Avolition is the inability to initiate or engage in goal-directed behaviors. It is sometimes a symptom of schizophrenia.
A person who displays avolition may notice the signs in various areas of their life, including their home life, work life, and relationships. Although there is no standard treatment for avolition in schizophrenia, certain strategies may help a person manage the effects of this symptom.
This article describes what avolition is, including how it may present in schizophrenia. It also discusses the causes of avolition in schizophrenia and outlines the available treatment options.
The American Psychological Association (APA) defines avolition as “failure to engage in goal-directed behavior.”
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The authors of this study describe avolition as “an inability to initiate and persist in goal-directed activities.” They add that it is an impairment in motivation that arises from an inability to anticipate pleasurable experiences.
According to the American Psychiatric Association, possible signs of avolition in schizophrenia include:
- a loss or decrease in the ability to make plans
- little to no interest or engagement in daily activities
- decreased experience of pleasure
At home
At home, avolition may present as one or more of
- staying at home alone for most of the day
- avoiding bathing or grooming
- avoiding household chores such as cleaning, vacuuming, and washing the dishes
- avoiding necessary chores such as paying bills
- zoning out in front of the television for hours or days at a time, but not paying attention to the content
At work
At work, avolition may present as one or more of the following:
- difficulty starting projects and meeting deadlines
- a lack of drive or enthusiasm
- disorganization
- a lack of desire to engage with work colleagues
In relationships
A person with avolition may demonstrate the following patterns of behavior in relationships:
- diminished desire to interact with others
- a lack of interest in other people’s lives
- unwillingness to attend social gatherings
- a tendency to ignore phone calls and text messages
Avolition vs. laziness
Avolition is different from laziness. In essence, avolition involves a lack of ability, whereas laziness involves a lack of will.
For example, a person with avolition may feel unable to make plans or engage in social activities, whereas someone experiencing laziness may feel able but unwilling to make plans or engage in social activities.
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- difficulty anticipating rewards
- impairments in reinforcement learning, which involves learning via reward and punishment
- difficulty with mental representations of value
The study cites evidence to suggest that the above abnormalities could be due to differences in the brain, such as:
- differences in levels of the neurotransmitter dopamine, which plays a key role in determining how much effort an individual will expend to obtain a reward
- differences in a part of the brain called the anterior cingulate cortex, which is involved in analyzing effort versus cost
- reduced activity in a part of the brain called the ventral striatum, which is involved in computing the value of rewards and signaling reward expectation
However, further studies are necessary to better understand the cause of avolition in schizophrenia.
Other negative symptoms
Avolition is one of
According to a
Affective flattening is an extreme lack of emotion in response to a particular situation. People exhibiting affective flattening may appear detached or have emotional reactions that seem very subdued.
The term “alogia” translates to “poverty of speech” and refers to difficulty speaking or a reduction in speech. People with alogia may not speak unless another person prompts them to and may give brief responses to questions.
According to the APA, avolition can sometimes be a symptom of a major depressive episode (MDE).
An MDE is a period characterized by persistent feelings of sadness or pessimism or a reduced ability to experience pleasure. MDEs are sometimes a defining feature of other mental health issues, such as major depressive disorder and bipolar disorder.
Although there is no cure for schizophrenia, treatments can help manage the symptoms. Such treatments appear to be particularly effective during the acute stage of the condition, when symptoms are more active.
However, scientists have yet to identify and develop treatments specifically for avolition.
Medication
According to a
Of the medications that researchers have developed to treat negative symptoms, those that target non-dopaminergic pathways appear the most successful. The non-dopaminergic pathways are those areas of the brain that do not involve the neurotransmitter dopamine.
Therapy
There is little research into the effect of therapy on avolition and other negative symptoms of schizophrenia.
An older pilot study from 2013 found that about 18 sessions of cognitive behavioral therapy reduced negative symptoms of psychosis within 6 months. However, this was an uncontrolled study with a small final sample size of 18 participants. Also, the researchers did not carry out any follow-up assessments, so it is not clear whether the effects were long lasting.
Brain stimulation therapies
Intermittent theta burst stimulation (iTBS) is a noninvasive procedure that involves using magnetic fields to stimulate neural networks in the brain for therapeutic effect.
The results of a 2021 study suggest that a type of iTBS called dorsomedial prefrontal theta burst stimulation (DPTBS) may be an effective treatment for people with avolition due to depression. However, the treatment did not yield the same beneficial effects for people with avolition due to schizophrenia.
The reason for this difference is not clear. However, the researchers speculated that it may be due to the following:
- higher overall resistance to treatment in the group with schizophrenia
- the need for a longer treatment duration in the group with schizophrenia
- differences in the cause of avolition between the two groups
- DPTBS not being an effective treatment for avolition in schizophrenia
Further research is necessary to determine whether DPTBS has the potential to improve avolition in people with schizophrenia and what duration of treatment might be beneficial.
Self-care
Certain self-care strategies may help minimize the effects of avolition in people with schizophrenia. Examples include:
- creating to-do lists to help with task planning and organization
- practicing mindfulness through meditation or journaling
- talking with family and friends about avolition and other symptoms of schizophrenia
Below are some questions people frequently ask about avolition in schizophrenia.
What does avolition feel like?
People with avolition may feel a general lack of motivation, which may present as a lack of enthusiasm and interest in everyday activities.
How do you know if you have avolition?
A person may suspect they have avolition if they severely lack motivation in various areas of their life, especially if they have an existing diagnosis of schizophrenia or depression.
Signs of avolition a person may experience include:
- difficulties making plans or seeing plans through to completion
- little to no interest or engagement in everyday activities
- an inability to experience pleasure
Anyone who notices signs of avolition should speak with a healthcare or mental health professional, especially if they have an underlying mental health condition.
Avolition is the inability to initiate or engage in goal-directed behaviors. It is a motivational impairment that arises from an inability to anticipate pleasurable experiences. Avolition can be a symptom of schizophrenia and depression.
People with avolition may lack motivation and enthusiasm across various areas of their life, including their home life, work life, and relationships.
Researchers have yet to identify and develop treatments specifically targeting avolition in schizophrenia. However, certain self-care strategies may help a person manage the effects of avolition in their day-to-day life. Examples include creating to-do lists, practicing mindfulness, and confiding in family and friends about personal struggles with avolition.
If a person believes they may be experiencing abolition, they should speak with a mental health professional.