In Search of a Theoretical Structure for Understanding Motivation in Schizophrenia

摘要

This themed issue considers different ways to conceptualize the motivational impairment that is a core negative symptom of schizophrenia. Motivational impairment has been linked to poor functional outcome, thus it is important to understand the nature and causes of motivational impairment in order to develop better treatment strategies to enhance motivation and engage patients in the process of recovery. Motivation refers to the processes whereby goal-directed activities are instigated and sustained and can be thought of as the product of a complex interaction of physiological processes and social contextual variables. In this issue, the physiological processes of motivation are the focus of Barch and Dowd, who highlight the role of prefrontal and subcortical mesolimbic dopamine systems in incentive-based learning and the difficulties people with schizophrenia have using internal representations of relevant experiences and goals to drive the behavior that should allow them to obtain desired outcomes. The articles in this issue by Choi et al., Nakagami et al., and Silverstein, focus on social contextual or environmental variables that can shape behavior and motivation. Together, these articles highlight the impact of external cues and goal properties on the expectations and values attached to goal outcomes. Expectancy-value and Self-Determination theories provide an overarching framework to accommodate the perspectives and data provided in all these articles. In the following introduction we show how the articles in this themed issue both support the role of expectancies and value in motivation in schizophrenia and elucidate possible deficiencies in the way expectations and value get assigned.