Motivational Symptoms Research Articles

Arrhythmia

The basic principles of atrial fibrillation(AF)treatment are stroke prevention with appropriate anticoagulation, rhythm and rate control with drugs, and non-pharmacological therapy. The current guidelines have been presented. Non-pharmacological treatment(catheter ablation)for AF, originally developed to eliminate motivational symptoms, has been shown to improve life outcomes, and indications for ablation are expanding rapidly. Catheter ablation has evolved remarkably from conventional radiofrequency to balloon ablation. Minimal complications are expected to occur with pulsed-field ablation. Ablation strategies for paroxysmal AF are almost established and approaches for persistent AF are becoming increasingly important. Surgical approaches have also evolved significantly, with robotic surgery, the thoracoscopic Wolf-Ohtsuka procedure, and minimally invasive cardiac surgery, becoming less invasive. Future studies should prioritize a system for better function and treatment options for the heart team.

Group cognitive remediation therapy for adolescents with anorexia nervosa: Outcomes before, after, and during follow-up in a real-world setting in Japan.

Objective: Cognitive remediation therapy (CRT) can be used as an adjunct treatment for adolescents with severe and complex anorexia nervosa (AN) requiring inpatient treatment. However, there has been only one study on CRT for adolescents with AN in Japan. This study explored group CRT as an adjunct to inpatient treatment for Japanese adolescents with severe and complex AN requiring inpatient care. Methods: Thirty-one adolescents with AN underwent group CRT. Neuropsychological (set-shifting and central coherence) and psychological assessments (motivation, self-esteem, and depressive symptoms) were measured before and after the intervention. Weight and AN symptoms were measured before and after the intervention and at follow-up, and the adolescents completed post-intervention and follow-up questionnaires. Results: Set-shifting led to medium to large effect size improvements. Medium effect size improvements in central coherence and depressive symptoms were also observed. The feedback from the adolescents was mainly positive, and the treatment completion rate was high. The patients also reported that the skills learned through group CRT could be applied in daily life. Conclusion: Group CRT may be beneficial for adolescents with severe and complex AN who require inpatient care.

Exploring cariprazine as a treatment option for varied depression symptom clusters.

Major depressive disorder (MDD) is among the most prevalent psychiatric conditions and a leading cause of disability worldwide. MDD presents a diverse range of symptoms that significantly impact personal, societal, and economic dimensions. Despite the availability of numerous antidepressant treatments (ADTs) targeting different molecular mechanisms, a substantial proportion of patients experience inadequate response, presenting a considerable challenge in MDD management. As a result, adjunctive strategies, particularly involving atypical antipsychotics, are often employed to enhance treatment efficacy. Cariprazine, a D2/D3 partial agonist, is distinguished from other atypical antipsychotics by its selective action on the D3 receptor and its modulation of 5-HT1A, 5-HT2A, and alpha 1B receptors. This distinctive pharmacological profile warrants investigation into its potential effectiveness and tolerability across various symptom domains of MDD, including pleasure, interest, and motivation; mood and suicidality; sleep and appetite; fatigue; psychomotor activity and anxiety; and cognitive function. Preliminary evidence from animal studies and clinical trials suggests that cariprazine may improve motivation, anhedonia, and cognitive function symptoms. Cariprazine shows promise in alleviating mood-related symptoms, though its impact on anxiety and its effects on agitation and psychomotor retardation remains uncertain. Cariprazine may be particularly beneficial for patients with MDD exhibiting anhedonia, cognitive deficits, and possibly fatigue and hypersomnia. Evaluating cariprazine's efficacy across these symptom domains could reveal patterns that support more personalized treatment approaches for depression. Further research is essential to elucidate the role of cariprazine as an adjunctive therapy for adults with major depressive disorder who have an inadequate response to antidepressant monotherapy.

