nach oben

Cognitive Therapy and Research

Erschienen in:

10.07.2018 | Original Article

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

verfasst von: Matthias Pillny, Katarina Krkovic, Tania M. Lincoln

Erschienen in: Cognitive Therapy and Research | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

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.

Nur mit Berechtigung zugänglich

We note that different terms such as “dysfunctional”, “irrational” or “maladaptive” have been used to describe people’s appraisals, thoughts, beliefs or attitudes in the field of psychopathology. However, classifying beliefs as dysfunctional may not meet the potential functional aspects of beliefs from a patient’s perspective (Westermann et al., in press). Here, we have decided to use the more neutral term “demotivating beliefs” (i.e. beliefs with negative content that are related to amotivation).

Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia Research, 3, 247–251. https://doi.org/10.1016/0920-9964(90)90005-R.CrossRefPubMed

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. https://doi.org/10.1016/j.schres.2016.05.015.CrossRefPubMed

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. https://doi.org/10.1176/appi.ajp.163.3.488.CrossRefPubMed

Beck, A. T. (1987). Cognitive models of depression. In R. Leahy & T. Dowd (Eds.), Journal of cognitive psychotherapy (1st ed.). New York: Springer.

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.CrossRef

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. https://doi.org/10.1146/annurev-clinpsy-032813-153734.CrossRefPubMed

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. https://doi.org/10.1016/j.schres.2017.10.046.CrossRefPubMed

Beck, A. T., & Rector, N. A. (2005). Cognitive approaches to schizophrenia: Theory and therapy. Annual Review of Clinical Psychology, 1, 577–606. https://doi.org/10.1146/annurev.clinpsy.1.102803.144205.CrossRefPubMed

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.

Bentler, P. M. (2007). On tests and indices for evaluating structural models. Personality and Individual Differences, 42, 825–829. https://doi.org/10.1016/J.PAID.2006.09.024.CrossRef

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. https://doi.org/10.1207/S15327574IJT0101_4.CrossRef

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. https://doi.org/10.1093/schbul/sbw026.CrossRefPubMedPubMedCentral

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. https://doi.org/10.1016/j.psychres.2009.01.020.CrossRefPubMed

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. https://doi.org/10.1017/S0033291798008150.CrossRef

Deusinger, I. M. (1986). Die Frankfurter Selbstkonzeptskalen: (FSKN). Göttingen: Hogrefe.

Eckblad, M. L., Chapman, L. J., Chapman, J. P., & Mishlove, M. (1982). The revised social anhedonia scale. Unpublished test.

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. https://doi.org/10.1016/j.psychres.2015.09.015.CrossRefPubMed

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. https://doi.org/10.1016/j.comppsych.2015.11.001.CrossRefPubMed

Foussias, G., & Remington, G. (2010). Negative symptoms in schizophrenia: Avolition and occam’s razor. Schizophrenia Bulletin, 36, 359–369. https://doi.org/10.1093/schbul/sbn094.CrossRefPubMed

Furr, M., & Bacharach, V. (2014). Test dimensionality and factor analysis. In Psychometrics: An introduction (2nd ed., pp. 71–98). Los Angeles: SAGE. https://doi.org/10.1111/j.1468-5922.2010.01872_2.x.CrossRef

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. https://doi.org/10.1016/j.jrp.2005.11.001.CrossRef

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. https://doi.org/10.1016/j.jagp.2012.10.014.CrossRefPubMed

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. https://doi.org/10.1093/schbul/sbx099.CrossRef

Grant, P. M., & Beck, A. T. (2010). Asocial beliefs as predictors of asocial behavior in schizophrenia. Psychiatry Research, 177, 65–70. https://doi.org/10.1016/j.psychres.2010.01.005.CrossRefPubMed

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. https://doi.org/10.1001/archgenpsychiatry.2011.129.CrossRefPubMed

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. https://doi.org/10.1017/S003329171700160X.CrossRefPubMed

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. https://doi.org/10.1093/schbul/sbu102.CrossRefPubMed

Hautzinger, M., Bailer, M., Hofmeister, D., & Keller, F. (2012). Allgemeine Depressionsskala (ADS). Psychiatrische Praxis, 39, 302–304. https://doi.org/10.1055/s-0032-1326702.CrossRef

Joormann, J. (2004). Die Faktorstruktur der Skala dysfunktionaler Einstellungen (DAS) in einer nicht-klinischen Stichprobe. Diagnostica, 50, 115–123. https://doi.org/10.1026/0012-1924.50.3.115.CrossRef

Kaiser, S., Heekeren, K., & Simon, J. J. (2011). The negative symptoms of schizophrenia: Category or continuum? Psychopathology, 44, 345–353. https://doi.org/10.1159/000325912.CrossRefPubMed

