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The relationship between negative symptom subdomains and cognition

Published online by Cambridge University Press:  18 April 2016

J. Lim ,
S.-A. Lee ,
M. Lam ,
A. Rapisarda ,
M. Kraus ,
R. S. E. Keefe  and
J. Lee
J. Lim
Affiliation:
Research Division, Institute of Mental Health, Singapore
S.-A. Lee
Affiliation:
Research Division, Institute of Mental Health, Singapore
M. Lam
Affiliation:
Research Division, Institute of Mental Health, Singapore
A. Rapisarda
Affiliation:
Research Division, Institute of Mental Health, Singapore Neuroscience & Behavioral Disorders, Duke-NUS Graduate Medical School, Singapore
M. Kraus
Affiliation:
Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
R. S. E. Keefe
Affiliation:
Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
J. Lee*
Affiliation:
Research Division, Institute of Mental Health, Singapore Department of General Psychiatry 1, Institute of Mental Health, Singapore Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
*
*Address for correspondence: Dr J. Lee, Research Division, Institute of Mental Health, 10 Buangkok View, Singapore 539747, Singapore. (Email: Jimmy_lee@imh.com.sg)
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Abstract

Background

Negative symptoms and cognitive deficits in schizophrenia are partially overlapping. However, the nature of the relationship between negative symptoms and cognition remains equivocal. Recent reviews have demonstrated the presence of two negative symptom subdomains, diminished emotional expression (DEE) and avolition. In view of this, we sought to clarify the relationship between negative symptoms and cognitive domains.

Method

A total of 687 participants with schizophrenia were assessed on measures of psychopathology and cognition. Three cognitive factors, namely executive function, fluency/memory and speed/vigilance were computed from the cognitive tests. Confirmatory factor analysis was utilized to examine if a one-factor or two-factor negative model was applicable to our sample. Subsequently, the relationships between negative symptoms and cognition were examined using structural equation modeling.

Results

Results demonstrated that the two-factor model fitted the data well. While negative symptoms were mildly to moderately associated with cognition, we found that DEE had unique associations with cognition compared to social avolition, contributing to the validity of the constructs and suggesting the possibility of common underlying substrates in negative symptoms and cognition.

Conclusions

Our study highlighted the need to classify DEE and social avolition separately as both are necessary in refining the complex relationship between negative symptoms and cognition as well as potentially guiding treatment and management of schizophrenia.

Keywords

Diminished emotional expressionexecutive functionfluencymemorysocial avolitionspeedvigilance
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 10 , July 2016 , pp. 2169 - 2177
Copyright
Copyright © Cambridge University Press 2016 

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