological / Q000187:drug effects; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition; D008875:Middle Aged; D009042:Motivation / Q000187:drug effects; D057181:Pleasure / Q000187:drug effects; D011446:Prospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents
keywords: Anticipatory pleasure; Antipsychotic medication; Metacognition; Motivation; Schizophrenia