Date Presented 3/30/2017
This study suggests that occupational therapists could assist persons with schizophrenia through knowledge of flow theory and self-determination theory, as well as enhancing their attention function and leisure satisfaction when providing therapeutic activities for increasing flow experience.
Primary Author and Speaker: Lin-Jye Huang
Additional Authors and Speakers: Fu-Chang Hu, Chinyu Wu, Yi-Hong Yang, Shu-Chun Lee, Hsu-Chang Huang, Chun-Yi Yu, Kuan-Yu Lai
PURPOSE: The aim of this study was to compare the affecting factors for flow experience between a sample with schizophrenia and a general population sample, exploring the key differences to help persons with schizophrenia facilitate flow experience through activity participation.
BACKGROUND: According to flow theory, flow experience occurs when the individual perceives a challenge that matches his or her ability in activities. While in flow status, individuals have clear goals for the task and full sense of control over their actions, forget about time and self, and experience pleasant feelings about life. Furthermore, from the perspective of self-determination theory, the person with autonomy orientation usually acts out of interest in and valuing of what is occurring.
In occupational therapy (OT) practice, lack of motivation, attention deficits, and poor activity participation have been commonly observed among persons with schizophrenia. Moreover, little is known about the differences between the general population and the schizophrenia population in capturing the flow experience. Accordingly, we intended to explore the key differences in the affecting factors for obtaining flow experience between a general population sample and a sample with schizophrenia to establish evidence-based information for occupational therapy practice.
DESIGN: This study used a prospective research design. We enrolled 204 adult participants in two groups. The schizophrenia group included 100 adults diagnosed with schizophrenia or schizoaffective disorder from psychiatric outpatient clinics, day hospitals, and vocational rehabilitation programs in Taipei, Taiwan. The control group contained 104 adults from the general population (without severe mental illness) including hospital staffs, volunteers, interns, and community residents in Taipei.
METHOD: First, we collected data using the Dispositional Flow State Scale–2, Activity Participation and Restriction Questionnaire, General Causality Orientations Scale, Satisfaction With Life Scale, Beck Depression Inventory–II, and Chu’s Attention Test. Second, each participant was encouraged by the instructor with autonomy support to determine the speed of balls and play with an interactive ping pong ball launcher for 50 balls (right and left sides alternately at 3-s intervals), followed by administration of the Flow State Scale–2 and Leisure Satisfaction Scale. We also administered the Positive and Negative Syndrome Scale to the participants in the schizophrenia group. We used the statistics software R 3.1.3 (R Foundation, Vienna, Austria) to conduct linear regression on the data.
RESULTS: Results for the schizophrenia group showed that dispositional flow tendency, leisure satisfaction, autonomy support, attention function, and autonomy orientation significantly predicted the experience of flow state, adjusted R
2 = 0.7316, F(10, 87) = 27.4402, p < .001. Results for the control group showed that dispositional flow tendency, leisure satisfaction, and autonomy support significantly predicted the experience of flow state, R
2 = 0.6103, adjusted R
2 = 0.5819, F(7, 96) = 21.4795, p < .001.
CONCLUSION: We found that deficiencies in attention function and autonomy orientation hindered the experience of flow state to a greater extent for participants with schizophrenia than for control participants.
IMPACT STATEMENT: Incorporating strategies for facilitating intrinsic motivation (e.g., autonomy support) and attention training program into OT interventions for persons with schizophrenia may help them capture flow experiences during activity participation. This study provides empirical evidence for the usefulness of activity participation in OT clinical practice and establishes a foundation for further assessing the effectiveness of such theory-based interventions in OT.
References
Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper Collins.
Stavrou, N. A. (2008). Intrinsic motivation, extrinsic motivation and amotivation: Examining self-determination theory from flow therapy perspective. In F. M. Olsson (Ed.), New developments in the psychology of motivation (pp. 1–24). New York: Nova Science Publishers.
