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Intrinsic Motivation as a Predictor of Work Outcome After Vocational Rehabilitation in Schizophrenia

Saperstein, Alice M. PhD*; Fiszdon, Joanna M. PhD; Bell, Morris D. PhD

The Journal of Nervous and Mental Disease: September 2011 - Volume 199 - Issue 9 - p 672-677
doi: 10.1097/NMD.0b013e318229d0eb
Original Articles

Intrinsic motivation is a construct commonly used in explaining goal-directed behavior. In people with schizophrenia, intrinsic motivation is usually subsumed as a feature of negative symptoms or underlying neurocognitive dysfunction. A growing literature reflects an interest in defining and measuring motivational impairment in schizophrenia and in delineating the specific role of intrinsic motivation as both an independent predictor and a mediator of psychosocial functioning. This cross-sectional study examined intrinsic motivation as a predictor of vocational outcomes for 145 individuals with schizophrenia and schizoaffective disorder participating in a 6-month work rehabilitation trial. Correlation and mediation analyses examined baseline intrinsic motivation and negative symptoms in relation to work hours and work performance. Data support a significant relationship between intrinsic motivation and negative symptoms and significant correlations with outcome variables, such that lower negative symptoms and greater intrinsic motivation were associated with better work functioning. Moreover, in this sample, intrinsic motivation fully mediated the relationships between negative symptoms, work productivity, and work performance. These results have significant implications on the design of work rehabilitation interventions for people with schizophrenia and support a role for targeting intrinsic motivation directly to influence vocational functioning. Future directions for research and intervention are discussed.

*Columbia University, New York, NY; and †VA Connecticut Healthcare System, West Haven, CT.

Funding for this study was provided by a VA Rehabilitation Research and Development Service grant (D 2356-R) awarded to Morris Bell, PhD. The funding source did not influence the research design, analyses, interpretation, or decision to submit this manuscript for publication.

All authors declare that they have no conflict of interest.

Send reprint requests to Alice M. Saperstein, PhD, 1051 Riverside Drive, Herbert Pardes Building, Mailbox 100, New York, NY 10032. E-mail: saperst@nyspi.columbia.edu.

© 2011 Lippincott Williams & Wilkins, Inc.