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Latent structure of cognition in schizophrenia: a confirmatory factor analysis of the MATRICS Consensus Cognitive Battery (MCCB)

Published online by Cambridge University Press:  28 April 2015

A. McCleery*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
M. F. Green
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
G. S. Hellemann
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
L. E. Baade
Affiliation:
University of Kansas School of Medicine at Wichita, Wichita, KS, USA
J. M. Gold
Affiliation:
Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
R. S. E. Keefe
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
R. S. Kern
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
R. I. Mesholam-Gately
Affiliation:
Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
L. J. Seidman
Affiliation:
Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA Massachusetts General Hospital, Boston, MA, USA
K. L. Subotnik
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
J. Ventura
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
K. H. Nuechterlein
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA UCLA Department of Psychology, Los Angeles, CA, USA
*
*Address for correspondence: A. McCleery, Ph.D., Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, 300 Medical Plaza, Room 2213, Los Angeles, CA 90095, USA. (Email: amccleery@mednet.ucla.edu)

Abstract

Background

The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia.

Method

Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor.

Results

Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models.

Conclusions

These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Allen, DN, Strauss, GP, Donohue, B, van Kammen, DP (2007). Factor analytic support for social cognition as a separable cognitive domain in schizophrenia. Schizophrenia Research 93, 325333.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) . American Psychiatric Press: Washington, DC.Google Scholar
Arnau, RC, Thompson, B (2000). Second-order confirmatory factor analysis of the WAIS-III. Wechsler Adult Intelligence Scale. Assessment 7, 237246.Google Scholar
August, SM, Kiwanuka, JN, McMahon, RP, Gold, JM (2012). The MATRICS Consensus Cognitive Battery (MCCB): clinical and cognitive correlates. Schizophrenia Research 134, 7682.CrossRefGoogle ScholarPubMed
Barch, DM, Ceaser, A (2012). Cognition in schizophrenia: core psychological and neural mechanisms. Trends in Cognitive Sciences 16, 2734.Google Scholar
Bell, M, Tsang, HWH, Greig, TC, Bryson, GJ (2009). Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophrenia Bulletin 35, 738747.Google Scholar
Benedict, RHB (1997). Brief Visuospatial Memory Test – Revised: Professional Manual. Psychological Assessment Resources, Inc.: Odessa.Google Scholar
Bentler, PM, Bonett, DG (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin 88, 588606.Google Scholar
Bentler, PM, Wu, EJ (2005). EQS 6.1 for Windows. Multivariate Software: Encino, CA.Google Scholar
Bollen, KA (1989). Structural Equations with Latent Variables. John Wiley & Sons: New York.Google Scholar
Brandt, J, Benedict, RHB (2001). The Hopkins Verbal Learning Test – Revised: Professional Manual. Psychological Assessment Resources, Inc.: Odessa, FL.Google Scholar
Braver, TS, Barch, DM, Cohen, JD (1999). Cognition and control in schizophrenia: a computational model of dopamine and prefrontal function. Biological Psychiatry 46, 312328.CrossRefGoogle ScholarPubMed
Burton, CZ, Vella, L, Harvey, PD, Patterson, TL, Heaton, RK, Twamley, EW (2013). Factor structure of the MATRICS Consensus Cognitive Battery (MCCB) in schizophrenia. Schizophrenia Research 146, 244248.Google Scholar
Carroll, JB (1993). Human Cognitive Abilities: a Survey of Factor-Analytic Studies. Cambridge University Press: New York, NY.Google Scholar
