Further support for the role of dysfunctional attitudes in models of real-world functioning in schizophrenia

William P. Horan, Yuri Rassovsky, Robert S. Kern, Junghee Lee, Jonathan K. Wynn, Michael F. Green

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

According to A.T. Beck and colleagues' cognitive formulation of poor functioning in schizophrenia, maladaptive cognitive appraisals play a key role in the expression and persistence of negative symptoms and associated real-world functioning deficits. They provided initial support for this model by showing that dysfunctional attitudes are elevated in schizophrenia and account for significant variance in negative symptoms and subjective quality of life. The current study used structural equation modeling to further evaluate the contribution of dysfunctional attitudes to outcome in schizophrenia. One hundred eleven outpatients and 67 healthy controls completed a Dysfunctional Attitudes Scale, and patients completed a competence measure of functional capacity, clinical ratings of negative symptoms, and interview-based ratings of real-world functioning. Patients reported higher defeatist performance beliefs than controls and these were significantly related to lower functional capacity, higher negative symptoms, and worse community functioning. Consistent with Beck and colleagues' formulation, modeling analyses indicated a significant indirect pathway from functional capacity → dysfunctional attitudes → negative symptoms → real-world functioning. These findings support the value of dysfunctional attitudes for understanding the determinants of outcome in schizophrenia and suggest that therapeutic interventions targeting these attitudes may facilitate functional recovery.

Original languageEnglish
Pages (from-to)499-505
Number of pages7
JournalJournal of Psychiatric Research
Volume44
Issue number8
DOIs
StatePublished - Jun 2010
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by Research Grants MH077141 (to W.P.H.), MH43292 and MH65707 (to M.F.G.) from the National Institute of Mental Health, and by the Department of Veterans Affairs, Veterans Integrated Service Network 22, Mental Illness Research Education and Clinical Center.

Funding

This research was supported by Research Grants MH077141 (to W.P.H.), MH43292 and MH65707 (to M.F.G.) from the National Institute of Mental Health, and by the Department of Veterans Affairs, Veterans Integrated Service Network 22, Mental Illness Research Education and Clinical Center.

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

    Keywords

    • Dysfunctional attitudes
    • Negative symptoms
    • Outcome
    • Recovery
    • Schizophrenia
    • Structural equation modeling

    Fingerprint

    Dive into the research topics of 'Further support for the role of dysfunctional attitudes in models of real-world functioning in schizophrenia'. Together they form a unique fingerprint.

    Cite this