A multidimensional examination of functional disability in schizophrenia.
Item
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Title
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A multidimensional examination of functional disability in schizophrenia.
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Identifier
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AAI9917630
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identifier
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9917630
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Creator
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Berns, Stefanie Mara.
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Contributor
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Adviser: Judith Jaeger
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Date
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1999
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Language
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English
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Publisher
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City University of New York.
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Subject
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Health Sciences, Mental Health | Psychology, Cognitive | Psychology, Clinical | Psychology, Personality
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Abstract
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This study aims to elucidate the correlates of the chronic functional disability in schizophrenia by using a multidimensional approach to examine the relative contributions of five domains of neuropsychological functioning (memory, attention, executive, motor and language) and psychopathological symptomatology (including anergia, anxiety, thought disturbance, activation and hostility) to functional disability (including vocational, social, and residential impairment).;Schizophrenia is the most disabling of all psychiatric disorders and the fifth most disabling of all medical disorders in the developed world. Remarkably, the causes of this chronic and pervasive disability are poorly understood and traditional rehabilitation programs and pharmacological treatments have been only minimally successful in improving functional disability. While psychopathological symptoms such as delusions and hallucinations are the target of pharmacotherapeutic and rehabilitation efforts, only a modest relationship between these symptoms and functional disability has been demonstrated. Several recent studies have demonstrated an association between neuropsychological impairment and functional disability that may be independent of psychopathology.;Sixty outpatients with schizophrenia, age 18 to 45, were administered a set of neuropsychological assessments, psychopathology ratings, and functional disability measures. Canonical correlation analyses revealed that measures of neuropsychological impairment (particularly in the attention domain) were modestly related to one aspect of functional disability, namely, vocational disability. The relationship between psychopathology ratings (particularly anergia and thought disturbance factors) and a different aspect of functional disability, namely social disability ratings reached the level of statistical trend. Analyses of the relationship between current neuropsychological performance, psychopathology ratings, and history of functional disability showed that executive functioning and psychopathology ratings were each related to different aspects of past functional disability. No relationship was found between neuropsychological performance and psychopathology ratings. The findings suggest that neuropsychological functioning and psychopathology reflect modest but independent contributors to functional disability. Increased understanding of the determinants of disability may lead to improvements in pharmacologic, rehabilitative and supportive interventions.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