Cornblatt, BA, Risch, NJ, Faris, G, Friedman, D, Erlenmeyer-Kimling, L (1988). The Continuous Performance Test, Identical Pairs Version (CPT-IP): I. New findings about sustained attention in normal families. Psychiatric Research 26, 223238.Google Scholar
Czobor, P, Jaeger, J, Berns, SM, Gonzalez, C, Loftus, S (2007). Neuropsychological symptom dimensions in bipolar disorder and schizophrenia. Bipolar Disorders 9, 7192.CrossRefGoogle ScholarPubMed
Dickinson, D, Goldberg, TE, Gold, JM, Elvevag, B, Weinberger, DR (2011). Cognitive factor structure and invariance in people with schizophrenia, their unaffected siblings, and controls. Schizophrenia Bulletin 37, 11571167.Google Scholar
Dickinson, D, Harvey, PD (2008). Systemic hypotheses for generalized cognitive deficits in schizophrenia: a new take on an old problem. Schizophrenia Bulletin 35, 403414.Google Scholar
Dickinson, D, Ragland, JD, Calkins, ME, Gold, JM, Gur, RC (2006). A comparison of cognitive structure in schizophrenia patients and healthy controls using confirmatory factor analysis. Schizophrenia Research 85, 2029.Google Scholar
First, M, Spitzer, R, Gibbon, M, Williams, J (2001). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P) . Biometrics Research Department, New York State Psychiatric Institute: New York.Google Scholar
Genderson, MR, Dickinson, D, Diaz-Asper, CM, Egan, MF, Weinberger, DR, Goldberg, TE (2007). Factor analysis of neurocognitive tests in a large sample of schizophrenic probands, their siblings, and healthy controls. Schizophrenia Research 84, 231239.Google Scholar
Gladsjo, JA, McAdams, LA, Palmer, BW, Moore, DJ, Jeste, DV, Heaton, RK (2004). A six-factor model of cognition in schizophrenia and related psychotic disorders: relationships with clinical symptoms and functional capacity. Schizophrenia Bulletin 30, 739754.Google Scholar
Gold, JM, Carpenter, C, Randolph, C, Goldberg, TE, Weinberger, DR (1997). Auditory working memory and Wisconsin Card Sorting Test performance in schizophrenia. Archives of General Psychiatry 54, 159165.CrossRefGoogle ScholarPubMed
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficits in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426445.Google Scholar
Hoe, M, Nakagami, E, Green, MF, Brekke, JS (2012). The causal relationships between neurocognition, social cognition and functional outcome over time in schizophrenia: a latent difference score approach. Psychological Medicine 42, 22872299.Google Scholar
Hooper, D, Coughlan, J, Mullen, MR (2008). Structural equation modelling: guidelines for determining model fit. Electronic Journal of Business Research Methods 6, 5360.Google Scholar
Hu, LT, Bentler, PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal 6, 155.Google Scholar
IBM (2012). IBM SPSS Statistics for Windows, Version 21.0. IBM Corp.: Armonk, NY.Google Scholar
Keefe, RS, Bilder, RM, Harvey, PD, Davis, SM, Palmer, BW, Gold, JM, Meltzer, HY, Green, MF, Miller del, D, Canive, JM, Adler, LW, Manschreck, TC, Swartz, M, Rosenheck, R, Perkins, DO, Walker, TM, Stroup, TS, McEvoy, JP, Lieberman, JA (2006). Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology 31, 20332046.CrossRefGoogle ScholarPubMed
Keefe, RS, Seidman, LJ, Christensen, BK, Hamer, RM, Sharma, T, Sitskoorn, MM, Lewine, RR, Yurgelun-Todd, DA, Gur, RC, Tohen, M, Tollefson, GD, Sanger, TM, Lieberman, JA (2004). Comparative effect of atypical and conventional antipsychotic drugs on neurocognition in first-episode psychosis: a randomized, double-blind trial of olanzapine versus low doses of haloperidol. Americal Journal of Psychiatry 161, 985995.Google Scholar
Keefe, RSE (1999). Brief Assessment of Cognition in Schizophrenia (BACS) Manual – A: Version 2.1. Duke University Medical Center: Durham, NC.Google Scholar
