Distress tolerance has fuzzy boundaries with neighboring emotion regulation abilities. In the present study, we probed the structure of this domain and examined its link to emotional disorder outcomes. We recruited mental health patient ( ns = 225 and 210) and university student ( n = 1,525) samples to report on diverse components of distress tolerance, emotion dysregulation, experiential avoidance, and anxiety sensitivity. Confirmatory factor analysis supported a one-factor model of these individual differences; this broad dimension was closely related to depressive symptoms (standardized effect range = .63 to .74) and suicide risk (.42 to .50), and it was almost perfectly associated with a latent dimension representing borderline personality disorder features (.93-.97). We conclude that a reformulation of this domain—with special attention to discriminant validity—would help understand how distress tolerance is so intimately intertwined with emotional health. The data sets and analysis code for this study are published at https://osf.io/8ab2v/ .
Objective: The purpose of this study is to identify subgroups of people with schizophrenia on the basis of self-assessment accuracy (metacognition) and examine group differences in rehabilitation potential. Method: Participants were 51 individuals with schizophrenia-spectrum disorders recruited from community mental health centers. Data from a self-report measure of cognition and a neuropsychological battery were compared and utilized to place participants in 3 accuracy groups: overestimators, accurate estimators, and underestimators. A multivariate analysis of variance was used to compare performance between accuracy groups on an index of rehabilitation potential. Results: Three distinct profiles of metacognitive ability were identified. The analysis found that participants who underestimated their cognitive functioning had the highest scores on an index of rehabilitation potential (learning potential), and those who overestimated their functioning had the lowest. No significant differences in diagnostic or sociodemographic variables were found among accuracy groups. Conclusions and Implications for Practice: Results suggest that there are differences in the way people with schizophrenia evaluate their cognition and, further, these metacognitive profiles are associated with differences in the ability to learn new tasks quickly. Thus, identifying subgroups of individuals based on metacognitive processing may help identify those most likely to benefit from cognitive remediation and other rehabilitative therapies. Future research should explore the link between metacognitive ability and rehabilitation potential in greater detail. Future investigations should also clarify the implications that underestimation of ability has for overall recovery and quality of life in people with schizophrenia.
Objective: To characterize variability in daily life functioning among individuals with serious mental illness based on a naturalistic performance measure of grocery shopping and standard neuropsychological tasks using cluster analytic methods. Methods: A naturalistic performance measure, the Test of Grocery Shopping Skills (TOGSS), and standard neuropsychological tasks, were completed by 191 participants with serious mental illness. Hierarchical cluster analytic techniques were used to explore functional subgroups based on naturalistic performance measure variables. Multivariate analyses of variance were utilized to compare subgroups on TOGSS variables and neuropsychological measures, respectively. Results: Two distinct functional subgroups emerged from the cluster analysis. On average, participants in cluster one were faster, more efficient, and more accurate compared to cluster two. Based on performance on neuropsychological tasks, cluster one had better verbal memory, visual attention, and processing speed, and executive functioning scores, compared to cluster two. The clusters did not differ on a measure of auditory working memory. Conclusions and Implications for Practice: Naturalistic performance measures can assist with characterizing the heterogeneity in real life functioning among people with serious mental illness. Further work to illuminate the relationship between specific cognitive abilities and specific functional abilities is warranted and may assist with targeting effective treatment plans for functional recovery.
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