Department of Psychiatry & Behavioral Health, Early Psychosis Intervention Center (EPICENTER), Columbus, Ohio.
Department of Psychology, The Ohio State University, Columbus, Ohio.
Early Interv Psychiatry. 2021 Feb;15(1):41-46. doi: 10.1111/eip.12907. Epub 2019 Dec 30.
Deficits in motivation are present early in the course of psychotic disorders. However, growing data have highlighted important heterogeneity in motivation among individuals with psychosis, suggesting that this variable may not be a unitary concept. Outside of the psychosis literature, research on self-determination theory has identified three motivational orientations that guide the initiation and regulation of behaviour: autonomous, controlled and impersonal. Thus, our study goal is to investigate the longitudinal course of motivational orientations among individuals participating in a specialized clinical service for individuals with first-episode psychosis (ie, coordinated specialty care: CSC).
Forty-one individuals with first-episode psychosis participating in CSC completed assessments of motivation orientations at enrolment and after 6 months of care.
Whereas there were no changes in controlled or impersonal orientations over the first 6-months of care, individuals with first-episode psychosis reported an increase in autonomous orientations. Moreover, while individuals with first-episode psychosis reported lower autonomous orientations at enrolment as compared to individuals without psychosis, after 6 months of care, ratings of autonomous orientations among individuals with first-episode psychosis were equivalent to those of individuals without psychosis.
Although the results should be interpreted cautiously given the uncontrolled study design, the results suggest that the benefits of participation in early intervention services for psychosis may extend to improvements in motivation.
在精神病障碍的早期阶段就存在动机不足的问题。然而，越来越多的数据突出了精神病患者之间动机的重要异质性，表明该变量可能不是一个单一的概念。在精神病学文献之外，自我决定理论的研究已经确定了指导行为启动和调节的三种动机取向：自主、控制和非个人。因此，我们的研究目的是调查首次出现精神病的个体（即协调专科护理：CSC）参与专门的临床服务时的动机取向的纵向过程。
41 名首次出现精神病的个体在 CSC 中完成了动机取向的评估，在入组时和 6 个月的护理后进行了评估。
在最初 6 个月的护理过程中，控制或非个人取向没有变化，但首次出现精神病的个体报告自主取向增加。此外，虽然首次出现精神病的个体在入组时的自主取向评分低于没有精神病的个体，但在 6 个月的护理后，首次出现精神病的个体的自主取向评分与没有精神病的个体相当。
尽管考虑到非控制研究设计，结果应谨慎解释，但结果表明，参与精神病早期干预服务的好处可能延伸到动机的改善。
