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Social motivation in patients with schizophrenia spectrum disorders: how it is recognized in the rehabilitation process

ABSTRACT The practice of psychosocial intervention for schizophrenia patients is dominated by cognitive–behavioural techniques. There is good justification for this on the basis of the empirical evidence, which speaks in favour of the efficacy of these approaches. Deficits in neurocognition and poor social skills in patients are considered the main targets of psychiatric rehabilitation programmes. However, there are research findings that suggest that distorted social motivation in the form of social anhedonia affects social cognition in schizophrenia patients. The authors describe a compound model of social cognition that includes its motivational component. The model rests on methodological assumptions of the Vygotskian Cultural-Historical Theory of Development, including that of the unity of intellectual and affective processes. The authors review the history of research into cognitive deficits in schizophrenia based on this assumption, and also the most recent empirical evidence confirming that social anhedonia contributes significantly to the impaired social cognition in schizophrenia. The authors conclude that rehabilitation programmes for schizophrenia patients must include psychosocial interventions focused on the remediation of social cognition impairment by means of techniques targeting the remediation of social motivation deficits.