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The causal relationships between neurocognition, social cognition and functional outcome over time in schizophrenia: a latent difference score approach

Published online by Cambridge University Press:  05 April 2012

M. Hoe ,
E. Nakagami ,
M. F. Green  and
J. S. Brekke
M. Hoe*
Affiliation:
Department of Social Welfare, College of Social Science, Keimyung University, Daegu, South Korea
E. Nakagami
Affiliation:
School of Social Work, University of Southern California, Los Angeles, CA, USA
M. F. Green
Affiliation:
Department of Psychiatry and Biobehavioral Science, University of California at Los Angeles, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
J. S. Brekke
Affiliation:
School of Social Work, University of Southern California, Los Angeles, CA, USA
*
*Address for correspondence: M. Hoe, Ph.D., Assistant Professor, Department of Social Welfare, College of Social Science, Keimyung University, 2800 Dalgubeoldearo, Dalseo-Gu, Daegu 704-701, South Korea. (Email: maanse@kmu.ac.kr)
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Abstract

Background

Social cognition has been identified as a significant construct for schizophrenia research with relevance to diagnosis, assessment, treatment and functional outcome. However, social cognition has not been clearly understood in terms of its relationships with neurocognition and functional outcomes. The present study sought to examine the empirical independence of social cognition and neurocognition; to investigate the possible causal structure among social cognition, neurocognition and psychosocial functioning.

Method

The sample consists of 130 individuals diagnosed with schizophrenia. All participants were recruited as they were admitted to four community-based psychosocial rehabilitation programs. Social cognition, neurocognition and psychosocial functioning were measured at baseline and 12 months. The empirical independence of social cognition and neurocognition was tested using confirmatory factor analysis (CFA) and the possible causal structure among social cognition, neurocognition and psychosocial functioning was investigated using latent difference score (LDS) analysis.

Results

A two-factor model of social cognition and neurocognition fit the data very well, indicating the empirical independence of social cognition, whereas the longitudinal CFA results show that the empirical independence of neurocognition and social cognition is maintained over time. The results of the LDS analysis support a causal model that indicates that neurocognition underlies and is causally primary to social cognition, and that neurocognition and social cognition are causally primary to functional outcome.

Conclusions

Social cognition and neurocognition could have independent and distinct upward causal effects on functional outcome. It is also suggested that the approaches for remediation of neurocognition and social cognition might need to be distinct.

Keywords

Causal relationshipneurocognitionpsychosocial rehabilitationschizophreniasocial cognition
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 11 , November 2012 , pp. 2287 - 2299
Copyright
Copyright © Cambridge University Press 2012

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