title: Achievement motivation in early schizophrenia: Relationship with symptoms, cognition and functional outcome.
abstract: Individuals with schizophrenia engage in goal-directed activities significantly less often compared to healthy individuals in the community. There is ample evidence documenting the presence of motivational deficits in schizophrenia using observer-based ratings; however, purely self-reported accounts of patients' motivation are less well understood. This study examined subjective accounts of trait achievement motivation among relatively young, clinically stable, early-course outpatients with schizophrenia.
  
  
  
  Thirty-nine early-course patients and 39 healthy comparison subjects completed clinical and cognitive assessments in addition to a self-report inventory measuring achievement motivation.
  
  
  
  Patients were found to endorse significantly lower levels of motivation, a mean difference which translated to a large effect size (Cohen's d = 1.1). Patients' self-reported motivation was significantly related to clinician ratings of motivational deficits which were based on behavioural output, and to vocational functioning. Within the patient sample, 33.3% of individuals were found to experience prominent or clinically significant levels of amotivation based on patients' own self-report. Self-reported achievement motivation was not associated with other clinical variables such as positive symptom severity or expressive negative symptoms.
  
  
  
  Our results serve to highlight the occurrence and prevalence of motivational deficits in patients with schizophrenia who are in the early stages of their illness. Subjective accounts of motivation in this population were found to be related to important outcomes such as community functioning, highlighting the importance of this domain of illness. Targeting these deficits early in the course of the illness offers the potential to curb potential prospective poor outcomes and sets the stage for recovery.
authors.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.
authors.forename: Gagan
authors.initials: G
authors.lastname: Fervaha
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Takeuchi
authors.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.
authors.forename: George
authors.initials: G
authors.lastname: Foussias
authors.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.
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Hahn
authors.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.
authors.forename: Ofer
authors.initials: O
authors.lastname: Agid
authors.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.
authors.forename: Gary
authors.initials: G
authors.lastname: Remington
mesh_terms: D000124:Achievement; D000328:Adult; D016022:Case-Control Studies; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010045:Outpatients; D011446:Prospective Studies; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D057566:Self Report; D055815:Young Adult
keywords: apathy; dopamine; intrinsic motivation; psychosis; reward; schizophrenia