Takeda Kazuyoshi, Sumiyoshi Tomiki, Matsumoto Madoka, Murayama Kou, Ikezawa Satoru, Matsumoto Kenji, Nakagome Kazuyuki
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Front Psychiatry. 2018 Jun 5;9:178. doi: 10.3389/fpsyt.2018.00178. eCollection 2018.
The ultimate goal of the treatment of schizophrenia is recovery, a notion related to improvement of cognitive and social functioning. Cognitive remediation therapies (CRT), one of the most effective cognition enhancing methods, have been shown to moderately improve social functioning. For this purpose, intrinsic motivation, related to internal values such as interest and enjoyment, has been shown to play a key role. Although the impairment of intrinsic motivation is one of the characteristics of schizophrenia, its neural mechanisms remain unclear. This is related to the lack of feasible measures of intrinsic motivation, and its response to treatment. According to the self-determination theory (SDT), not only intrinsic motivation, but extrinsic motivation has been reported to enhance learning and memory in healthy subjects to some extent. This finding suggests the contribution of different types of motivation to potentiate the ability of the CRT to treat cognitive impairment of schizophrenia. In this paper, we provide a review of psychological characteristics, assessment methods, and neural correlates of intrinsic motivation in healthy subjects and patients with schizophrenia. Particularly, we focus on neuroimaging studies of intrinsic motivation, including our own. These considerations are relevant to enhancement of functional outcomes of schizophrenia.
精神分裂症治疗的最终目标是康复，这一概念与认知和社会功能的改善相关。认知矫正疗法（CRT）是最有效的认知增强方法之一，已被证明能适度改善社会功能。为此，与兴趣和享受等内在价值观相关的内在动机已被证明起着关键作用。尽管内在动机受损是精神分裂症的特征之一，但其神经机制仍不清楚。这与缺乏可行的内在动机测量方法及其对治疗的反应有关。根据自我决定理论（SDT），不仅内在动机，而且外在动机在健康受试者中也被报道在一定程度上能增强学习和记忆。这一发现表明不同类型的动机有助于增强CRT治疗精神分裂症认知障碍的能力。在本文中，我们综述了健康受试者和精神分裂症患者内在动机的心理特征、评估方法和神经关联。特别是，我们重点关注包括我们自己的研究在内的内在动机神经影像学研究。这些考量与改善精神分裂症的功能结局相关。
