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Predictors of Community Outcome in Schizophrenia: The Factor Structure of Cognition and Functional Capacity

Predictors of Community Outcome in Schizophrenia: The Factor Structure of Cognition and Functional Capacity

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Title: Predictors of Community Outcome in Schizophrenia: The Factor Structure of Cognition and Functional Capacity
Author: Muharib, Eva
Abstract: Cognition is considered a key predictor of community outcome in schizophrenia and is the target of an increasingly large number of pharmacological and behavioural interventions. The proliferation of functional capacity instruments grew out of the need to introduce a co-primary measure in intervention studies that was associated with cognition, related to community outcome, and face valid (Buchanan et al., 2005). While use of functional capacity measures has increased substantially, there is much variability in how this construct is understood and utilized. Theoretically, this ability is distinct from cognition; however, this distinction has not been established empirically. The current research examined the widely-held notion that functional capacity and cognition represent distinct constructs. This was achieved by performing an exploratory factor analysis on cognitive and functional capacity measures in an archival dataset (n = 96) followed by a confirmatory factor analysis on data collected at a second time-point (n = 95). Unlike previous studies, cognitive tests included in the analysis represented all cognitive domains claimed to be separable (Nuechterlein et al., 2004) and applied best practices for exploratory factor analysis (Costello & Osborne, 2005). The results indicated that cognition and functional capacity are determined by the same latent construct and should not be considered distinct. These results were then replicated with a second archival dataset (n = 155 and n = 128) which utilized different measures of cognition and functional capacity. Given that functional capacity instruments are redundant with cognitive measures, efforts will need to be invested into investigating alternative co-primary measures. Reaching a consensus on a co-primary measure will support the development of treatments aimed at improving community outcome.
Subject: Clinical psychology
Keywords: Schizophrenia
Community outcome
Cognition
Neuropsychology
Functional capacity
Factor structure
Type: Electronic Thesis or Dissertation
Rights: Author owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
URI: http://hdl.handle.net/10315/34558
Supervisor: Heinrichs, Robert Walter
Degree: PhD - Doctor of Philosophy
Program: Psychology(Functional Area: Clinical Psychology)
Exam date: 2018-01-25
Publish on: 2018-05-28

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