Pathways between early visual processing and functional outcome in schizophrenia
Pathways between early visual processing and functional outcome in schizophrenia
复制标题
DOI：
10.1017/s0033291710001054
复制
发表时间：
2011-03-01
影响因子：
6.9
通讯作者：
Green, M. F.
中科院分区：
文献类型：
--
作者：
Rassovsky, Y.;Horan, W. P.;Green, M. F.
背景。在精神分裂症中可以可靠地检测到早期视觉处理缺陷，并显示出与现实世界功能不良的关系。然而，这种关系的性质是复杂的。理论模型和最近使用统计建模方法的研究表明，涉及多种干预因素。我们之前报道过，视觉处理和功能状态之间存在直接而显着的关联，这是通过社会感知的测量来调节的。本研究检验了阴性症状对该模型的贡献。方法。我们利用 174 名精神分裂症门诊患者的数据，采用结构方程模型 (SEM) 来测试几种结果模型。具体来说，我们检查了早期视觉处理、社会感知和阴性症状对功能结果的直接和间接相对贡献。结果。首先，我们发现，与社会感知类似，阴性症状的测量介导了视觉信息处理和功能状态之间的关联。其次，我们发现阴性症状的纳入大大增强了模型的解释力。值得注意的是，负性症状（无欲和快感缺乏）的体验方面比表达方面（情感扁平和失语）更能解释功能结果的显着差异，特别是在功能结果构建的社会成分方面。结论。社会认知和阴性症状在精神分裂症的功能障碍中发挥着相关作用。社会认知和消极症状在统计上都介导了视觉处理和功能结果之间的联系。然而，鉴于社会认知和阴性症状之间缺乏关联，这些结构似乎通过不同的途径对功能产生影响。
Background. Early visual processing deficits are reliably detected in schizophrenia and show relationships to poor real-world functioning. However, the nature of this relationship is complex. Theoretical models and recent studies using statistical modeling approaches suggest that multiple intervening factors are involved. We previously reported that a direct and significant association between visual processing and functional status was mediated by a measure of social perception. The present study examined the contribution of negative symptoms to this model.Method. We employed structural equation modeling (SEM) to test several models of outcome, using data from 174 schizophrenia out-patients. Specifically, we examined the direct and indirect relative contributions of early visual processing, social perception and negative symptoms to functional outcome.Results. First, we found that, similar to social perception, a measure of negative symptoms mediated the association between visual information processing and functional status. Second, we found that the inclusion of negative symptoms substantially enhanced the explanatory power of the model. Notably, it was the experiential aspect of negative symptoms (avolition and anhedonia) more than the expressive aspect (affective flattening and alogia) that accounted for significant variance in functional outcome, especially in the social component of the construct of functional outcome.Conclusions. Social perception and negative symptoms play relevant roles in functional impairment in schizophrenia. Both social perception and negative symptoms statistically mediate the connection between visual processing and functional outcome. However, given the lack of association between social perception and negative symptoms, these constructs appear to have an impact on functioning through separate pathways.