Faculty of Psychology, Speech and Laguage Therapy and Education Sciences, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Place des Orateurs 1, 4000, Liège, Belgium.
Department of Neurosciences, Center for Contextual Psychiatry (CCP), Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
BMC Psychiatry. 2020 Sep 25;20(1):464. doi: 10.1186/s12888-020-02824-5.
Motivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes in a naturalistic setting, and to explore the dynamics between the processes.
We used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time.
The intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up).
This study used an innovative approach to look at the effectiveness of an intervention. The intervention seems to lead to meaningful improvements in motivational negative symptoms and functional outcomes. The mechanisms of change need to be further investigated.
ClinicalTrials.gov, NCT04325100 . Registered 27 March 27, 2020 -retrospectively registered.
Guidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement were followed.
动机性阴性症状会阻碍精神分裂谱系障碍患者的生活质量和日常功能。最近开发的一种干预措施 Switch，已显示出对阴性症状和功能结果的有希望的效果。Switch 针对与动机和目标导向行为相关的多个认知、情感和行为过程。我们旨在自然环境中研究其对动机和相关过程的影响，并探索这些过程之间的动态关系。
我们使用了单一案例方法（n=3），采用了前后测和随访评估设计，其中还包括动态评估（经验抽样法，ESM；和步数计数）。我们计算了自回归滞后 1 模型，以评估干预对日常动机水平和相关过程的影响，使用描述性饼图，以及向量自回归模型来揭示随着时间的推移过程的动态变化。
根据传统的动机性阴性症状、冷漠、日常功能和生活质量评估，该干预对每位参与者均有益。对 ESM 变量的影响揭示了每位个体的不同结果。各个过程之间的动态关系在参与者之间存在差异，并且在参与者内部（当比较基线、干预阶段和随访时）也存在波动。
本研究采用了一种创新的方法来研究干预措施的有效性。该干预似乎导致了动机性阴性症状和功能结果的有意义改善。需要进一步研究变化的机制。
ClinicalTrials.gov，NCT04325100。2020 年 3 月 27 日注册-回溯注册。
本研究遵循了非随机设计评估的透明报告（TREND）声明的指南。
