Cognitive Therapy and Research

, Volume 42, Issue 6, pp 867–877 | Cite as

Development of the Demotivating Beliefs Inventory and Test of the Cognitive Triad of Amotivation

  • Matthias PillnyEmail author
  • Katarina Krkovic
  • Tania M. Lincoln
Original Article


Recent cognitive models of negative symptoms in psychosis posit that amotivation relevant beliefs are reflected in the cognitive triad of negative beliefs concerning the self, others and the future. The aim of this study was to test the proposed three-factor structure of putative ‘demotivating beliefs’ and to ascertain the strength of their association with self-reported amotivation. We combined existing scales assessing ‘demotivating beliefs’ to the Demotivating Beliefs Inventory. This scale was used for exploratory and confirmatory factor analyses as well as latent regression analyses with amotivation in two independent community (n1 = 98; n2 = 347) and one clinical sample (n = 36). We found a three-factor structure with satisfying model fit (‘selfdefeating beliefs’, ‘social indifference beliefs’ and ‘low-expectancy-of-pleasure beliefs’). Each factor showed moderate associations with amotivation (β-coefficients from 0.34 to 0.43; R2 = .30). Our results support the validity of the cognitive triad and its benefit as a framework to analyze demotivating beliefs.


Avolition Apathy Motivation Reduced activity Dysfunctional attitudes Experiential negative symptoms 



We thank Denise Fischer for her support in recruiting participants, Maik Erdas for his support in the item translation process and Esther Wolfram for her language editing.

Compliance with Ethical Standards

Conflict of Interest

Matthias Pillny, Katarina Krkovic and Tania M. Lincoln declare that they have no conflict of interest including any financial, personal or other relationships with other people or organizations within 3 years of beginning the work submitted that could inappropriately influence, or be perceived to influence, their work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10608_2018_9940_MOESM1_ESM.docx (28 kb)
Supplementary material 1 (DOCX 28 KB)


