Motivation in Schizophrenia
Deficits in motivation are common in schizophrenia and play a crucial role in treatment adherence, quality of life, and the ability to function well in the community. Nevertheless, little is known about the specific mechanisms of these deficits or how they present in everyday life. We have several on-going projects to address these gaps in our understanding of motivation and schizophrenia.
Current Research Projects
Home
Assessment in
Schizophrenia
Affective Maintenance in Schizophrenia
Reliability of an Affective Maintenance Task
Novel Approach to Ecological Momentary Assessment in Schizophrenia
Development of an Interview/Ratings System on Motivation in Schizophrenia
Additional Projects
Publications and Presentations
2010 & 2011 2009 2008 2007 2006 2004 2003 2002 2001 Resources
Research has begun to systematically assess problems with motivation in schizophrenia using laboratory, self-report, and ecological momentary methods (to name a few). Our laboratory in collaboration with Sophia Vinogradov, MD and Melissa Fisher, Ph.D. at the UCSF/SFVAMC, has begun to assess the influence of the home environment on motivation in schizophrenia. Although research has shown that level of cognitive stimulation in the home environment predicts intrinsic motivation several years later in children, this has not been well studied in adults or with people with schizophrenia. Therefore we are currently interviewing people with and without schizophrenia in their home environments and assessing the level of cognitive stimulation and how rewarding the environment is, in order to better understand the role of the environment on motivation levels in people with schizophrenia. Lindsley (Sunny) Pence is coordinating this study.
Affective Maintenance in Schizophrenia
Previous research has consistently shown that people with schizophrenia
report the symptom of anhedonia (diminished experience of pleasure) and
have deficits in motivation and engaging in goal-directed behavior. In
contrast to this, numerous other studies have indicated that people with
schizophrenia show similar responses to positive stimuli as people without
schizophrenia. One potential resolution to this paradox
might be that people with schizophrenia
have
difficulty holding on to an affective experience once they are no longer
in the presence of the affect-eliciting stimulus. This process is termed
‘affective maintenance’ and is an essential part of goal-directed
behavior. We are currently testing whether people with and without schizophrenia
differ in their ability to hold on to an affective
experience over a delay. Specifically, we are using a task designed by
Joseph Mikels, Ph.D., where participants view affective images for a period
of 5 seconds and hold the experience created by the image over a delay
of
8-10 seconds. After this delay participants are presented with a second
image for 5 seconds. Their task is simply to state which image was more
emotionally intense. Subsequent ratings of the images allows for a
‘percentage correct’ to be computed, or their ability to affectively
maintain the experience over a delay. Shanna Cooper (graduate student in
the Masters in Psychological Research program) is currently coordinating
this study.
Reliability of an Affective Maintenance Task
Using a college student sample, Rose Broome (graduate student in the Masters in Psychological Research program) is testing whether the affective maintenance task described above is a reliable measure (testing it over 2 time points) and whether the ability to maintain an affective experience is related to other cognitive abilities such as visual or verbal working memory. This study will be crucial in future research that will test whether certain interventions are effective at increasing patients’ ability to maintain an affective experience. Rose presented this research at the Western Psychological Association in Portland in April, 2009 and will be submitting the paper for publication soon.
Novel Approach to Ecological Momentary Assessment in Schizophrenia
In previous research we have shown that people with schizophrenia have difficulty anticipating that certain experiences will be enjoyable to them but show no differences in in-the-moment experience relative to people without schizophrenia (Gard et al., 2007). This was accomplished using a typical ecological momentary assessment (EMA) methodology, involving pagers and booklets. Although this work was important in differentiating anticipatory pleasure from consummatory (or in-the-moment) pleasure, the typical use of EMA methodology limits the types and number of questions that we can ask of individuals because of the cognitive complexity of the task itself. Since people with schizophrenia often have deficits in cognitive ability we often are limited in the ways that we can follow up on certain questions. Since we are very interested in the ways that goal-directed actions occur and the ways in which they are impaired in schizophrenia we are adapting a methodology used with other populations including high risk mothers (Lefever et al., 2008), couples (Song et al., 2008), adolescents (Puccio et al., 2006), and individuals with substance abuse (Galloway et al., 2008) – specifically using cell phones and a semi-structured questionnaire. This will divert the cognitive burden of questions and follow-ups away from the participants and instead onto the researchers. To our knowledge this is the first EMA study using cell phones with schizophrenia patients in this manner.
Development of an Interview/Ratings System on Motivation in Schizophrenia
Although individual ratings items for motivation exist in several symptom measurements and quality of life measures there are no systematic tests of motivational deficits in schizophrenia. Drawing on the basic science research of motivation we are developing a reliable measure of motivation.
