Browsing by Subject "apathy"

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    Apathy as a Treatment Target in Alzheimer's Disease: Implications for Clinical Trials
    (Elsevier, 2022-02) Mortby, Moyra E.; Adler , Lawrence; Agüera-Ortiz , Luis; Bateman, Daniel R.; Brodaty , Henry; Cantillon , Marc; Geda , Yonas E.; Ismail, Zahinoor; Lanctôt, Krista L.; Marshall, Gad A.; Padala, Prasad R.; Politis, Antonios; Rosenberg, Paul B.; Siarkos, Kostas; Sultzer, David L.; Theleritis, Christos; ISTAART NPS PIA; Psychiatry, School of Medicine
    Apathy is one of the most prevalent, stable and persistent neuropsychiatric symptom across the neurocognitive disorders spectrum. Recent advances in understanding of phenomenology, neurobiology and intervention trials highlight apathy as an important target for clinical intervention. We conducted a comprehensive review and critical evaluation of recent advances to determine the evidence-based suggestions for future trial designs. This review focused on 4 key areas: 1) pre-dementia states; 2) assessment; 3) mechanisms/biomarkers and 4) treatment/intervention efficacy. Considerable progress has been made in understanding apathy as a treatment target and appreciating pharmacological and non-pharmacological apathy treatment interventions. Areas requiring greater investigation include: diagnostic procedures, symptom measurement, understanding the biological mechanisms/biomarkers of apathy, and a well-formed approach to the development of treatment strategies. A better understanding of the subdomains and biological mechanisms of apathy will advance apathy as a treatment target for clinical trials.
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    A meta-analytic review of self-reported, clinician-rated, and performance-based motivation measures in schizophrenia: Are we measuring the same “stuff”?
    (Elsevier, 2018) Luther, Lauren; Firmin, Ruth L.; Lysaker, Paul H.; Minor, Kyle S.; Salyers, Michelle P.; Psychiatry, School of Medicine
    An array of self-reported, clinician-rated, and performance-based measures has been used to assess motivation in schizophrenia; however, the convergent validity evidence for these motivation assessment methods is mixed. The current study is a series of meta-analyses that summarized the relationship between methods of motivation measurement in 45 studies of people with schizophrenia. The overall mean effect size between self-reported and clinician-rated motivation measures (r = 0.27, k = 33) was significant, positive, and approaching medium in magnitude, and the overall effect size between performance-based and clinician-rated motivation measures (r = 0.21, k = 11) was positive, significant, and small in magnitude. The overall mean effect size between self-reported and performance-based motivation measures was negligible and non-significant (r = −0.001, k = 2), but this meta-analysis was underpowered. Findings suggest modest convergent validity between clinician-rated and both self-reported and performance-based motivation measures, but additional work is needed to clarify the convergent validity between self-reported and performance-based measures. Further, there is likely more variability than similarity in the underlying construct that is being assessed across the three methods, particularly between the performance-based and other motivation measurement types. These motivation assessment methods should not be used interchangeably, and measures should be more precisely described as the specific motivational construct or domain they are capturing.