  1. Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia Research, 3, 247–251. Scholar
  2. Aleman, A., Lincoln, T. M., Bruggeman, R., Melle, I., Arends, J., Arango, C., & Knegtering, H. (2017). Treatment of negative symptoms: Where do we stand, and where do we go? Schizophrenia Research, 186, 55–62. Scholar
  3. Artaloytia, J. F., Arango, C., Lahti, A., Sanz, J., Pascual, A., Cubero, P., … Palomo, T. (2006). Negative signs and symptoms secondary to antipsychotics: A double-blind, randomized trial of a single dose of placebo, haloperidol, and risperidone in healthy volunteers. American Journal of Psychiatry, 163, 488–493. Scholar
  4. Beck, A. T. (1987). Cognitive models of depression. In R. Leahy & T. Dowd (Eds.), Journal of cognitive psychotherapy (1st ed.). New York: Springer.Google Scholar
  5. Beck, A. T., Grant, P. M., Huh, G. A., Perivoliotis, D., & Chang, N. A. (2013). Dysfunctional attitudes and expectancies in deficit syndrome schizophrenia. Schizophrenia Bulletin, 39, 43–51.CrossRefGoogle Scholar
  6. Beck, A. T., & Haigh, E. A. P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24. Scholar
  7. Beck, A. T., Himelstein, R., & Grant, P. M. (2017). In and out of schizophrenia: Activation and deactivation of the negative and positive schemas. Schizophrenia Research. Scholar
  8. Beck, A. T., & Rector, N. A. (2005). Cognitive approaches to schizophrenia: Theory and therapy. Annual Review of Clinical Psychology, 1, 577–606. Scholar
  9. Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. (2009). A cognitive conceptualization of negative symptoms. In Schizophrenia: Cognitive theory research and therapy (pp. 142–159). New York: Guilford Press.Google Scholar
  10. Bentler, P. M. (2007). On tests and indices for evaluating structural models. Personality and Individual Differences, 42, 825–829. Scholar
  11. Byrne, B. M. (2001). Structural equation modeling with AMOS, EQS, and LISREL: Comparative approaches to testing for the factorial validity of a measuring instrument. International Journal of Testing 1, 55–86. Scholar
  12. Campellone, T. R., Sanchez, A. H., & Kring, A. M. (2016). Defeatist performance beliefs, negative symptoms, and functional outcome in schizophrenia: A meta-analytic review. Schizophrenia Bulletin, 42, 1343–1352. Scholar
  13. Chan, R. C. K., Wang, Y., Huang, J., Shi, Y., Wang, Y., Hong, X., … Kring, A. M. (2010). Anticipatory and consummatory components of the experience of pleasure in schizophrenia: Cross-cultural validation and extension. Psychiatry Research, 175, 181–183. Scholar
  14. Christensen, H., Jorm, A. F., Mackinnon, A. J., Korten, A. E., Jacomb, P. A., Henderson, A. S., & Rodgers, B. (1999). Age differences in depression and anxiety symptoms: A structural equation modelling analysis of data from a general population sample. Psychological Medicine, 29, S0033291798008150. Scholar
  15. Deusinger, I. M. (1986). Die Frankfurter Selbstkonzeptskalen: (FSKN). Göttingen: Hogrefe.Google Scholar
  16. Eckblad, M. L., Chapman, L. J., Chapman, J. P., & Mishlove, M. (1982). The revised social anhedonia scale. Unpublished test.Google Scholar
  17. Engel, M., Fritzsche, A., & Lincoln, T. M. (2015). Subclinical negative symptoms and the anticipation, experience and recall of emotions related to social interactions: An experimental study. Psychiatry Research, 230, 350–356. Scholar
  18. Engel, M., & Lincoln, T. M. (2016). Motivation and Pleasure Scale-Self-Report (MAP-SR): Validation of the German version of a self-report measure for screening negative symptoms in schizophrenia. Comprehensive Psychiatry, 65, 110–115. Scholar
  19. Foussias, G., & Remington, G. (2010). Negative symptoms in schizophrenia: Avolition and occam’s razor. Schizophrenia Bulletin, 36, 359–369. Scholar
  20. Furr, M., & Bacharach, V. (2014). Test dimensionality and factor analysis. In Psychometrics: An introduction (2nd ed., pp. 71–98). Los Angeles: SAGE. Scholar
  21. Gard, D. E., Gard, M. G., Kring, A. M., & John, O. P. (2006). Anticipatory and consummatory components of the experience of pleasure: A scale development study. Journal of Research in Personality, 40, 1086–1102. Scholar
  22. Granholm, E., Holden, J., Link, P. C., McQuaid, J. R., & Jeste, D. V. (2013). Randomized controlled trial of cognitive behavioral social skills training for older consumers with schizophrenia: Defeatist performance attitudes and functional outcome. American Journal of Geriatric Psychiatry, 21, 251–262. Scholar
