Boredom and psychotic disorders: cognitive and motivational issues.

CHRONIC BOREDOM and the conditions that induce boredom are associated with a host of undesirable outcomes. It is proposed that the course and treatment of schizophrenia and other severe mental illnesses (SMI) that require extended care in community-based treatment facilities are often complicated by such outcomes. Brief case studies are used to illustrate how sustained boredom can contribute to (1) postpsychotic mood disturbances, (2) increased risk-taking and substance-seeking behaviors in the residual phases of the illness, (3) the exacerbation of positive symptoms such as paranoia and hallucinations, (4) changes in distractibility and overall cognitive efficiency, and (5) a hypohedonic state of highly generalized uninterest. The observation is made that despite the potential value of boredom as a prodomal marker, few, if any, of the instruments commonly used to assess clinical change include a measure of boredom. It is suggested that training in covert boredom coping skills should be integrated into the social skills training and rehabilitation strategies currently employed with individuals with severe and persistent mental disorders.