Social cognition has been suggested to be an important mediating variable in the relationship between neurocognition and functional outcome. The present study tested this model in relation to work rehabilitation outcome and added self-reported social discomfort as a possible mediator. One hundred fifty-one participants with schizophrenia or schizoaffective disorder participated in a 26-week work therapy program. Neurocognition was constructed as a latent construct comprised of selected variables from our intake test battery representing executive functioning, verbal memory, attention and working memory, processing speed, and thought disorder. Social cognition at intake was the other latent construct comprised of variables representing affect recognition, theory of mind, self-reported egocentricity, and ratings of rapport. The 2 latent constructs received support from confirmatory factor analysis. Social discomfort on the job was based on their self-report on a weekly questionnaire. In addition, we constructed a composite rehabilitation outcome that was based on how many hours they worked, how well they worked, and how complex was the job that they were doing. Path analysis showed direct effects of neurocognition on rehabilitation outcome and indirect effects mediated by social cognition and social discomfort. This model proved to be a good fit to the data and far superior to another model where only social cognition was the mediating variable between neurocognition and rehabilitation outcome. Findings suggest that neurocognition affects social cognition and that poorer social cognition leads to social discomfort on the job, which in turn leads to poorer rehabilitation outcomes. Implications for rehabilitation interventions are discussed.
The purpose of this study was to explore the relationship between Theory of Mind (ToM) performance and schizophrenia subtype, symptom, and neuropsychological variables. One hundred twenty-eight stable outpatients with schizophrenia or schizoaffective disorder were assessed during the intake phase of a vocational and cognitive rehabilitation study. Results indicate that ToM performance differed significantly by schizophrenia diagnosis, with people diagnosed with disorganized schizophrenia performing the most poorly. Theory of Mind performance was also significantly correlated with measures of thought disorder and verbal memory. Regression analysis revealed that thought disorder and verbal memory measures explained 30% of the variance in ToM scores. Findings suggest that there is theory of mind variance in the schizophrenia population and theory of mind is strongly related to thought disorder, verbal memory, and cognitive disorganization. Contrary to previous reports, ToM was not related to measures of paranoia.
Abstract-Cognitive deficits are a major determinant of social and occupational dysfunction in schizophrenia, and new treatments are needed that address these impairments. The current study determined whether neurocognitive enhancement therapy (NET) in combination with work therapy (WT) would show improvement in performance on neuropsychological tests that endured 6 months after completion of training. A total of 145 participants with schizophrenia or schizoaffective disorder were randomly assigned to NET + WT or WT alone. NET included computer-based training on attention, memory, and executive function tasks. WT included paid work activity in job placements at the medical center. Neuropsychological assessment was performed at baseline, at the end of the 6-month active intervention, and 12 months after training began. Repeated measures multivariate analyses of variance revealed greater neuropsychological improvements on working memory (p < 0.05) and executive function (p < 0.05) for the NET + WT group over the 12 months. Both groups showed sustained improvements on verbal and nonverbal memory.Clinical Trial Registration: ClinicalTrials.gov, NCT00430560; .
This article describes the development and initial score validation of the 20-item Teacher Multicultural Attitude Survey (TMAS), a unidimensional self-report inventory of teachers' multicultural awareness and sensitivity. In two separate studies, a principal components analysis supported a global factor of multicultural awareness. Construct validity of TMAS scores was further established through convergent correlations with related instruments. Criterion validity was demonstrated using the group differences approach with sample cohort groups. Multiple measures of internal consistency and a test-retest stability assessment indicated satisfactory levels of score reliability. Finally, a social desirability assessment indicated no contamination of the TMAS.
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