  23. Granholm, E., Holden, J., & Worley, M. (2017). Improvement in negative symptoms and functioning in cognitive-behavioral social skills training for schizophrenia: Mediation by defeatist performance attitudes and asocial beliefs. Schizophrenia Bulletin, 44, 653–661. Scholar
  24. Grant, P. M., & Beck, A. T. (2010). Asocial beliefs as predictors of asocial behavior in schizophrenia. Psychiatry Research, 177, 65–70. Scholar
  25. Grant, P. M., Huh, G. A., Perivoliotis, D., Stolar, N. M., & Beck, A. T. (2012). Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. Archives of General Psychiatry, 69, 121. Scholar
  26. Grant, P. M., Perivoliotis, D., Luther, L., Bredemeier, K., & Beck, A. T. (2018). Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy. Psychological Medicine, 48, 261–268. Scholar
  27. Hartmann, M. N., Hager, O. M., Reimann, A. V., Chumbley, J. R., Kirschner, M., Seifritz, E., … Kaiser, S. (2015). Apathy but not diminished expression in schizophrenia is associated with discounting of monetary rewards by physical effort. Schizophrenia Bulletin, 41, 503–512. Scholar
  28. Hautzinger, M., Bailer, M., Hofmeister, D., & Keller, F. (2012). Allgemeine Depressionsskala (ADS). Psychiatrische Praxis, 39, 302–304. Scholar
  29. Joormann, J. (2004). Die Faktorstruktur der Skala dysfunktionaler Einstellungen (DAS) in einer nicht-klinischen Stichprobe. Diagnostica, 50, 115–123. Scholar
  30. Kaiser, S., Heekeren, K., & Simon, J. J. (2011). The negative symptoms of schizophrenia: Category or continuum? Psychopathology, 44, 345–353. Scholar
  31. Kirkpatrick, B. (2006). Editor’s introduction: Theme issue on negative symptoms. Schizophrenia Bulletin, 32, 212–213. Scholar
  32. Kirkpatrick, B., Fenton, W. S., Carpenter, W. T., & Marder, S. R. (2006). The NIMH-MATRICS consensus statement on negative symptoms. Schizophrenia Bulletin, 32, 214–219. Scholar
  33. Kirkpatrick, B., Mucci, A., & Galderisi, S. (2017). Primary, enduring negative symptoms: An update on research. Schizophrenia Bulletin, 43, 730–736. Scholar
  34. Kluge, A., Kirschner, M., Hager, O. M., Bischof, M., Habermeyer, B., Seifritz, E., … Kaiser, S. (2017). Combining actigraphy, ecological momentary assessment and neuroimaging to study apathy in patients with schizophrenia. Schizophrenia Research, 195, 176–182. Scholar
  35. Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P. (2013). The Clinical Assessment Interview for Negative Symptoms (CAINS): Final development and validation. American Journal of Psychiatry, 170, 165–172. Scholar
  36. Lincoln, T. M., Mehl, S., Kesting, M. L., & Rief, W. (2011). Negative symptoms and social cognition: Identifying targets for psychological interventions. Schizophrenia Bulletin, 37, 23–32. Scholar
  37. Lincoln, T. M., Riehle, M., Pillny, M., Helbig-Lang, S., Fladung, A. K., Hartmann-Riemer, M., & Kaiser, S. (2017). Using functional analysis as a framework to guide individualized treatment for negative symptoms. Frontiers in Psychology. Scholar
  38. Linscott, R. J., & van Os, J. (2010). Systematic reviews of categorical versus continuum models in psychosis: Evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annual Review of Clinical Psychology, 6, 391–419.CrossRefGoogle Scholar
  39. Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). New Jersey: Wiley.CrossRefGoogle Scholar
  40. Llerena, K., Park, S. G., McCarthy, J. M., Couture, S. M., Bennett, M. E., & Blanchard, J. J. (2013). The Motivation and Pleasure Scale-Self-Report (MAP-SR): Reliability and validity of a self-report measure of negative symptoms. Comprehensive Psychiatry, 54, 568–574. Scholar
  41. Lutgens, D., Gariepy, G., & Malla, A. (2017). Psychological and psychosocial interventions for negative symptoms in psychosis: Systematic review and meta-analysis. British Journal of Psychiatry, 210, 324–332. Scholar
  42. Müller, M. J., Marx-Dannigkeit, P., Schlösser, R., Wetzel, H., Addington, D., & Benkert, O. (1999). The Calgary Depression Rating Scale for Schizophrenia: Development and interrater reliability of a German version (CDSS-G). Journal of Psychiatric Research, 33, 433–443. Scholar
  43. Muthén, L. K., & Muthén, B. O. (2012). Mplus User’s Guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
