“I just don't look forward to anything”. How anticipatory pleasure and negative beliefs contribute to goal-directed activity in patients with negative symptoms of psychosis

Abstract

Anticipatory pleasure refers to a state of positive affect in anticipation of future events that has been found to motivate goal-directed behavior. Previous research has indicated that patients with negative symptoms of psychosis show reduced goal-directed behavior because ‘demotivating beliefs’ impede anticipatory pleasure. This study aims to link demotivating beliefs and anticipatory pleasure to patients' motivation in everyday life. Using the Experience Sampling Method, we examined the motivational process of goal-directed activity in the daily lives of 35 patients with negative symptoms and 36 healthy controls. We tested whether the mechanism underlying goal-directed behavior differs between patients and healthy controls and whether demotivating beliefs interfere with goal-directed behavior by impeding anticipatory pleasure. Multilevel analyses revealed that anticipatory pleasure mediated the association between goal-intentions and goal-directed activity in both groups (indirect effects: 24–30%). In the patient group, however, the association between social goal-intentions and anticipatory pleasure was weaker (b = −0.09, SE = 0.05, p ≤ .01, [−0.17;−0.04]) than in the controls, but this was not found for goal-intentions related self-care or recreational activites. Also, demotivating beliefs were more pronounced in the patient sample. (F(1,70) = 72.11, p ≤ .001) and moderated the effect of goal-intentions on anticipatory pleasure for social activities in the whole sample (b = −0.12, SE = 0.05, p ≤ .01, [−0.20;−0.08]). Our results support the assumption that a set of demotivating beliefs prevents patients with negative symptoms from looking forward to social activities and thus provide a possible psychological explanation for the social withdrawal of patients with negative symptoms.