Clarifying the direction of impact of negative symptoms and neurocognition on prospective work functioning in psychosis: A 20-year longitudinal study.
Clarifying the direction of impact of negative symptoms and neurocognition on prospective work functioning in psychosis: A 20-year longitudinal study.
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DOI：
10.1016/j.schres.2020.03.012
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发表时间：
2020-06
影响因子：
4.5
通讯作者：
Harrow M
中科院分区：
文献类型：
--
作者：
Luther L;Suor JH;Rosen C;Jobe TH;Faull RN;Harrow M
在严重精神疾病（SMI）患者中，神经认知和阴性症状都与功能结果（如工作功能）有很强的联系。先前的模型表明，神经认知能力降低1）先于或预测更严重的阴性症状，2）通过对阴性症状的影响间接影响功能结果。目前的研究还试图测试一个不同的模型：更大的负面症状是否预示着神经认知的降低，并通过对神经认知的影响间接影响工作功能。这两个模型进行了测试，使用横截面和前瞻性数据跨越20年的样本中的277人与精神病性特征的SMI。结果表明，这两个模型都支持横截面分析。然而，在预测工作功能的前瞻性模型中，只有通过神经认知检查阴性症状对工作功能（7.5至20年后）的间接影响的模型显示出显著的中介作用（即，一个显着的间接影响）;此外，较高的阴性症状显着预测较低的前瞻性神经认知，而较低的神经认知并没有显着预测更大的前瞻性阴性症状。虽然横截面数据与先前的模型一致，但我们的前瞻性模型为从阴性症状到神经认知而不是反向到工作功能的假定因果通路提供了更大的支持。研究结果对促进纵向工作功能的机制有影响，并表明在神经认知之前针对阴性症状可能对长期工作成果更有益。
Both neurocognition and negative symptoms have demonstrated strong links to functional outcomes, such as work functioning, among those with severe mental illness (SMI). Prior models have suggested that reduced neurocognition 1) precedes or predicts greater negative symptoms and 2) indirectly influences functional outcomes via its impact on negative symptoms. The current study sought to also test a divergent model: whether greater negative symptoms predict reduced neurocognition and indirectly influence work functioning through their impact on neurocognition. Both models were tested using cross-sectional and prospective data spanning 20-years in a sample of 277 people with a SMI with psychotic features. Results showed that both models were supported in cross-sectional analyses. However, in prospective models predicting work functioning, only the models examining the indirect influence of negative symptoms on work functioning (7.5 to up to 20-years later) through neurocognition demonstrated significant mediation (i.e., a significant indirect effect); further, higher negative symptoms significantly predicted lower prospective neurocognition, while lower neurocognition did not significantly predict greater prospective negative symptoms. Although cross-sectional data were consistent with prior models, our prospective models offered greater support for a putative causal pathway running from negative symptoms to neurocognition—rather than the reverse—to work functioning. Findings have implications for mechanisms contributing to longitudinal work functioning and suggest that targeting negative symptoms prior to neurocognition could be more beneficial for long-term work outcomes.
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影响因子：
6.9
作者：
Harrow, M.;Jobe, T. H.;Faull, R. N.
通讯作者：
Faull, R. N.
DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
--
作者：
Grant, Paul M.;Huh, Gloria A.;Beck, Aaron T.
通讯作者：
Beck, Aaron T.
影响因子：
4.5
作者：
Foussias, G.;Siddiqui, I.;Remington, G.
通讯作者：
Remington, G.
影响因子：
10.5
作者：
CARPENTER, WT;SACKS, MH;RAYNER, J
通讯作者：
RAYNER, J