Biosocial pathways to functional outcome in schizophrenia

John Brekke, Diane D. Kay, Kimmy S. Lee, Michael F. Green

Research output: Contribution to journalArticlepeer-review

343 Scopus citations

Abstract

Biosocial models are preeminent in the study of schizophrenia, yet there has been little empirical testing of these models. Objective: This study provided the first test of a biosocial causal model of functional outcome in schizophrenia, using neurocognition, social cognition, social competence and social support as predictors of both global and specific domains of functional outcome. Method: The design used baseline variables to predict both concurrent functional status and prospective 12-month functional outcome. Subjects were recruited upon admission to outpatient community-based psychosocial rehabilitation programs shown in previous studies to be effective in improving functional outcomes. 139 individuals diagnosed with schizophrenia or schizoaffective disorder participated in the study; 100 participants completed the 12-month assessments. Face-to-face interviews assessed neurocognitive functioning (with five neuropsychological measures), social cognition (as perception of emotion), social competence, social support, and functional outcome which consisted of items covering the domains of social, independent living, and work functioning. Results: Path analysis modeling showed that the proposed biosocial models had strong fit with the data, for both concurrent and 12-month global functional outcomes, with fit indices ranging from .95 to .98. The model explained 21% of the variance in concurrent global functional outcome, and 14% of the variance in 12-month prospective outcome. Conclusions: The support for this model was strong, and it has implications for understanding the causal factors related to functional outcome, as well as for intervention strategies for improving functional outcomes in schizophrenia.

Original languageEnglish
Pages (from-to)213-225
Number of pages13
JournalSchizophrenia Research
Volume80
Issue number2-3
DOIs
StatePublished - 15 Dec 2005
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by grants MH53282 and MH01628 from the National Institute of Mental Health awarded to the first author, and by the Department of Veterans Affair VISN 22 Mental Illness Research Education and Clinical Center.

Funding

This research was supported by grants MH53282 and MH01628 from the National Institute of Mental Health awarded to the first author, and by the Department of Veterans Affair VISN 22 Mental Illness Research Education and Clinical Center.

FundersFunder number
National Institute of Mental HealthR01MH053282
U.S. Department of Veterans Affairs

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