P2: Clinical Improvement Analysis using Montgomery-Åsberg Depression Rating Scale (MADRS) for Outpatient Elderly using Antidepressant Medication in Cipto Mangunkusumo National General Referral Hospital

Background: Clinical outcome is one of the indicators for treatment effect in specific populations such as the elderly. Depression is manifested as the result of biological, psychological, and social factors which are interrelated in the symptoms of low mood, energy, and motivation. In specific population of elderly, depression is related to the issue of loneliness and may impact the quality of life, as well as the progression of other medical comorbidities. Therefore, it is important to monitor the progress of treatment among theelderly.Objectives: The Objectives of this study is to observe clinical improvement of depressive symptoms through the Montgomery-Åsberg Depression Rating Scale (MADRS).Methods: This is an observational cohort study conducted in the outpatient clinic setting. The data was collected after one month of follow-up. Each patient was assessed using the MADRS questionnaire in every clinical encounter. The MADRS scores were analysed statistically using descriptive and dependent variableanalysis.Results: We collected 304 data of patients using MADRS as part of the clinical measurement. The average age is 69.98±6.6 years old. From gender distribution, 57.6% are female and 42.4% are male. From one-month follow-up, 37.8% of patients showed improvement of MADRS score and 39.1% remains the same from the previous visit.Statistical analysis showed significant change of MADRS score after follow-up, indicating the importance of routine visit and monitoring for elderly showing symptoms of depression.Conclusions: Psychometric evaluation is an essential component for observing the clinical improvement for elderly with symptoms of depression.

Psychological Characteristics of Children with Attention Deficit Hyperactivity Disorder as a Cause of Their Stigmatization and Victimization in Society

The psychological characteristics of children with attention deficit hyperactivity disorder (ADHD) are a significant barrier to their adaptation to society and the realization of their personal potential. There is a shortage of literature reviews on this topic, taking into account research over the past few years on. The basis for the literature review material was 51 foreign sources (of which 100% of the sources were in the last four years from 2020 to 2024, with 21 (41%) sources in 2024). Methods of comparative analysis and synthesis were used in writing the literature review. Modern literature indicates the presence of a complex of psychological characteristics in children with ADHD, which are based on disorders in the cognitive, emotional-volitional and behavioral spheres. In the cognitive sphere of children with ADHD, there are impairments in spatial abilities, decreased working memory, attention deficit and low speed of information processing, which are the cause of specific learning disabilities in more than half of children with ADHD. The most common emotional disturbances in children with ADHD are abnormal symptoms of anxiety, stress, low mood, motivation, and depression. Common behavioral symptoms of ADHD include impulsivity, irritability, suicidal behavior, and deliberate attempts at non-suicidal self-harm. All of these cognitive, emotional and behavioral characteristics of children with ADHD can act as predictors of external stigma, most often expressed by school bullying (victimization), as well as internal stigmatization (low self-esteem). Horse riding, music therapy, group psychodrama, training in magic tricks, etc. are cited as the main modern non-pharmacological means of correcting the symptoms of ADHD.

‘We did not even know it was tuberculosis’: a qualitative evaluation of integrating tuberculosis services into paediatric entry points in the CaP-TB programme in Cameroon and Kenya

IntroductionPaediatric tuberculosis (TB) is often undiagnosed and under-reported. The Catalysing Paediatric TB (CaP-TB) programme provided integrated and decentralised TB screening and diagnosis services through multiple paediatric care entry points. This...

Workplace harassment as a moderator of sexual minority employees’ minority stress and psychological distress

ABSTRACT Proximal minority stressors (e.g. internalised homonegativity, motivation to conceal a sexual minority identity) have severe adverse effects on sexual minority individuals’ mental health. Many sexual minorities report experiencing workplace harassment, which is linked to poorer mental health outcomes. However, the precise nature of how workplace harassment shapes the relationship between minority stress and mental health is unknown. To address this question, we tested the moderation effect of workplace harassment on the relationship between proximal minority stressors, specifically internalised homonegativity and concealment motivation, and psychological distress (i.e. depression, anxiety, somatisation) using Hayes’ PROCESS macro package in SPSS. Sexual minority employees living in the United States (N = 529) completed a survey involving measures of proximal minority stressors, workplace harassment, and psychological symptoms via Prolific. Results of the moderation analyses supported the hypothesis that workplace harassment amplifies the positive relationship between internalised homonegativity and anxiety symptoms as well as the relationship between internalised homonegativity and somatic symptoms, though a similar moderation effect was not found for depression. We did not find a significant moderation effect of workplace harassment on the link between concealment motivation and psychological symptoms. We conclude by emphasising the importance of creating safer workplace environments for sexual minorities and identifying directions for future research.

