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. 2009 Nov;115(1):74-81.
doi: 10.1016/j.schres.2009.08.015. Epub 2009 Sep 23.

Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia

David E Gard  1 , Melissa Fisher, Coleman Garrett, Alexander Genevsky, Sophia Vinogradov
Affiliations

Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia

David E Gard et al. Schizophr Res. 2009 Nov.

Abstract

Objective: A burgeoning area of research has focused on motivational deficits in schizophrenia, producing hypotheses about the role that motivation plays in the well-known relationship between neurocognition and functional outcome. However, little work has examined the role of motivation in more complex models of outcome that include social cognition, despite our increased understanding of the critical role of social cognition in community functioning in schizophrenia, and despite new basic science findings on the association between social cognitive and reward processing in neural systems in humans. Using path analysis, we directly contrasted whether motivation 1) causally influences known social cognitive deficits in schizophrenia, leading to poor outcome or 2) mediates the relationship between social cognitive deficits and outcome in this illness.

Method: Ninety one patients with schizophrenia or schizoaffective disorder completed interview-based measures of motivation and functional outcome as well as standardized measures of neurocognition and social cognition in a cross-sectional design.

Results: In line with recent research, motivation appears to mediate the relationship between neurocognition, social cognition and functional outcome. A model with motivation as a causal factor resulted in poor fit indicating that motivation does not appear to precede neurocognition.

Conclusions: Findings in the present study indicate that motivation plays a significant and mediating role between neurocognition, social cognition, and functional outcome. Potential psychosocial treatment implications are discussed, especially those that emphasize social cognitive and motivational enhancement.

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Figures

Figure 1
Figure 1
a) Green and colleagues' model of Global Functional Outcome is shown below (Brekke et al., 2005). Values represent standardized beta coefficients. An excellent fit to the data is provided. b) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor. c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor.
Figure 1
Figure 1
a) Green and colleagues' model of Global Functional Outcome is shown below (Brekke et al., 2005). Values represent standardized beta coefficients. An excellent fit to the data is provided. b) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor. c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor.
Figure 1
Figure 1
a) Green and colleagues' model of Global Functional Outcome is shown below (Brekke et al., 2005). Values represent standardized beta coefficients. An excellent fit to the data is provided. b) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor. c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor.
Figure 2
Figure 2
a) Similar results in the present study as Green and colleagues' model of Global Functional Outcome - social cognition fully mediates the relationship between neurocognition and functional outcome. Note that the present study did not include social competence or social support as measured variables. b) The hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor, is not confirmed due to poor model fit (see Table 3). c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor is confirmed.
Figure 2
Figure 2
a) Similar results in the present study as Green and colleagues' model of Global Functional Outcome - social cognition fully mediates the relationship between neurocognition and functional outcome. Note that the present study did not include social competence or social support as measured variables. b) The hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor, is not confirmed due to poor model fit (see Table 3). c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor is confirmed.
Figure 2
Figure 2
a) Similar results in the present study as Green and colleagues' model of Global Functional Outcome - social cognition fully mediates the relationship between neurocognition and functional outcome. Note that the present study did not include social competence or social support as measured variables. b) The hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a causal or exogenous factor, is not confirmed due to poor model fit (see Table 3). c) A hypothesized model of the relationship between Neurocognition, Social Cognition, Motivation and Functional Outcome, with Motivation as a mediating factor is confirmed.
See this image and copyright information in PMC

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