Uncontrolled trial of specialized, multi-component care for individuals with first-episode psychosis: Effects on motivation orientations

Aim: Deficits in motivation are present early in the course of psychotic disorders. However, growing data have highlighted important heterogeneity in motivation among individuals with psychosis, suggesting that this variable may not be a unitary concept. Outside of the psychosis literature, research on self-determination theory has identified three motivational orientations that guide the initiation and regulation of behaviour: autonomous, controlled and impersonal. Thus, our study goal is to investigate the longitudinal course of motivational orientations among individuals participating in a specialized clinical service for individuals with first-episode psychosis (ie, coordinated specialty care: CSC). Methods: Forty-one individuals with first-episode psychosis participating in CSC completed assessments of motivation orientations at enrolment and after 6 months of care. Results: Whereas there were no changes in controlled or impersonal orientations over the first 6-months of care, individuals with first-episode psychosis reported an increase in autonomous orientations. Moreover, while individuals with first-episode psychosis reported lower autonomous orientations at enrolment as compared to individuals without psychosis, after 6 months of care, ratings of autonomous orientations among individuals with first-episode psychosis were equivalent to those of individuals without psychosis. Conclusions: Although the results should be interpreted cautiously given the uncontrolled study design, the results suggest that the benefits of participation in early intervention services for psychosis may extend to improvements in motivation.