Dissociable effects of dopaminergic medications on depression symptom dimensions in Parkinson disease

Depression in Parkinson disease (PD) is common, is disabling and responds poorly to standard antidepressants. Motivational symptoms of depression are particularly prevalent in PD and emerge with loss of dopaminergic innervation of the striatum. Optimizing dopaminergic treatment for PD can improve depressive symptoms. However, the differential effect of antiparkinsonian medication on symptom dimensions of depression is not known. Using data from a large (n = 412) longitudinal study of patients with newly diagnosed PD followed over 5 years, we investigated whether there are dissociable effects of dopaminergic medications on different depression symptom dimensions in PD. Previously validated ‘motivation’ and ‘depression’ dimensions were derived from the 15-item geriatric depression scale. Dopaminergic neurodegeneration was measured using repeated striatal dopamine transporter imaging. We identified dissociable associations between dopaminergic medications and different dimensions of depression in PD. Dopamine agonists were shown to be effective for treatment of motivational symptoms of depression. In contrast, monoamine oxidase-B inhibitors improved both depressive and motivation symptoms, albeit the latter effect is attenuated in patients with more severe striatal dopaminergic neurodegeneration.

Profiles of motivational impairment and their relationship to functional decline in frontotemporal dementia

Motivational disturbances are pervasive in frontotemporal dementia (FTD) and impact negatively on everyday functioning. Despite mounting evidence of anhedonia in FTD, it remains unclear how such changes fit within the broader motivational symptom profile of FTD, or how anhedonia relates to functional outcomes. Here we sought to comprehensively characterize motivational disturbances in FTD and their respective relationships with functional impairment. A cross-sectional study design was used including 211 participants—68 behavioral-variant FTD (bvFTD), 32 semantic dementia (SD), 43 Alzheimer’s disease (AD), and 68 healthy older control participants. Anhedonia severity was measured using the Snaith–Hamilton Pleasure Scale while severity of apathy was assessed across Emotional, Executive, and Initiation dimensions using the Dimensional Apathy Scale. Functional impairment was established using the FTD Functional Rating Scale (FRS). Distinct motivational profiles emerged in each dementia syndrome: a domain-general motivational impairment in bvFTD; a predominantly anhedonic profile in SD; and more pronounced initiation and executive apathy in AD. Correlation analyses revealed differential associations between motivational symptoms and severity of functional impairment in each group. Executive apathy was associated with functional impairment in bvFTD, while anhedonia was strongly correlated with functional decline in SD. Finally, executive and emotional apathy were associated with functional decline in AD. Our study indicates distinct profiles of apathy and anhedonia in FTD syndromes, which in turn are differentially associated with functional decline. This detailed characterization of motivational phenotypes can inform patient stratification for targeted interventions to improve functional outcomes.

Autistic Traits and Psychosocial Predictors of Depressive Symptoms.

Higher rates of depression and of depressed mood are associated with autistic traits, and both are associated with social interaction factors, such as social self-efficacy, social motivation and loneliness. This study examined whether these social factors explain the association between autistic traits and depression.658 participants (527 women) completed an online survey with measures of autistic traits (AQ), social self-efficacy (Social Self-Efficacy Scale), social motivation (Social Striving Assessment Scale), loneliness (UCLA Loneliness Scale) and depressive symptoms (Beck Depression Inventory-II). A mediation analysis found the relationship between autistic traits and depressive symptoms was fully mediated by the other three factors (β[indirect] = .005, z = 2.63, p < .01; β[direct] = .05, z = 1.58, p > .05), forming a pathway from autistic traits, to social self-efficacy, to social motivation, to loneliness and finally to depressive symptoms. These results suggest that targeting social self-efficacy may break this pathway and disrupt this relationship. Interventions targeting supporting positive social interaction should be considered.

Adaptive coding of reward in schizophrenia, its change over time and relationship to apathy.

