Human Assessment: Cognition and Motivation

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Similarly, interventions that affect motivation and effort should also affect cognitive performance. To this point, increasing dopaminergic transmission via amphetamine, which is well known to affect motivation and reward processing, has been shown to improve performance on cognitive tests.

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In evaluating the present study, limitations should be mentioned. First, the measure used to assess intrinsic motivation was derived from the Heinrichs-Carpenter Quality of Life Scale rather than being a stand-alone measure. Recently, an intrinsic motivation inventory has been developed for and validated in patients with schizophrenia 84 ; we have used this specific measure in a previous study and the results are consistent with those presented herein. Although this measure included 3 distinct items and each demonstrated a relationship with cognitive performance, future studies should examine whether multiple indicators of motivation and effort eg, performance validity tests might explain a greater portion of variance in cognitive test performance.

Third, the relationship between change in intrinsic motivation and change in cognitive test performance, although statistically significant, was of a modest effect size. This effect may be owing in part to the relatively small improvement in cognition scores 51 and level of intrinsic motivation estimated mean difference, 0. Fourth, although the present results are interpreted as intrinsic motivation affecting cognitive performance scores, directionality cannot be established with the present set of analyses.

The possibility that cognitive impairment undermines volition remains. Finally, the influence of motivation and effort on cognitive test performance is not specific to individuals with schizophrenia 17 - 19 ; however, the prevalence of motivational deficits in this disorder suggests that this relationship may be particularly salient and ought to be taken into account.

The present results strongly encourage the assessment of variables such as motivation and effort when evaluating cognitive performance in schizophrenia. Taking these other variables into account may enhance the discovery of variables eg, genetic that are specifically related to core neurocognitive ability.

At the very least, our results suggest that poor cognitive test performance scores should not be inferred at face value to reflect impairment purely in neural processes subserving the cognitive process in question ie, neuroanatomical localization.

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In addition, our findings suggest that in the ongoing search for therapeutics to improve functional outcomes among individuals with schizophrenia, a greater focus on motivational and effort-based deficits and their underlying neurobiology, or indeed the shared mechanisms underlying the motivation-cognition relationship, may facilitate efforts aimed at ameliorating these impairments and improving outcomes. Submitted for Publication: January 31, ; final revision received April 15, ; accepted April 20, Published Online: July 30, Author Contributions: Mr Fervaha had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Acquisition, analysis, or interpretation of data: Fervaha, Foussias, Remington. Critical revision of the manuscript for important intellectual content: All authors. Administrative, technical, or material support: Fervaha, Foussias, Agid, Remington. Conflict of Interest Disclosures: Dr Foussias has been involved in research sponsored by Medicure Inc and Neurocrine Bioscience; has received consultant fees from Roche; and has received speaker fees from Roche, Lundbeck, and Novartis.

No other disclosures were reported. Role of the Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Disclaimer: This study reflects the views of the authors and may not reflect the opinions or views of the CATIE study investigators or the National Institutes of Health.

All Rights Reserved. Figure 1. View Large Download. Illustration of the Components of Cognitive Test Performance. Table 1. Sociodemographic and Clinical Characteristics of Study Patients. Scatterplot showing level of intrinsic motivation and cognitive test performance composite cognitive performance scores eTable 1. Bivariate correlations between intrinsic motivation items and cognitive test scores eTable 2. Bivariate correlations between level of intrinsic motivation and global cognitive test performance stratified by medications eTable 3.

Partial correlations between level of intrinsic motivation and specific domain cognitive performance scores controlling for other variables eTable 4. PubMed Google Scholar Crossref. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. Relationship of cognition and psychopathology to functional impairment in schizophrenia. Motivational and neurocognitive deficits are central to the prediction of longitudinal functional outcome in schizophrenia [published online May 22, ].

Acta Psychiatr Scand. Google Scholar. Negative symptoms and cognitive deficits: what is the nature of their relationship? Schizophr Bull. Does negative symptom change relate to neurocognitive change in schizophrenia? Schizophr Res. The relationships among cognition, motivation, and emotion in schizophrenia: how much and how little we know. Stability and course of neuropsychological deficits in schizophrenia.

Arch Gen Psychiatry. Meta-analyses of cognitive and motor function in youth aged 16 years and younger who subsequently develop schizophrenia. Psychol Med. The Consortium on the Genetics of Schizophrenia: neurocognitive endophenotypes. Attention and Effort. Energetics and Human Information Processing. Dordrecht, the Netherlands: Nijhoff; Controlled and automatic human information processing, II: perceptual learning, automatic attending and a general theory. Psychol Rev. Google Scholar Crossref. Cognitive disorders and negative symptoms as correlates of motivational deficits in psychotic patients.

Arousal, activation, and effort in the control of attention. J Appl Psychol. Conation: a neglected aspect of neuropsychological functioning. Arch Clin Neuropsychol.

Effort has a greater effect on test scores than severe brain injury in compensation claimants. Brain Inj.


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Conducting research with non-clinical healthy undergraduates: does effort play a role in neuropsychological test performance? Role of test motivation in intelligence testing.

Effort and cognition in schizophrenia patients. The role of effort, cognitive expectancy appraisals and coping style in the maintenance of the negative symptoms of schizophrenia. Psychiatry Res. Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Depression, avolition, and attention disorders in patients with schizophrenia: associations with verbal memory efficiency.

J Neuropsychiatry Clin Neurosci. Apathy, cognitive deficits and functional impairment in schizophrenia.

Bibliographic Information

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