Coping Mechanisms in Regulation of Negative Affect in Major Depressive Disorder: This project is looking at the emotion regulation in patients diagnosed with Major Depressive Disorder. This study was developed by Ozlem Ayduk, Ph.D. at UC Berkeley and Ethan Kross, Ph.D. at the University of Michigan.
The Development of the Supervisory Alliance: Building an effective supervisory alliance is crucial in the development of beginning therapists (Gard & Lewis, 2008). We are in the process of investigating what factors contribute to the most effective alliances between beginning therapists and their clinical supervisors
Publications and Presentations
Gard, D. E., Cooper, S. *, Fisher, M., Genevsky, A.*, Mikels, J. A. & Vinogradov, S. (2011) Evidence for an emotion maintenance deficit in schizophrenia. Psychiatry Research, 187, 24-29. [Download]
Kring, A. M., Germans Gard, M. K., & Gard, D. E. (2011). Emotion deficits in schizophrenia: Timing matters. Journal of Abnormal Psychology. 120, 79-87. [Download]
Loas G., Monestes J., Yon V., Thomas, P. & Gard, D.E. (2010). Anticipatory anhedonia in schizophrenia patients. L'Encéphale. 36, 85-87. [Download]
Pence, S.*, Gard, D.E., Cooper, S.*, Grotewold, S.*, Mahayni, A.*, Woo, J.*, Fisher, M., Vinogradov, S. (2010, May). Reducing Cognitive Demand in Ecological Momentary Assessment in Schizophrenia: A Feasibility Study Using Cellular Telephones. Poster session presented at the Society of Biological Psychiatry, New Orleans, LA. [coming soon]
Cooper, S.*, Gard, D.E., Pence, S.*, Mahayni, A.*, Woo, J.*, Mikels, J.A., Fisher, M., & Vinogradov, S. (2010, May). Evidence for an Affective Maintenance Deficit in Schizophrenia: Implications for Understanding Amotivation. Poster session presented at the Association for Psychological Science, Boston, MA. [coming soon]
Gard, D. E., Fisher, M., Garrett, C., Genevsky, A.* & Vinogradov, S. (2009). Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophrenia Research. 115, 74-81. [Download]
Gard, D.E. & Kring, A.M. (2009). Emotion in the daily lives of schizophrenia patients: Context matters. Schizophrenia Research. 115, 379-380. [Download]
Loas G., Monestes J., Ameller A., Bubrovszky M., Yon V., Wallier J., Berthoz M., Corcos M., Thomas, P., Gard D.E. (2009) Psychometric properties of the French version of the Temporal Experience of Pleasure Scale (TEPS): Study on 125 university students and on 162 psychiatric subjects. Les Annales Medico-Psychologues.
Gard, D.E. (2009, April). Anhedonia in Schizophrenia: Evidence for Impairment in Promotion Focused Self-Regulation. Paper presented in D.E. Gard & D. Friedman-Wheeler (co-chairs) symposium entitled, Understanding Promotion and Prevention in Clinical Populations: Research in Depression, Schizophrenia, and Smoking at the annual meeting of the Western Psychological Association, Portland, OR.
Broome, R.*, Gard, D.E., Cooper, S.*, Pollak, J.*, & Kubkova, H.*. (2009, April). Reliability of an Affective Working Memory Task: Implications for Psychopathology Research. Poster session presented at the Western Psychological Association, Portland, OR. [Download]
Gard, D.E. Lewis, J.M. (2008). Building the supervisory alliance with beginning therapists. The Clinical Supervisor. 27, 39-60. [Download]
Genevsky, A.*, Gard, D.E., Cooper, S.,* Broome, R.,* Washington, S.L.*& Shehabi, L.* (2008, October). The Impact of Choice on the Affective Startle Modulation: Evidence for Decreased Defensive Response. Poster session presented at the Society for Psychophysiology Research, Austin, TX. [Download]
Matlow, R.*, Gard, D.E., Berg, D.J., Krausova, M.* & Jones, R* (2008, October). Difficulty Disengaging from affective Stimuli in Anxiety: Converging Evidence of Reaction Time and Eye Movement. Poster session presented at the Society for Psychophysiology Research, Austin, Tx. [Download]
Gard, D.E., Lewis J.M. & Whiteside, A.* (2008, May). Developing a Supervisory Alliance with Beginning Therapists: An Integrative Approach. Paper presented at the annual meeting of the California Association for Marriage and Family Therapists, Los Angeles, CA.
