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Metacognition moderates the relationship between self-reported and clinician-rated motivation in schizophrenia.

Luther L, Bonfils KA, Fischer MW, Johnson-Kwochka AV, Salyers MP. Metacognition moderates the relationship between self-reported and clinician-rated motivation in schizophrenia. Schizophrenia research. Cognition. 2020 Mar 1; 19:100140.

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Abstract:

INTRODUCTION: Prior work has found varied relationships between self-reported and clinician-rated motivation measures in schizophrenia, suggesting that moderators might impact the strength of this relationship. This current study sought to identify whether metacognition - the ability to form complex representations about oneself, others, and the world - moderates the relationship between self-reported and clinician-rated motivation measures. We also explored whether clinical insight and neurocognition moderated this relationship. METHODS: Fifty-six participants with a schizophrenia-spectrum disorder completed the Motivation and Pleasure Self-Report Scale and the clinician-rated motivation index from the Heinrichs-Carpenter Quality of Life Scale. RESULTS: Metacognition significantly moderated the relationship; self-reported and clinician-rated motivation were positively and significantly correlated only when metacognition was relatively high. Neither clinical insight nor neurocognition moderated the relationship. DISCUSSION: Metacognition appears to be a key variable impacting the strength of the relationship between self-reported and clinician-rated motivation measures and may help to partly explain the varied relationships observed in prior work. Using a metacognitive framework to guide assessment interviews and targeting metacognition in psychosocial treatments may help to improve the synchrony between self-perceptions and clinician ratings of motivation.





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