McClure Margaret M, Bowie Christopher R, Patterson Thomas L, Heaton Robert K, Weaver Christine, Anderson Hannah, Harvey Philip D
Department of Veterans Affairs, VISN-3 Mental Illness Research, Education, and Clinical Center (MIRECC), 130 West Kingsbridge Road Bronx, NY 10468, USA.
Schizophr Res. 2007 Jan;89(1-3):330-8. doi: 10.1016/j.schres.2006.07.024. Epub 2006 Sep 18.
Neuropsychological (NP) performance is a consistent correlate of everyday functioning in schizophrenia, but it is unclear whether relationships between individual NP ability areas and domains of everyday functioning are general or specific. Assessments of real-world everyday functioning may be influenced by environmental and social factors (e.g., social security, disability status, opportunities and restrictions in living situations). This study examined the specificity of the relationships between different NP abilities and performance-based measures of social and living skills.
181 ambulatory older (age>50) patients with schizophrenia were examined with NP tests measuring episodic and working memory, executive functioning, verbal fluency, and processing speed. All subjects performed tasks examining social (Social Skills Performance Assessment: SSPA) and everyday living (UCSD Performance Based Skills Assessment: UPSA) skills.
Using canonical analysis, the NP variables were used to predict the functional capacity measures. The analysis found that 37% of the variance in the functional capacity and NP measures was shared, X(2) (54)=106.29, p<.001. Two canonical roots described the cognitive variables and the roots were differentially associated with everyday living and social skills. The root loading on processing speed, episodic memory, and executive functions were associated with UPSA scores, while the root loading on working and episodic memory and verbal fluency were associated most strongly with social competence.
Social and everyday living skills deficits in patients with schizophrenia may reflect generally independent domains of functional outcome, linked through cognitive performance. The data suggest that somewhat different cognitive processes are associated with these two domains of functional capacity, although there appears to be some overlap, which may be due to the nature of the NP tests employed.
神经心理学（NP）表现是精神分裂症患者日常功能的一个持续相关因素，但个体NP能力领域与日常功能领域之间的关系是普遍的还是特定的尚不清楚。对现实世界中日常功能的评估可能会受到环境和社会因素（如社会保障、残疾状况、生活环境中的机会和限制）的影响。本研究考察了不同NP能力与基于表现的社会和生活技能测量之间关系的特异性。
对181名年龄大于50岁的门诊精神分裂症患者进行NP测试，测量情景记忆和工作记忆、执行功能、语言流畅性和处理速度。所有受试者都完成了考察社会技能（社会技能表现评估：SSPA）和日常生活技能（加利福尼亚大学圣地亚哥分校基于表现的技能评估：UPSA）的任务。
使用典型分析，NP变量被用于预测功能能力测量。分析发现，功能能力和NP测量中37%的方差是共享的，X(2)（54）=106.29，p<.001。两个典型根描述了认知变量，且这些根与日常生活技能和社会技能有不同的关联。处理速度、情景记忆和执行功能的根负荷与UPSA分数相关，而工作记忆、情景记忆和语言流畅性的根负荷与社会能力的关联最为强烈。
精神分裂症患者的社会和日常生活技能缺陷可能反映了功能结果的一般独立领域，通过认知表现相互关联。数据表明，尽管似乎存在一些重叠，这可能是由于所采用的NP测试的性质，但这两个功能能力领域与略有不同的认知过程相关。
