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Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures.

ABSTRACT: This study aimed to investigate what characterizes individuals with schizophrenia who experience more or less subjective executive dysfunction in everyday life compared to objective executive performance on neuropsychological tests. Sixty-six participants with broad schizophrenia spectrum disorders completed a comprehensive assessment of executive function. Discrepancies between performance on neuropsychological tests (objective) and an extensive self-report questionnaire (subjective) of central executive functions (inhibition, shifting and working memory) were calculated. Higher level of self-efficacy was the best predictor of experiencing fewer subjective cognitive complaints compared to objective performance, followed by higher levels of disorganized symptoms. Depressive symptoms did not predict discrepancy between subjective and objective executive function. Higher estimated IQ predicted greater subjective working memory difficulties in everyday life despite better objective performance. Results may aid clinicians in the assessment and remediation of cognitive impairment. Low self-efficacy may identify individuals who are not able to utilize their potential executive functions in daily life. Interventions aimed at fostering self-efficacy ought to be included in cognitive remediation for these individuals. Disorganized symptoms could prove useful in identifying individuals who are in need of cognitive remediation for executive dysfunction, despite that they overestimate their skills. These individuals may benefit from efforts to increase insight into cognitive dysfunction.

SUBMITTER: Haugen I

PROVIDER: S-EPMC8217703 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Advances in wearable technology allow for the objective assessment of motor performance in both in-home and in-clinic environments and were used to explore motor impairments in Parkinson's disease (PD). The aims of this study were to: 1) assess differences between in-clinic and in-home gait speed, and sit-to-stand and stand-to-sit duration in PD patients (in comparison with healthy controls); and 2) determine the objective physical activity measures, including gait, postural balance, instrumented Timed-up-and-go (iTUG), and in-home spontaneous physical activity (SPA), with the highest correlation with subjective/semi-objective measures, including health survey, fall history (fallers vs. non-fallers), fear of falling, pain, Unified Parkinson's Disease Rating Scale, and PD stage (Hoehn and Yahr). Objective assessments of motor performance were made by measuring physical activities in the same sample of PD patients (n = 15, Age: 71.2±6.3 years) and age-matched healthy controls (n = 35, Age: 71.9±3.8 years). The association between in-clinic and in-home parameters, and between objective parameters and subjective/semi-objective evaluations in the PD group was assessed using linear regression-analysis of variance models and reported as Pearson correlations (R). Both in-home SPA and in-clinic assessments demonstrated strong discriminatory power in detecting impaired motor function in PD. However, mean effect size (0.94±0.37) for in-home measures was smaller compared to in-clinic assessments (1.30±0.34) for parameters that were significantly different between PD and healthy groups. No significant correlation was observed between identical in-clinic and in-home parameters in the PD group (R = 0.10-0.25; p>0.40), while the healthy showed stronger correlation in gait speed, sit-to-stand duration, and stand-to-sit duration (R = 0.36-0.56; p<0.03). This suggests a better correlation between supervised and unsupervised motor function assessments in healthy controls compared to PD group. In the PD group, parameters related to velocity and range-of-motion of lower extremity within gait assessment (R = 0.58-0.84), and turning duration and velocity within iTUG test (R = 0.62-0.77) demonstrated strong correlations with PD stage (p<0.01).

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Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures.

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