Gard, D.E., Kring, A.M., Germans Gard, M.K., Horan, W. & Green, M.F. (2007). Anhedonia in schizophrenia: Distinctions between anticipatory and consummatory pleasure. Schizophrenia Research. 93, 253-260. [Download]
Gard, D.E., Germans Gard, M.K., Mehta, N., Kring, A.M., & Patrick, C.P. (2007). Impact of motivational salience on affect modulated startle at early and late probe times. International Journal of Psychophysiology. 66, 266-270. [Download]
Rao, S.M., Soto, J., Friedman-Wheeler, D., & Gard, D.E. (2007). Manual for group cognitive behavioral therapy for chronic pain management.
Matlow, R.*, Gard, D.E., Lima, M.*, Bergstrom, J.*, Krausova, R.* & Rao, S.M. (2007, November). Attention bias in Chronic Pain Patients: Difficulty Disengaging from Negative Stimuli. Poster session presented at the annual meeting of the Association for Behavioral and Cognitive Therapies, Philadelphia, PA. [Download]
Schweizer, A.*, Gard, D.E., Genevsky, A.*, Deshpande, P.* & Rao, S.M. (2007, November). The Role of Approach and Avoidance Motivation in Chronic Pain Patients. Poster session presented at the annual meting of the Association for Behavioral and Cognitive Therapies, Philadelphia, PA. [Download]
Kring, A.M., Gard, D.E., Horan, W., Green, M., Ursu, S., Minzenberg, M., Germans Gard, M. & Carter, C. (2007, October). Anticipatory pleasure deficits in schizophrenia: Boundaries and specificity. Paper presented in D. Barch (chair) symposium entitled, The Nature of Emotion, Motivation and Reward Processing in Schizophrenia: Surprising Finding, New Insights and Future Direction at the annual meeting of the Society for Research in Psychopathology, Iowa City, Iowa.
Gard, D.E., Germans Gard, M.K., Kring, A.M., & John, O.P. (2006). Anticipatory and consummatory experience of pleasure: A scale development study. Journal of Research in Personality. 40, 1086-1102. [Download]
Gard, D.E. & Kring, A.M. (2004, October). Anticipation and the elicitation of the approach motivational system: The role of gender. Poster session presented at the Society for Psychophysiology Research, Santa Fe, NM. [Download]
Mehta Shah, N., Gard, D.E., Germans Gard, M.K., Kring, A.M., & Patrick, C.P. (2004, October). Emotion and motivation on early picture processing: A startle modulation study. Poster session presented at the Society for Psychophysiology Research, Santa Fe, NM. [Download]
Kring, A.M., Feldman Barrett, L. & Gard, D.E. (2003). Representations of affective knowledge in schizophrenia. Psychological Science. 14, 207-214. [Download]
Gard, D.E., Germans Gard, M.K., Horan, W.P., Kring, A.M., John, O.P., & M.F. Green. (2003, October). Anticipatory and consummatory pleasure in schizophrenia: A scale development study. Poster session presented at the Society for Research in Psychopathology, Toronto, Canada. [Download]
Kring, A.M., Gard, D.E., Gruber, J.L., & Feldman Barrett, L. (2003, October). Emotional experience in schizophrenia: Linking emotion and cognition. Deanna Barch (Chair) symposium entitled Cognition and Emotion in Schizophrenia: Empirical and Theoretical Considerations. Society for Research in Psychopathology, Toronto, Canada.
Kring, A.M. & Gard, D.E. (2001, October). Out of the lab and into the world: Emotion in the daily lives of schizophrenia patients. Paper presented at the annual meeting of the Emotion Research group, Olema, Ca.
Gard, D.E. (2001, August). Positive emotion in the daily life of patients with schizophrenia. D. Sloan (Chair) Symposium entitled Emotion and Psychopathology at the meeting of the American Psychological Association, San Francisco, Ca.
Kring, A.M., & Gard, D.E. (2001, July). On the nature of emotion dysfunction in schizophrenia. D. Sloan (Chair) symposium entitled Emotion and Psychopathology at the meeting of the American Psychological Association, San Francisco, Ca.
Temporal Experience of Pleasure Scale (TEPS) and Item Key. [Download]
State Version of the Temporal Experience of Pleasure Scale [Download]
Chinese translation of the Temporal Experience of Pleasure Scale [Download]
Dutch translation of the Temporal Experience of Pleasure Scale [Download]
French translation of the Temporal Experience of Pleasure Scale [Download]
Italian translation of the Temporal Experience of Pleasure Scale [Download]
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