Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 180 Fort Washington Avenue HP234, New York, NY 10032, USA.
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S122-8. doi: 10.1093/schbul/sbr063.
Learning during skills-based psychosocial treatments for schizophrenia is influenced by the motivating properties of the treatment context and the motivational orientation of the client. Given that motivational impairment is a core feature of schizophrenia with significant functional implications, intervention strategies emphasizing extrinsic and/or intrinsic goals may be prescribed to enhance skill learning and treatment outcomes. The purpose of this article is to consider the role that motivation plays in treatment success by evaluating the relationship between motivation and learning during cognitive remediation for schizophrenia. As intrinsic motivation (IM) is most often associated with learning, we will integrate research findings which address 3 main questions: (1) is IM in schizophrenia static or dynamic, (2) is it possible to manipulate the state of being intrinsically motivated and if so do manipulations of IM affect learning? and (3) can motivation theory be translated into clinical practice? This knowledge can facilitate treatment strategies to address the low base rate of IM that is characteristic of schizophrenia and can be applied to cognitive remediation as well as other psychosocial interventions which require learning for treatment success.
在以技能为基础的精神分裂症心理社会治疗中，学习受到治疗环境的激励属性和患者的动机取向的影响。鉴于动机障碍是精神分裂症的核心特征，具有重要的功能意义，强调外在和/或内在目标的干预策略可能被规定为提高技能学习和治疗效果。本文的目的是通过评估动机与精神分裂症认知矫正过程中的学习之间的关系，来考虑动机在治疗成功中的作用。由于内在动机（IM）通常与学习有关，我们将整合解决以下 3 个主要问题的研究结果：（1）精神分裂症中的内在动机是静态的还是动态的；（2）是否可以操纵内在动机的状态，如果可以，对内在动机的操纵是否会影响学习；（3）动机理论能否转化为临床实践？这些知识可以促进治疗策略，以解决精神分裂症中内在动机率低的问题，并且可以应用于认知矫正以及其他需要学习才能成功治疗的心理社会干预。