Adaptive coding of reward is the process by which neurons adapt their response to the context of available compensations. Higher rewards lead to a stronger brain response, but the increase of the response depends on the range of available rewards. A steeper increase is observed in a narrow range and a more gradual slope in a wider range. In schizophrenia, adaptive coding appears to be affected in different domains, especially in the reward domain. Here, we tested adaptive coding of reward in a large group of patients with schizophrenia (n = 86) and control subjects (n = 66). We assessed: (i) the association between adaptive coding deficits and symptoms; (ii) the longitudinal stability of deficits (the same task was performed 3 months apart); and (iii) the stability of results between two experimental sites. We used functional MRI and the monetary incentive delay task to assess adaptation of participants to two different reward ranges: a narrow range and a wide range. We used a region-of-interest analysis to evaluate adaptation within striatal and visual regions. Patients and control subjects underwent a full demographic and clinical assessment. We found reduced adaptive coding in patients, with a decreased slope in the narrow reward range with respect to that of control participants, in striatal but not visual regions. This pattern was observed at both research sites. Upon retesting, patients increased their narrow-range slopes, showing improved adaptive coding, whereas control subjects slightly reduced them. At retesting, patients with overly steep slopes in the narrow range also showed higher levels of negative symptoms. Our data confirm deficits in reward adaptation in schizophrenia and reveal an effect of practice in patients, leading to improvement, with steeper slopes upon retesting. However, in some patients, an excessively steep slope may result in poor discriminability of larger rewards, owing to early saturation of the brain response. Together, the loss of precision of reward representation in new (first exposure, underadaptation) and more familiar (retest, overadaptation) situations might contribute to the multiple motivational symptoms in schizophrenia.

Pupillary responses as a biomarker of cognitive effort and the impact of task difficulty on reward processing in schizophrenia

Negative symptoms of schizophrenia robustly predict functional outcomes but remain relatively resistant to available treatments. Better measures of negative symptoms, especially motivational deficits, are needed to better understand these symptoms and improve treatment development. Recent research shows promise in linking behavioral effort tasks to motivational negative symptoms, reward processing deficits, and defeatist attitudes, but few studies account for individual or group (patient v. control) differences in cognitive ability to perform the tasks. Individuals with poorer abilities might be less motivated to perform tasks because they find them more difficult to perform. This study used a personalized digit span task to control task difficulty while measuring task effort via pupillary responses (greater dilation indicates greater cognitive effort) at varying monetary rewards ($1 & $2). Participants with schizophrenia (N = 34) and healthy controls (N = 41) performed a digit span task with personalized max span lengths and easy (max− 2 digits) and overload (max+ 2 digits) conditions. Consistent with many studies, pupillary responses (cognitive effort) increased with greater difficulty until exceeding capacity. A similar pattern of reward responsivity was seen in both groups, such that greater reward increased dilation (effort) comparably for both groups when difficulty was within capacity. Neither patients nor controls exerted increased effort for greater reward when difficulty exceeded capacity. In patients, positive relationships were found between pupil dilation and defeatist performance beliefs if task difficulty was within capacity; a relationship that reversed if the task was too difficult. The findings demonstrate the importance of accounting for cognitive capacity and task difficulty when evaluating motivation and reward sensitivity and illustrate the utility of pupillary responses as an objective measure of effort in schizophrenia.

Psychophysiological Responses to High-Intensity Interval Training Exercise over Menstrual Cycle Phases: An Exploratory Study.

Although there is potential for the menstrual cycle to impact psychophysiological responses to exercise, there has been a paucity of studies investigating this aspect, specifically in the context of high-intensity interval training (HIIT). This exploratory study aimed to examine the psychophysiological responses to HIIT over the menstrual cycle. Twenty-three healthy and physically active young women were recruited. Each woman completed a cycle ergometer HIIT session in the menstrual, follicular, and luteal phases of the menstrual cycle in a random order. Psychophysiological variables of interest were collected at baseline, and during and after exercise. Primary variables of interest were anxiety, mood, motivation, enjoyment, arousal, affect, and menstrual distress. Higher pain, water retention, behavior change (related to social interactions, eating habits, and self-performance), and autonomic reactions (consisting of nausea, dizziness, hot flashes, and cold sweats) were observed before HIIT during the menstrual phase compared with the follicular phase ( P < 0.05). Participants exhibited worse psychological responses to HIIT sessions during the menstrual phase, followed by the luteal phase. Findings also noted participants arrived to the laboratory with lower motivation to initiate HIIT sessions during the luteal and menstrual phases compared with the follicular phase. This difference was observed before and during HIIT. Motivation and depressive symptoms showed a significant reduction from pre-HIIT to post-HIIT ( P < 0.05), regardless of menstrual phase. The findings revealed that the menstrual cycle had a significant impact on psychophysiological responses. Moreover, HIIT could be adopted to improve motivation and depressive symptoms; however, further research is needed to explore the effects of HIIT across the menstrual cycle in women with clinical depression.

