Self-Determination Theory and First-Episode Psychosis: A Replication

Self-determination theory (SDT) posits that human well-being depends on the satisfaction of three basic psychological needs: autonomy, competence, and relatedness. Although many scholars have suggested that SDT may be relevant to psychotic disorders, only one empirical study of SDT in individuals with psychosis has been completed to date by Breitborde and colleagues (2012). This study revealed that individuals with first-episode psychosis reported lower satisfaction of the three basic psychological needs as compared to individuals without psychosis. Moreover, greater satisfaction of basic psychological needs was modestly associated with lower general symptoms (e.g., anxiety and depression), greater social functioning, and better quality of life. Thus, the goal of this project was to replicate Breitborde et al.’s (2012) investigation of basic psychological need satisfaction among individuals with first-episode psychosis. Our results supported the conclusion that individuals with first-episode psychosis report lower autonomy, competence, and relatedness than individuals without psychosis. Moreover, our results comport with the finding that greater need satisfaction was associated with less severe symptomatology and better social functioning and quality of life. In total, the findings lend further credence to the hypothesis that SDT may help to inform the development of improved clinical services for individuals with psychotic disorders. 1. Introduction Self-determination theory (SDT: [1]) posits that human well-being and motivation are dependent on the satisfaction of three basic psychological needs: autonomy (i.e., viewing oneself as the volitional source of one’s actions), competence (i.e., perceiving one’s self as effective in interactions in one’s local world), and relatedness (i.e., feeling a sense of connectedness and belongingness with others in one’s local world). Recently, several scholars have suggested that SDT theory may be relevant to psychotic disorders [2, 3]. For example, Choi and colleagues [4] have shown that greater intrinsic motivation—a construct underpinned by the three basic psychological needs [1]—is associated with greater participation in and response to cognitive remediation among individuals with schizophrenia. Yet, despite this potential utility of SDT, only one study to date has examined basic psychological need satisfaction among individuals with psychosis. In this study, Breitborde and colleagues [5] found that individuals with first-episode psychosis reported lower feelings of autonomy, competence, and relatedness as