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Factor Structure of Neurocognition and Functional Capacity in Schizophrenia: A Multidimensional Examination of Temporal Stability

Published online by Cambridge University Press:  21 February 2013

Philip D. Harvey ,
Tenko Raykov ,
Elizabeth W. Twamley ,
Lea Vella ,
Robert K. Heaton  and
Thomas L. Patterson
Philip D. Harvey*
Affiliation:
Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida Research Service, Miami VA Medical Center, Miami, Florida
Tenko Raykov
Affiliation:
Department of Education and Measurement, Michigan State University, East Lansing, Michigan
Elizabeth W. Twamley
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California Psychiatry Service, San Diego VA Medical Center, La Jolla, California
Lea Vella
Affiliation:
Department of Psychology, UCSD-SDSU Joint Doctoral Program, San Diego, California
Robert K. Heaton
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California
Thomas L. Patterson
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California
*
Correspondence and reprint requests to: Philip D. Harvey, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1450, Miami, FL 33136. E-mail: philipdharvey1@cs.com
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Abstract

Although neurocognition is commonly described in terms of different functional domains, some factor analytic studies have suggested a simpler dimensional structure for neuropsychological (NP) tests in patients with schizophrenia. Standardized tasks of everyday functioning, or tests of “functional capacity” (FC), are viewed differently from traditional NP tests, and are hence used as a co-primary measure in treatment studies. However, FC and NP tests have been found to be highly correlated. In fact, a recent study of ours suggested that performances on these different types of tasks constituted a single latent trait in a cross-sectional analysis. The current study examined the longitudinal factor structure of a combined set of NP and FC tests. Patients with schizophrenia (n = 195) were examined at two assessment occasions separated by periods ranging from 6 weeks to 6 months. Participants were assessed with the MATRICS Consensus Cognitive Battery (MCCB) and two performance-based assessments of FC. A single latent trait was extracted using full information maximum likelihood procedures, and its temporal stability was examined in terms of: stability of the latent trait scores, the inter-correlations of the three indicators of the latent trait, and the stability of loadings for the FC and NP items underlying the latent trait at the two measurement occasions. All indices of temporal stability were confirmed, with stability not related to follow-up duration. Variation in clinical symptoms and treatments across the measurement occasions was negligible. These findings raise the question of whether cognitive abilities measured by NP tests and FC instruments are tapping a single ability construct, which might have shared causal influences as well. (JINS, 2013, 19, 1–8)

Keywords

NeuropsychologyDisabilityLatent traitsLongitudinal studiesFunctional capacityLinear models
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 6 , July 2013 , pp. 656 - 663
Copyright
Copyright © The International Neuropsychological Society 2013 

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