Kirkpatrick, B. (2006). Editor’s introduction: Theme issue on negative symptoms. Schizophrenia Bulletin, 32, 212–213. https://doi.org/10.1093/schbul/sbj061.CrossRefPubMedCentral

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. https://doi.org/10.1093/schbul/sbj053.CrossRefPubMedPubMedCentral

Kirkpatrick, B., Mucci, A., & Galderisi, S. (2017). Primary, enduring negative symptoms: An update on research. Schizophrenia Bulletin, 43, 730–736. https://doi.org/10.1093/schbul/sbx064.CrossRefPubMedPubMedCentral

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. https://doi.org/10.1016/j.schres.2017.09.034.CrossRefPubMed

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. https://doi.org/10.1176/appi.ajp.2012.12010109.CrossRefPubMed

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. https://doi.org/10.1093/schbul/sbr066.CrossRef

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. https://doi.org/10.3389/fpsyg.2017.02108.CrossRefPubMedPubMedCentral

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.CrossRef

Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). New Jersey: Wiley.CrossRef

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. https://doi.org/10.1016/j.comppsych.2012.12.001.CrossRefPubMedPubMedCentral

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. https://doi.org/10.1192/bjp.bp.116.197103.CrossRefPubMed

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. https://doi.org/10.1016/S0022-3956(99)00018-7.CrossRefPubMed

Muthén, L. K., & Muthén, B. O. (2012). Mplus User’s Guide (7th ed.). Los Angeles, CA: Muthén & Muthén.

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. https://doi.org/10.1016/j.psychres.2016.07.018.CrossRefPubMed

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. https://doi.org/10.1016/j.schres.2012.01.015.CrossRefPubMed

Radloff, L. S. (1977). The CES-D scale. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306.CrossRef

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. https://doi.org/10.1891/jcop.18.2.163.65959.CrossRef

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. https://doi.org/10.1093/schbul/sbv226.CrossRefPubMedPubMedCentral

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. https://doi.org/10.1081/E-EBS.CrossRef

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. https://doi.org/10.1159/000478534.CrossRef

Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures Package, 61, 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. https://doi.org/10.3200/JOER.99.6.323-338.CrossRef

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. https://doi.org/10.2466/pr0.1982.51.2.663.CrossRef

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. https://doi.org/10.1016/j.jbtep.2013.01.004.CrossRefPubMed

Strauss, G. P., & Cohen, A. S. (2017). A transdiagnostic review of negative symptom phenomenology and etiology. Schizophrenia Bulletin, 43, 712–729. https://doi.org/10.1093/schbul/sbx066.CrossRefPubMedPubMedCentral

Trémeau, F., Nolan, K. A., Malaspina, D., & Javitt, D. C. (2012). Behavioral validation of avolition in schizophrenia. Schizophrenia Research, 138, 255–261. https://doi.org/10.1016/j.schres.2012.02.018.CrossRefPubMed

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. https://doi.org/0.1176/appi.ajp.2013.13081159.CrossRef

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. https://doi.org/10.1017/S0033291714001147.CrossRefPubMed

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. https://doi.org/10.1024//0170-1789.24.1.3.CrossRef

Weissman, A. (1979). Dysfunctional Attitude Scale (DAS). Acceptance and commitment therapy. Measures 54. Retrieved from http://integrativehealthpartners.org/downloads/ACTmeasures.pdf.

Westermann, S., Cavelti, M., Heibach, E., & Caspar, F. (2015). Motive-oriented therapeutic relationship building for patients diagnosed with schizophrenia. Frontiers in Psychology, 6, 1294. https://doi.org/10.3389/fpsyg.2015.01294.CrossRefPubMedPubMedCentral

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).

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. https://doi.org/10.1016/j.psychres.2017.08.023.CrossRefPubMed

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. https://doi.org/10.1207/s15327752jpa8703_10.CrossRefPubMed

Titel: Development of the Demotivating Beliefs Inventory and Test of the Cognitive Triad of Amotivation
verfasst von: Matthias Pillny
Katarina Krkovic
Tania M. Lincoln
Publikationsdatum: 10.07.2018
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 6/2018
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9940-7

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2018

Personalizing Affective Stimuli Using a Recommender Algorithm: An Example with Threatening Words for Trauma Exposed Populations

Is Integrated CBT Effective in Reducing PTSD Symptoms and Substance Use in Iraq and Afghanistan Veterans? Results from a Randomized Clinical Trial

Reasons for Living Among U.S. Army Personnel Thinking About Suicide

Thought–Action Fusion in Individuals with a History of Recurrent Depression and Suicidal Depression: Findings from a Community Sample

Prospective Relation Between Peer Victimization and Suicidal Ideation: Potential Cognitive Mediators