Mindset profiles of secondary school students: Associations with academic achievement, motivation and school burnout symptoms.

According to Dweck's mindset theory, implicit beliefs (a.k.a. mindset) have an organizing function, bringing together mindset, achievement goals and effort beliefs in a broader meaning system. Two commonly described meaning systems are a growth-mindset meaning system with mastery goals and positive effort beliefs, and a fixed-mindset meaning system with performance goals and negative effort beliefs. Because of assumed heterogeneity within these two meaning systems, we aim to (1) examine multiple-mindset profiles based on mindset, achievement goals and effort beliefs, by using a data-driven person-oriented approach, and (2) relate these different profiles to several outcome measures (academic achievement, motivation and school burnout symptoms). Self-report questionnaire data were collected from 724 students (11.0-14.7 y.o.; 46.7% girl; 53.3% boy; Mage = 12.8 y.o.). Latent profile analysis was conducted using mindset, achievement goals and effort beliefs. Four profiles were revealed: one fixed-mindset profile and three growth-mindset profiles, which differed in their performance goal levels (low, moderate and high). Growth-mindset students with low- or moderate-performance goals had more advantageous outcomes, for example, higher math grades and lower school burnout symptoms, compared to growth-mindset students with high-performance goals. Fixed-mindset students had the least advantageous outcomes, for example, lower grades, less intrinsic motivation and more school burnout symptoms. Our study emphasizes the importance of taking a holistic approach when examining mindset meaning systems, revealing the importance of the level of performance goals and including multiple academic outcomes.

Dysfunctional attributions of success as a distinct feature of amotivation

We examined the association between causal attributions and self-reported motivational negative symptoms (amotivation) in a German online community sample (n = 251). Bivariate correlations revealed significant associations between amotivation and attribution of success to external, variable, and specific causes. No associations between amotivation and failure attributions were found. Our data suggest that demotivational causal attributions of success could be a feature of amotivation and a promising target for research and intervention.

Differences in Intrinsic and Extrinsic Motivation and Obsessive-Compulsive Symptoms among High School Students in light of Some Variables

The present study investigated whether there are differences in intrinsic and extrinsic motivation and obsessive-compulsive symptoms by gender, academic stream and grade level. The sample of the study consisted of 512 high school students in Northern Almazar District, Jordan. Data were collected using three scales measuring intrinsic and extrinsic motivation and obsessive-compulsive symptoms. Three-way ANOVA, and three-way MANOVA were used. This study used an analytical-descriptive methodology. Results showed that males scored significantly higher on the intrinsic motivation scale, scientific stream students scored significantly higher on the intrinsic motivation scale, literary stream students scored significantly higher on the extrinsic motivation scale, twelfth grade students scored significantly higher on the extrinsic motivation scale, literary stream students scored significantly higher on the slowness subscale of the obsessive-compulsive scale, and twelfth grade students scored significantly higher on the doubting subscale of the obsessive-compulsive scale.

Stressors–performance relationship in public accounting firms: a quasi-longitudinal study

PurposeThis study aims to examine the changes in the correlations between stressors and performance in French chartered and accounting firms.Design/methodology/approachThe linkages between role stressors and performance were analyzed through a quasi-longitudinal study of 476 chartered public accountants and trainee-chartered accountants surveyed before and after the busy season, using the partial least squares approach.FindingsOnly challenge appraisals are positively related to motivation before and after the 2018 busy season. Stress arousal is positively associated with burnout and physical symptoms. However, the associations between role ambiguity and conflict, and hindrance appraisals became insignificant after the busy season. The challenge appraisals–role ambiguity linkage persisted but reduced significantly. The burnout–performance association was insignificant in the two time periods.Practical implicationsA busy season with its increased challenge stressors has positive effects on performance through motivation but also negative effects through strains, which explains the observed insignificant net impact.Originality/valueThis quasi-longitudinal study first suggests the role of appraisals, motivation and physical symptoms as mediators of the effects of role stressors on performance. Then, it aids in the broad generalization of certain findings from previous studies. Finally, it demonstrates the applicability of the partial least squares approach, which has been hitherto under-used in behavioral accounting.

