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精神分裂症中经验定义的执行功能缺陷模式及其与日常功能的关系:一种以个体为中心的方法。

Empirically defined patterns of executive function deficits in schizophrenia and their relation to everyday functioning: a person-centered approach.

机构信息

Temple University, Philadelphia, PA 19122, USA.

出版信息

Clin Neuropsychol. 2012;26(7):1166-85. doi: 10.1080/13854046.2012.721399. Epub 2012 Oct 4.

Abstract

Executive function (EF) deficits in schizophrenia (SZ) are well documented, although much less is known about patterns of EF deficits and their association to differential impairments in everyday functioning. The present study empirically defined SZ groups based on measures of various EF abilities and then compared these EF groups on everyday action errors. Participants (n = 45) completed various subtests from the Delis-Kaplan Executive Function System (D-KEFS) and the Naturalistic Action Test (NAT), a performance-based measure of everyday action that yields scores reflecting total errors and a range of different error types (e.g., omission, perseveration). Results of a latent class analysis revealed three distinct EF groups, characterized by (a) multiple EF deficits, (b) relatively spared EF, and (c) perseverative responding. Follow-up analyses revealed that the classes differed significantly on NAT total errors, total commission errors, and total perseveration errors; the two classes with EF impairment performed comparably on the NAT but performed worse than the class with relatively spared EF. In sum, people with SZ demonstrate variable patterns of EF deficits, and distinct aspects of these EF deficit patterns (i.e., poor mental control abilities) may be associated with everyday functioning capabilities.

摘要

精神分裂症(SZ)患者的执行功能(EF)缺陷已有大量记载,但其 EF 缺陷模式及其与日常功能差异的关联则知之甚少。本研究基于各种 EF 能力的测量,对 SZ 患者进行了实证分组,然后比较了这些 EF 分组在日常行为错误方面的表现。参与者(n=45)完成了 Delis-Kaplan 执行功能系统(D-KEFS)和自然行为测试(NAT)的各种子测试,NAT 是一种基于表现的日常行为测试,其分数反映了总错误和多种不同错误类型(例如遗漏、固着)。潜在类别分析的结果显示了三个不同的 EF 组,其特点分别为(a)多种 EF 缺陷,(b)相对保留的 EF,和(c)固着反应。后续分析显示,NAT 总错误、总错误数和总固着错误数在这三个组之间存在显著差异;EF 受损的两个组在 NAT 上的表现相当,但比 EF 相对保留的组差。总之,SZ 患者表现出不同模式的 EF 缺陷,而这些 EF 缺陷模式的不同方面(即较差的心理控制能力)可能与日常功能能力相关。

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