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Correlates of real-world goal-directed behavior in schizophrenia

Published online by Cambridge University Press:  12 November 2021

Jaisal T. Merchant Open the ORCID record for Jaisal T. Merchant [Opens in a new window] ,
Erin K. Moran ,
Michael J. Strube  and
Deanna M. Barch
Jaisal T. Merchant*
Affiliation:
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
Erin K. Moran
Affiliation:
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
Michael J. Strube
Affiliation:
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
Deanna M. Barch
Affiliation:
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
*
Author for correspondence: Jaisal T. Merchant, E-mail: jaisalmerchant@wustl.edu
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Abstract

Background

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.

Methods

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.

Results

Individuals with schizophrenia completed more goal-directed activities than they planned [t(62) = −4.01, p < 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, p = 0.005]. Increased effort expenditure for high probability rewards (planned: OR 1.01, p = 0.034, completed: OR 1.01, p = 0.034) along with performance on a daily functional skills task (planned: OR 1.04, p = 0.002, completed: OR 1.03, p = 0.047) negatively related to both planned and completed goal-directed activity.

Conclusions

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.

Keywords

Anticipationcognitive functionecological momentary assessmenteffort-cost decision-makinggoal-directed behaviormotivationnegative symptomsschizophreniaworking memory
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 6 , April 2023 , pp. 2409 - 2417
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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