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A Group Intervention for Motivational Deficits: Preliminary Investigation of a Blended Care Approach Using Ambulatory Assessment
Behavior Modification ( IF 2.0 ) Pub Date : 2021-09-28 , DOI: 10.1177/01454455211047605
Bénédicte Thonon 1 , Marie-Noëlle Levaux 2 , Evelyne van Aubel 3 , Frank Larøi 1
Affiliation  

Motivational deficits are an important predictor of functional outcomes in individuals with a serious mental illness such as schizophrenia and mood spectrum disorders. The aim of the present study was to explore the feasibility, acceptability, and preliminary efficacy of a group version of “Switch,” an intervention that targets motivational deficits, enriched with an ecological momentary intervention (EMI) approach (i.e., prompts on the participants’ smartphone to encourage the use of trained strategies in their daily life). Eight participants with schizophrenia, schizoaffective, or major depressive disorder entered the study. The intervention took place twice a week for 2 months. Assessment measures included traditional evaluations of motivational negative symptoms, apathy, quality of life and daily functioning, in addition to ambulatory assessment methods strategies, including the experience sampling method (ESM) to assess motivation and related processes, and actigraphy (daily step-count) to assess participants’ activity level. Four participants were considered as non-completers (followed less than 2/3 of the program) and four were considered as completers. Only completers presented a decrease in amotivation/apathy and an improvement in functional outcomes after the intervention and at follow-up. Furthermore, mixed-effects ESM models showed significant interaction effects on multiple processes related to motivation, indicating improvements only in completers: heightened motivation, increased engagement in meaningful and effortful activities, better mood, higher levels of confidence, increased frequency of projection into the future (pleasure anticipation), and of positive reminiscence. This preliminary investigation provides evidence that Switch may be an effective intervention, with specific effects on motivation and associated processes.



中文翻译:

动机缺陷的集体干预:使用流动评估的混合护理方法的初步调查

动机缺陷是严重精神疾病(如精神分裂症和情绪谱系障碍)患者功能结果的重要预测因素。本研究的目的是探索“转换”小组版本的可行性、可接受性和初步功效,这是一种针对动机缺陷的干预,并通过生态瞬时干预 (EMI) 方法(即提示参与者'智能手机鼓励他们在日常生活中使用训练有素的策略)。八名患有精神分裂症、分裂情感或重度抑郁症的参与者进入了研究。干预每周进行两次,持续 2 个月。评估措施包括对动机阴性症状、冷漠、生活质量和日常功能的传统评估,除了动态评估方法策略外,还包括用于评估动机和相关过程的经验抽样方法 (ESM),以及用于评估参与者活动水平的活动记录法(每日步数)。四名参与者被认为是未完成者(跟随不到该计划的 2/3),四名被认为是完成者。只有完成者在干预后和随访时表现出动力/冷漠减少和功能结果改善。此外,混合效应 ESM 模型对与动机相关的多个过程显示出显着的交互效应,表明仅在完成者中有所改善:动机增强、对有意义和努力活动的参与度增加、情绪更好、信心水平更高、预测未来的频率增加(快乐的预期)和积极的回忆。这项初步调查提供的证据表明,Switch 可能是一种有效的干预措施,对动机和相关过程具有特定影响。

更新日期:2021-09-29
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