Negative symptomatology and neurocognitive variables have been considered good predictors of functional outcome in schizophrenia. Specifically, secondary verbal memory has been proposed to be one of the main predictors of psychosocial functioning. In this study, negative symptoms and memory performance were analyzed for associations with psychosocial function. Linear regression methods were used to analyze the value of verbal memory and negative symptomatology as predictors of everyday life skills in a sample of 29 DSM-IV schizophrenia outpatients with predominant negative symptoms. We also took into account the role of gender in the analyses. Secondary verbal memory was found to explain 40% of the variance in psychosocial functioning, independently of gender, whereas the negative symptoms predicted 26%. When both variables were combined, the explained variance was about 49%. These results support the hypothesis that cognitive variables are better predictors than symptomatology. Finally, secondary verbal memory is a good predictor of psychosocial functioning in chronic schizophrenia with predominant negative symptomatology.
"Social withdrawal contributes to the social dysfunction seen in patients with psychotic disorders (Addington et al., 2003; Sanches- Moreno et al., 2009). Positive and negative symptoms (Puig et al., 2008) and cognitive features have been identified as important correlates of reduced social engagement. These include inflexible use of knowledge regarding representations (Lysaker et al., 2010b) and inability to reason about mental states (Salvatore et al., 2008). "
[Show abstract][Hide abstract] ABSTRACT: In this study, we investigated the relationships between observed social withdrawal (Positive and Negative Syndrome Scale [PANSS] Passive Social Withdrawal and PANSS Active Social Avoidance), subjectively experienced social withdrawal (Social Functioning Scale [SFS] Withdrawal and SFS Interpersonal Behavior), and their associations to the underlying psychological patterns of Object Relations and Reality Testing. Patients with schizophrenia (n = 55) and bipolar disorder (n = 51) from the ongoing Thematically Organized Psychosis project, Oslo University Hospital, Norway, were evaluated using the Bell Object Relations and Reality Testing Inventory, the PANSS, and the SFS. Object relations and reality testing subscales related differentially to PANSS Passive Social Withdrawal and PANSS Active Social Avoidance. These two measures, together with the level of alienation, explained a significant amount of variance in self-experienced social dysfunction. Findings reveal the multidimensional nature of social dysfunction in severe mental disorders.
The Journal of nervous and mental disease 03/2013; 201(3):222-5. DOI:10.1097/NMD.0b013e3182848ae0 · 1.69 Impact Factor
"Metaanalyses have shown that schizophrenia patients exhibit the greatest impairments in the domains of learning, memory, and processing speed (Aleman, Hijman, de Haan, & Kahn, 1999; Dickinson, Ramsey, & Gold, 2007; Fioravanti et al., 2005; Heinrichs & Zakzanis, 1998; Saykin et al., 1991). In addition, memory ability has the best predictive power for functional outcome in schizophrenia , making memory an ideal target for drug development and improved quality of life in schizophrenia (Green, 1996; Puig et al., 2008; Velligan, Bow-Thomas, Mahurin, Miller, & Halgunseth, 2000). Previous research has shown that declarative memory, and in particular episodic memory, is impaired in schizophrenia (Aleman et al., 1999; Cirillo & Seidman, 2003; Ranganath, Minzenberg, & Ragland, 2008; Weiss & Heckers, 2001), with consistent findings of moderate-to-large effect sizes relative to healthy controls (Danion , Huron, Vidailhet, & Berna, 2007; Heinrichs & Zakzanis, 1998; Leavitt & Goldberg, 2009). "
[Show abstract][Hide abstract] ABSTRACT: Patients with schizophrenia have widespread cognitive impairments, with selective deficits in relational memory. We previously reported a differential relational memory deficit in schizophrenia using the Associative Inference Paradigm (AIP), a task suggested by the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative to examine relational memory. However, the AIP had limited feasibility for testing in schizophrenia because of high attrition of schizophrenia patients during training. Here we developed and tested a revised version of the AIP to improve feasibility.
30 healthy control and 37 schizophrenia subjects received 3 study-test sessions on 3 sets of paired associates: H-F1 (house paired with face), H-F2 (same house paired with new face), and F3-F4 (two novel faces). After training, subjects were tested on the trained, noninferential Face-Face pairs (F3-F4) and novel, inferential Face-Face pairs (F1-F2), constructed from the faces of the trained House-Face pairs.
Schizophrenia patients were significantly more impaired on the inferential F1-F2 pairs than the noninferential F3-F4 pairs, providing evidence for a differential relational memory deficit. Only 8% of schizophrenia patients were excluded from testing because of poor training performance.
The revised AIP confirmed the previous finding of a relational memory deficit in a larger and more representative sample of schizophrenia patients.
"Verbal memory has been proposed to be one of the main predictors of psychosocial functioning, being independent of gender . This supports the hypothesis that cognitive variables are better predictors of functioning than symptomatology. "
[Show abstract][Hide abstract] ABSTRACT: Schizophrenia is among the most disabling of mental illnesses and frequently causes impaired functioning. We explore issues of definition and terminology, and the relationship between social functioning, cognition, and psychopathology considering relevant research findings.
The present article describes measures of social functioning and outlines their psychometric properties. It considers their usefulness in research and clinical settings. Treatment aims and objectives are explored in the context of cognitive and social functioning. Finally, we identify areas for developing research and refining the measurement of social functioning.
The definition and measurement of social functioning in schizophrenia remains a complex and disputed area. The relationships between symptoms, cognitive functioning and social functioning are complex but we are beginning to understand them better. Scales for measuring functioning in clinical practice must be brief and sensitive to change and the Personal and Social Performance (PSP) scale may offer several advantages in these regards. Brief cognitive assessments focusing upon the domains most commonly affected in schizophrenia, such as verbal memory and executive functions, should be coadministered with measures of functioning.
The use of validated scales for schizophrenia that are sensitive to change over the course of the illness and its treatment, should allow for a better understanding of patients' functional disabilities, enabling better and more comprehensive monitoring and evaluation of both pharmacological and non-pharmacological treatment strategies.
Annals of General Psychiatry 06/2011; 10(1):18. DOI:10.1186/1744-859X-10-18 · 1.40 Impact Factor
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