Intrinsic and Extrinsic Motivation and Learning in Schizophrenia
Conceptually, motivation can be separated into two types, intrinsic and extrinsic. Intrinsic motivation involves goal-directed behaviors that meet internal psychological needs, while extrinsic motivation involves behaviors executed to obtain external reward or avoid punishment. Both these types of motivation are diminished in psychosis and are linked to amotivation and anhedonia, two of the negative symptoms seen in schizophrenia. In the last several years, the field of motivation research has advanced by (a) developing better instruments to quantify intrinsic motivation, (b) studying the role of effort in evaluating the importance of rewards, (c) examining the neurobiological and behavioral correlates of deficits in learning from feedback, and (d) honing neurophysiologic and behavioral interventions to directly target motivation impairments. In this review, we examine each of the above topics and comment on how our current understanding of motivation may inform the development and testing of new interventions to optimize psychiatric recovery.