Distinct profiles of psychological and neuropsychological functions underlying goal-directed pursuit in schizophrenia

Aust N Z J Psychiatry. 2022 Dec;56(12):1628-1641. doi: 10.1177/00048674221077031. Epub 2022 Feb 22.

Abstract

Objectives: Several components are known to underlie goal-directed pursuit, including executive, motivational and volitional functions. These were explored in schizophrenia spectrum disorders in order to identify subgroups with distinct profiles.

Methods: Multiple executive, motivational and volitional tests were administered to a sample of outpatients with schizophrenia spectrum diagnoses (n = 59) and controls (n = 63). Research questions included whether distinct profiles exist and whether some functions are impacted disproportionately. These questions were addressed via cluster analysis and profile analysis, respectively.

Results: Some such functions were significantly altered in schizophrenia while others were unaffected. Two distinct profiles emerged, one characterized by energizing deficits, reduced reward sensitivity and few subjective complaints; while another was characterized by markedly increased punishment sensitivity, intact reward sensitivity and substantial subjective reporting of avolitional symptoms and boredom susceptibility.

Conclusion: These findings highlight the importance of considering distinct patterns of strengths and deficits in functions governing goal-directed pursuit in schizophrenia that demarcate identifiable subtypes. These distinctions have implications for treatment, assessment and research.

Keywords: Schizophrenia; amotivation; avolition; executive function.

MeSH terms

  • Goals
  • Humans
  • Motivation
  • Neuropsychological Tests
  • Reward
  • Schizophrenia* / diagnosis
  • Schizophrenic Psychology