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Motivation and engagement during cognitive training for schizophrenia spectrum disorders

Best, Michael W., Milanovic, Melissa, Tran, Tanya, Leung, Pauline, Jackowich, Robyn ORCID:, Gauvin, Stéphanie, Leibovitz, Talia and Bowie, Christopher R. 2020. Motivation and engagement during cognitive training for schizophrenia spectrum disorders. Schizophrenia Research: Cognition 19 , 100151. 10.1016/j.scog.2019.100151

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Background Motivation and engagement are important factors associated with therapeutic outcomes in cognitive training for schizophrenia. The goals of the present report were to examine relations between objective treatment engagement (number of sessions attended, amount of homework completed) and self-reported motivation (intrinsic motivation and perceived competence to complete cognitive training) with neurocognitive and functional outcomes from cognitive training. Methods Data from a clinical trial comparing two cognitive training approaches in schizophrenia-spectrum disorders were utilized in the current report (n = 38). Relations were examined between baseline intrinsic motivation, perceived competence, homework completion, and session attendance with improvements in neurocognition, functional competence, and community functioning. Results Number of sessions attended (r = 0.38) and time doing homework (r = 0.51) were significantly associated with improvements in neurocognition. Homework completion was associated with change in community functioning at a trend-level (r = 0.30). Older age was associated with greater treatment engagement (β = 0.37) and male biological sex was associated with greater self-reported motivation (β = 0.43). Homework completion significantly mediated the relationship between session attendance and neurocognitive treatment outcomes. Conclusions Objective measures of treatment engagement were better predictors of treatment outcomes than subjective measures of motivation. Homework completion was most strongly related to treatment outcomes and mediated the relationship between session attendance and treatment outcomes, suggesting continued engagement with cognitive stimulation may be an especially important component of cognitive remediation programs. Future research should examine methods to improve homework completion and session attendance to maximize therapeutic outcomes.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Publisher: Elsevier
ISSN: 2215-0013
Date of Acceptance: 3 May 2019
Last Modified: 12 Sep 2023 12:00

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