Schretlen David J, Peña Javier, Aretouli Eleni, Orue Izaskun, Cascella Nicola G, Pearlson Godfrey D, Ojeda Natalia
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bipolar Disord. 2013 Jun;15(4):422-33. doi: 10.1111/bdi.12075. Epub 2013 May 9.
We sought to determine whether a single hypothesized latent factor structure would characterize cognitive functioning in three distinct groups.
We assessed 576 adults (340 community controls, 126 adults with bipolar disorder, and 110 adults with schizophrenia) using 15 measures derived from nine cognitive tests. Confirmatory factor analysis (CFA) was conducted to examine the fit of a hypothesized six-factor model. The hypothesized factors included attention, psychomotor speed, verbal memory, visual memory, ideational fluency, and executive functioning.
The six-factor model provided an excellent fit for all three groups [for community controls, root mean square error of approximation (RMSEA) <0.048 and comparative fit index (CFI) = 0.99; for adults with bipolar disorder, RMSEA = 0.071 and CFI = 0.99; and for adults with schizophrenia, RMSEA = 0.06 and CFI = 0.98]. Alternate models that combined fluency with processing speed or verbal and visual memory reduced the goodness of fit. Multi-group CFA results supported factor invariance across the three groups.
Confirmatory factor analysis supported a single six-factor structure of cognitive functioning among patients with schizophrenia or bipolar disorder and community controls. While the three groups clearly differ in level of performance, they share a common underlying architecture of information processing abilities. These cognitive factors could provide useful targets for clinical trials of treatments that aim to enhance information processing in persons with neurological and neuropsychiatric disorders.
我们试图确定单一的假设潜在因素结构是否能表征三个不同组的认知功能。
我们使用来自九项认知测试的15项指标评估了576名成年人（340名社区对照者、126名双相情感障碍成年人和110名精神分裂症成年人）。进行验证性因素分析（CFA）以检验假设的六因素模型的拟合度。假设的因素包括注意力、心理运动速度、言语记忆、视觉记忆、思维流畅性和执行功能。
六因素模型对所有三组均提供了极佳的拟合度[对于社区对照者，近似均方根误差（RMSEA）<0.048且比较拟合指数（CFI）=0.99；对于双相情感障碍成年人，RMSEA = 0.071且CFI = 0.99；对于精神分裂症成年人，RMSEA = 0.06且CFI = 0.98]。将流畅性与处理速度或言语和视觉记忆相结合的替代模型降低了拟合优度。多组CFA结果支持三组间的因素不变性。
验证性因素分析支持精神分裂症或双相情感障碍患者及社区对照者认知功能的单一六因素结构。虽然三组在表现水平上明显不同，但它们共享信息处理能力的共同潜在架构。这些认知因素可为旨在增强神经和神经精神疾病患者信息处理能力的治疗临床试验提供有用的靶点。