Comparison between self‐ and informant‐rated versions of the Mild behavioral impairment checklist in patients with mild cognitive impairment

AbstractBackgroundMild behavioral impairment (MBI) describes de novo emergent and persistent neuropsychiatric symptoms in older individuals. MBI is common in individuals with mild cognitive impairment (MCI), but self‐endorsed symptoms may not align with reports from informants. In this study, we explore the consistency between self‐ and informant‐rated versions of the Mild behavioral impairment checklist (MBI‐C), which is used to assess MBI.MethodWe included 68 individuals with MCI (MMSE 26.59±2.55) who underwent neurological, extensive neuropsychological examination and brain MRI within the Czech Brain Aging Study and had no history of prior psychiatric disorder. Both participants and their close informants completed The Czech version of the MBI‐C (MBI‐C self and MBI‐C informant, respectively). The consistency and differences between the MBI‐C self and informant total and domain scores (i.e. motivation, affect, impulse dyscontrol, social inappropriateness and psychotic symptoms), and the presence of MBI based on a cut‐off of ≥7, were examined using Wilcoxon signed‐rank test, the binomial test and Spearman´s rank correlation. Further, we explored the association between the informant‐self score difference with the MMSE as a measure of global cognition.ResultThere was no difference between MBI‐C self and informant total score (both median ratings were 5.0). Among the domain scores, we observed a difference between self and informant ratings in the impulse dyscontrol (Z = ‐2.97, p = 0.003), but not in any other score. Disagreements on the presence of MBI were observed in 19 participants (28%), but both patients and informants were equally likely to disagree on the MBI presence vs. absence. We observed weak to modest correlations between MBI‐C self and informant total and domain scores (rS = 0.34‐0.53, ps&lt;0.01). The informant‐self score difference in MBI‐C impulse dyscontrol was negatively associated with the MMSE (rS = ‐0.39, p = 0.001).ConclusionPatients with MCI and their informants were not consistent regarding the presence of MBI, but among those who disagreed, neither informants nor patients were more likely to report MBI. The informants reported more severe impulse dyscontrol symptoms compared to the patients with MCI themselves and this difference was negatively associated with lower MMSE. The observed inconsistencies provide implications for clinical and research settings.

Role of emotional creativity and achievement motivation on trauma symptoms among university students.

The aim of this study was to understand the levels of trauma symptoms and the mediating role of achievement motivation, along with emotional creativity, among university students. Many students from various faculties exhibit diverse levels of academic motivation due to their program structures. However, the traumatic experiences faced by students and the subsequent post-traumatic symptoms can lead to various psychosocial and emotional consequences, potentially impacting their emotional creativity and achievement motivation. The present study employed a quantitative approach, utilizing measures to assess emotional creativity, achievement motivation, and trauma symptoms within the sample. The sample under investigation comprised 337 undergraduates from nine different faculties at the University of Peradeniya, Sri Lanka. The study's results indicated a significant correlation between emotional creativity and achievement motivation. While emotional novelty did not display a significant correlation with achievement motivation, emotional effectiveness and authenticity did show such a correlation. Notably, hyperarousal, as a trauma symptom, exhibited a negative correlation with achievement motivation. The study identified both direct and indirect impacts of emotional creativity on achievement motivation. The findings from the regression analysis suggested that the impact of emotional creativity on achievement motivation falls between higher and lower levels. Furthermore, the study concluded that trauma symptoms mediate the relationship between emotional creativity and achievement motivation among undergraduates.

Add-on pramipexole for anhedonic depression: study protocol for a randomised controlled trial and open-label follow-up in Lund, Sweden

IntroductionMany depressed patients do not achieve remission with available treatments. Anhedonia is a common residual symptom associated with treatment resistance as well as low function and quality of life. There...