Haugen Ingvild, Stubberud Jan, Ueland Torill, Haug Elisabeth, Øie Merete Glenne
Research Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway.
Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway.
Schizophr Res Cogn. 2021 Jun 15;26:100201. doi: 10.1016/j.scog.2021.100201. eCollection 2021 Dec.
This study aimed to investigate what characterizes individuals with schizophrenia who experience more or less subjective executive dysfunction in everyday life compared to objective executive performance on neuropsychological tests. Sixty-six participants with broad schizophrenia spectrum disorders completed a comprehensive assessment of executive function. Discrepancies between performance on neuropsychological tests (objective) and an extensive self-report questionnaire (subjective) of central executive functions (inhibition, shifting and working memory) were calculated. Higher level of self-efficacy was the best predictor of experiencing fewer subjective cognitive complaints compared to objective performance, followed by higher levels of disorganized symptoms. Depressive symptoms did not predict discrepancy between subjective and objective executive function. Higher estimated IQ predicted greater subjective working memory difficulties in everyday life despite better objective performance. Results may aid clinicians in the assessment and remediation of cognitive impairment. Low self-efficacy may identify individuals who are not able to utilize their potential executive functions in daily life. Interventions aimed at fostering self-efficacy ought to be included in cognitive remediation for these individuals. Disorganized symptoms could prove useful in identifying individuals who are in need of cognitive remediation for executive dysfunction, despite that they overestimate their skills. These individuals may benefit from efforts to increase insight into cognitive dysfunction.
本研究旨在调查与神经心理测试中的客观执行表现相比，日常生活中经历或多或少主观执行功能障碍的精神分裂症患者有何特征。66名患有广泛精神分裂症谱系障碍的参与者完成了一项全面的执行功能评估。计算了神经心理测试（客观）表现与一份关于中央执行功能（抑制、转换和工作记忆）的广泛自我报告问卷（主观）之间的差异。与客观表现相比，较高水平的自我效能感是主观认知抱怨较少的最佳预测因素，其次是较高水平的紊乱症状。抑郁症状并不能预测主观和客观执行功能之间的差异。尽管客观表现较好，但较高的估计智商预示着日常生活中主观工作记忆困难更大。研究结果可能有助于临床医生评估和纠正认知障碍。低自我效能感可能会识别出那些在日常生活中无法发挥其潜在执行功能的个体。针对这些个体的认知康复应包括旨在提高自我效能感的干预措施。尽管紊乱症状会导致个体高估自己的技能，但它们可能有助于识别那些需要针对执行功能障碍进行认知康复的个体。这些个体可能会从增强对认知功能障碍的洞察力的努力中受益。