  44. Pillny, M., & Lincoln, T. M. (2016). Predictors of improved functioning in patients with psychosis: The role of amotivation and defeatist performance beliefs. Psychiatry Research, 244, 117–122. Scholar
  45. Rabinowitz, J., Levine, S. Z., Garibaldi, G., Bugarski-Kirola, D., Berardo, C. G., & Kapur, S. (2012). Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: Analysis of CATIE data. Schizophrenia Research, 137, 147–150. Scholar
  46. Radloff, L. S. (1977). The CES-D scale. Applied Psychological Measurement, 1, 385–401. Scholar
  47. Rector, N. A. (2004). Dysfunctional attitudes and symptom expression in schizophrenia: Differential associations with paranoid delusions and negative symptoms. Journal of Cognitive Psychotherapy, 18, 163–173. Scholar
  48. Reddy, L. F., Waltz, J. A., Green, M. F., Wynn, J. K., & Horan, W. P. (2016). Probabilistic reversal learning in schizophrenia: Stability of deficits and potential causal mechanisms. Schizophrenia Bulletin, 42, 942–951. Scholar
  49. Rencher, A. C., & Christensen, W. F. (2012). Exploratory factor analysis. In A. Field (Ed.), Methods of multivariate analysis (4th ed., pp. 435–477). London: SAGE. Scholar
  50. Riehle, M., Pillny, M., & Lincoln, T. M. (2017). Are the negative symptoms of schizophrenia treatable at all? A systematic review on efficacy studies for targeted psychological interventions for negative symptoms. Verhaltenstherapie, 27, 199–208. Scholar
  51. Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures Package, 61, 52.Google Scholar
  52. Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. (2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research, 99, 323–338. Scholar
  53. Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The Self-Efficacy Scale: Construction and validation. Psychological Reports, 51, 663–671. Scholar
  54. Staring, A. B. P., ter Huurne, M.-A. B., & van der Gaag, M. (2013). Cognitive behavioral therapy for negative symptoms (CBT-n) in psychotic disorders: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 44, 300–306. Scholar
  55. Strauss, G. P., & Cohen, A. S. (2017). A transdiagnostic review of negative symptom phenomenology and etiology. Schizophrenia Bulletin, 43, 712–729. Scholar
  56. Trémeau, F., Nolan, K. A., Malaspina, D., & Javitt, D. C. (2012). Behavioral validation of avolition in schizophrenia. Schizophrenia Research, 138, 255–261. Scholar
  57. Turner, D. T., van der Gaag, M., Karyotaki, E., & Cuijpers, P. (2014). Psychological interventions for psychosis: A meta-analysis of comparative outcome studies. American Journal of Psychiatry, 171, 1–16. Scholar
  58. Velthorst, E., Koeter, M., van der Gaag, M., Nieman, D. H., Fett, A. J., & Smit, F. (2015). Adapted cognitive – behavioural therapy required for targeting negative symptoms in schizophrenia: Meta-analysis and meta-regression. Psychological Medicine, 45, 453–465. Scholar
  59. von Collani, G., & Herzberg, P. Y. (2003). Eine revidierte Fassung der deutschsprachigen Skala zum Selbstwertgefühl von Rosenberg. Zeitschrift Für Differentielle Und Diagnostische Psychologie, 24, 3–7. Scholar
  60. Weissman, A. (1979). Dysfunctional Attitude Scale (DAS). Acceptance and commitment therapy. Measures 54. Retrieved from
  61. Westermann, S., Cavelti, M., Heibach, E., & Caspar, F. (2015). Motive-oriented therapeutic relationship building for patients diagnosed with schizophrenia. Frontiers in Psychology, 6, 1294. Scholar
  62. Westermann, S., Gantenbein, V., Caspar, F., & Cavelti, M. (in press). Maintaining delusional beliefs as means for the satisfaction and protection of psychological needs. Zeitschrift Für Psychologie, 226(3).Google Scholar
  63. Westermann, S., Grezellschak, S., Oravecz, Z., Moritz, S., Lüdtke, T., & Jansen, A. (2017). Untangling the complex relationships between symptoms of schizophrenia and emotion dynamics in daily life: Findings from an experience sampling pilot study. Psychiatry Research, 257, 514–518. Scholar
  64. Wuthrich, V. M., & Bates, T. C. (2006). Confirmatory factor analysis of the three-factor structure of the Schizotypal Personality Questionnaire and Chapman schizotypy scales. Journal of Personality Assessment, 87, 292–304. Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Psychology and Psychotherapy, Institute of PsychologyUniversität HamburgHamburgGermany

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