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 language | English |
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Pages (from-to) | 499-505 |
Number of pages | 7 |
Journal | Journal of Psychiatric Research |
Volume | 44 |
Issue number | 8 |
DOIs | |
State | Published - Jun 2010 |
Externally published | Yes |
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.
Funders | Funder number |
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National Institute of Mental Health | |
U.S. Department of Veterans Affairs |
Keywords
- Dysfunctional attitudes
- Negative symptoms
- Outcome
- Recovery
- Schizophrenia
- Structural equation modeling