Ecological assessment of executive dysfunction in the psychosis prodrome: A pilot study

Abstract

Individuals with psychosis have prominent executive functioning (EF) deficits on neuropsychological tests, but their relationship to EF deficits in daily life is unclear. This study evaluates behavioral manifestations of EF deficits, assessed by the Behavioral Rating Inventory of Executive Functioning (BRIEF), and their clinical correlates in individuals at ultra-high-risk for psychosis (UHR). UHR subjects showed significantly elevated BRIEF scores, particularly on the Working Memory scale. BRIEF scores were associated with positive symptoms and functioning, but not with neuropsychological performance. The BRIEF appears to capture unique aspects of executive dysfunction, possibly associated with illness progression and functioning in the psychosis prodrome.

Neuroimaging correlates of parent ratings of working memory in typically developing children

“…Nevertheless, given the relative time and cost efficiency of caregiver ratings (compared with performance-based assessments), they may play an important role in screening, and as an integral part of comprehensive neuropsychological and developmental evaluations. Consistent with previous studies examining the validity of the BRIEF in predicting neuropsychological test performance (Anderson et al, 2002; Bodnar et al, 2007; Mahone et al, 2002b; Niendam et al, 2007; Vriezen & Pigott, 2002), the BRIEF appears to capture different elements of the EF construct than do performance-based measures. When used together with performance-based tests, the BRIEF may be a better predictor of integrity of frontal lobe development.…”

What drives poor functioning in the at-risk mental state? A systematic review

“…However, significant improvement in social functioning was associated with improved processing speed, visual learning and memory (Niendam et al, 2007b).…”

“…Observational studies suggest that antipsychotic medication use is unrelated to social or occupational functioning (Niendam et al, 2007b;Jang et al, 2011), subjective satisfaction with social relationships or long-term functional recovery (Schlosser et al, 2012;Carrión et al, 2013). Despite no differences in cognitive impairment or positive symptoms, patients in one study who were taking antipsychotic medication exhibited significantly poorer functioning (Niendam et al, 2006b).…”

“…Two small studies reported that neurocognitive performance at baseline was not predictive of subsequent functional outcome (Niendam et al, 2007b;Ziermans et al, 2014). However, significant improvement in social functioning was associated with improved processing speed, visual learning and memory (Niendam et al, 2007b).…”

Premorbid cognitive deficits in young relatives of schizophrenia patients

“…A large body of evidence shows social cognition aberrations to be the predominant cognitive deficit in the prodrome, a phase that often progresses to psychotic disorder (Moller and Husby, 2000; Cohen et al, 2006; Niendam et al, 2006, 2007a; Simon et al, 2006; Cannon et al, 2008; Chung et al, 2008). Social dysfunction is a predictor of future positive symptoms (Moller and Husby, 2000; Cohen et al, 2006; Niendam et al, 2006; Cannon et al, 2008) and influences prodromal morbidity and functioning more than other neurocognitive deficits (Niendam et al, 2006, 2007b; Simon et al, 2006; Calkins et al, 2007; Shim et al, 2008; O'Brien et al, 2009).…”