Correlates of real-world goal-directed behavior in schizophrenia

Deficits in goal-directed behavior (i.e. behavior conducted to achieve a specific goal or outcome) are core to schizophrenia, difficult to treat, and associated with poor functional outcomes. Factors such as negative symptoms, effort-cost decision-making, cognition, and functional skills have all be...

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Bibliographic Details
Published in:Psychological medicine 2023-04, Vol.53 (6), p.2409-2417
Main Authors: Merchant, Jaisal T., Moran, Erin K., Strube, Michael J., Barch, Deanna M.
Format: Article
Language:English
Subjects:
Behavior
Clinical interviews
Cognition
Cognition & reasoning
Cognitive ability
Decision making
Ecological momentary assessment
Emotional behavior
Expenditures
Functional impairment
Goals
Humans
Insight
Laboratories
Memory
Mental depression
Mental disorders
Motivation
Negative symptoms
Objectives
Original Article
Pleasure
Population studies
Psychosis
Reward
Schizophrenia
Schizophrenic Psychology
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Summary:Deficits in goal-directed behavior (i.e. behavior conducted to achieve a specific goal or outcome) are core to schizophrenia, difficult to treat, and associated with poor functional outcomes. Factors such as negative symptoms, effort-cost decision-making, cognition, and functional skills have all been associated with goal-directed behavior in schizophrenia as indexed by clinical interviews or laboratory-based tasks. However, little work has examined whether these factors relate to the real-world pursuit of goal-directed activities in this population. This study aimed to fill this gap by using Ecological Momentary Assessment (four survey prompts per day for 1 week) to test hypotheses about symptom, effort allocation, cognitive, and functional measures associated with planned and completed goal-directed behavior in the daily lives of 63 individuals with schizophrenia. Individuals with schizophrenia completed more goal-directed activities than they planned [ (62) = -4.01, < 0.001]. Motivation and pleasure (i.e. experiential) negative symptoms, controlling for depressive symptoms, negatively related to planned goal-directed behavior [odds ratio (OR) 0.92, 0.005]. Increased effort expenditure for high probability rewards (planned: OR 1.01, 0.034, completed: OR 1.01, 0.034) along with performance on a daily functional skills task (planned: OR 1.04, 0.002, completed: OR 1.03, 0.047) negatively related to both planned and completed goal-directed activity. Our results present correlates of real-world goal-directed behavior that largely align with impaired ability to make future estimations in schizophrenia. This insight could help identify targeted treatments for the elusive motivated behavior deficits in this population.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291721004281