Kern, RS, Gold, JM, Dickinson, D, Green, MF, Nuechterlein, KH, Baade, LE, Keefe, RS, Mesholam-Gately, RI, Seidman, LJ, Lee, C, Sugar, CA, Marder, SR (2011). The MCCB impairment profile for schizophrenia outpatients: results from the MATRICS psychometric and standardization study. Schizophrenia Research 126, 124131.Google Scholar
Mayer, JD, Salovey, P, Caruso, DR (2002). Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) User's Manual. Multi-Health System Publishers: Toronto.Google Scholar
Mesholam-Gately, RI, Giuliano, AJ, Goff, KP, Faraone, SV, Seidman, LJ (2009). Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 23, 315336.Google Scholar
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 2939.Google Scholar
Nuechterlein, KH, Edell, WS, Norris, M, Dawson, ME (1986). Attentional vulnerability indicators, thought disorder, and negative symptoms. Schizophrenia Bulletin 12, 408426.Google Scholar
Nuechterlein, KH, Green, MF, Kern, RS, Baade, LE, Barch, DM, Cohen, JD, Essock, S, Fenton, WS, Frese, FJ III, Gold, JM, Goldberg, T, Heaton, RK, Keefe, RS, Kraemer, H, Mesholam-Gately, R, Seidman, LJ, Stover, E, Weinberger, DR, Young, AS, Zalcman, S, Marder, SR (2008). The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. American Journal of Psychiatry 165, 203213.Google Scholar
Ojeda, N, Pena, J, Schretlen, DJ, Sanchez, P, Aretouli, E, Elizagarate, E, Ezcurra, J, Gutierrez, M (2012). Hierarchical structure of the cognitive processes in schizophrenia: the fundamental role of processing speed. Schizophrenia Research 135, 7278.CrossRefGoogle ScholarPubMed
Schretlen, DJ, Peña, J, Aretouli, E, Orue, I, Cascella, NG, Pearlson, GD, Ojeda, N (2013). Confirmatory factor analysis reveals a latent cognitive structure common to bipolar disorder, schizophrenia, and normal controls. Bipolar Disorders 15, 422433.Google Scholar
Sergi, MJ, Rassovsky, Y, Widmark, C, Reist, C, Erhart, S, Braff, DL, Marder, SR, Green, MF (2007). Social cognition in schizophrenia: relationships with neurocognition and negative symptoms. Schizophrenia Research 90, 316324.Google Scholar
Spreen, O, Strauss, E (1998). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford University Press: New York.Google Scholar
Subotnik, KL, Casaus, LR, Ventura, J, Luo, JS, Hellemann, GS, Gretchen-Doorly, D, Marder, S, Nuechterlein, KH (in press). Risperidone long-acting injection for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia: a randomized clinical trial. JAMA Psychiatry.Google Scholar
Tulsky, DS, Price, LR (2003). The joint WAIS-III and WMS-III factor structure: development and cross-validation of a six-factor model of cognitive functioning. Psychological Assessment 15, 149162.Google Scholar
US Army (1944). Army Individual Test Battery: Manual of Directions and Scoring. Adjutant General's Office, War Department: Washington, DC.Google Scholar
Van Hooren, S, Versmissen, D, Janssen, I, Myin-Germeys, I (2008). Social cognition and neurocognition as independent domains in psychosis. Schizophrenia Research 103, 257265.CrossRefGoogle ScholarPubMed
Wechsler, D (1987). Wechsler Memory Scale – Revised, manual. Psychological Corporation: New York.Google Scholar
Wechsler, D (1995). Manual for the Wechsler Adult Intelligence Scale III. The Psychological Corporation: New York.Google Scholar
White, T, Stern, RA (2003). Neuropsychological Assessment Battery: Psychometric and technical manual. Psychological Assessment Resources, Inc.: Lutz, FL.Google Scholar
Williams, LM, Whitford, TJ, Flynn, G, Wong, W, Liddell, BJ, Silverstein, S, Galletly, C, Harris, AW, Gordon, E (2008). General and social cognition in first episode schizophrenia: identification of separable factors and prediction of functional outcome using the IntegNeuro test battery. Schizophrenia Research 99, 182191.Google Scholar
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