Brekke J S, Raine A, Ansel M, Lencz T, Bird L
School of Social Work, University of Southern California, Los Angeles 90089-0411, USA.
Schizophr Bull. 1997;23(1):19-28. doi: 10.1093/schbul/23.1.19.
This study tested hypothesized relationships between neuropsychological and psychophysiological variables and concurrent levels of clinical and psychosocial functioning in schizophrenia. The sample consisted of 40 subjects diagnosed with a chronic schizophrenia spectrum disorder and living in community-based settings. The psychophysiological variables were tonic skin conductance (SC) level, SC reactivity to stressors, and SC response to orienting stimuli. The neuropsychological measures were the Stroop, the Controlled Word Association Test, and four subtests of the Wechsler Adult Intelligence Scale-Revised (block design, digit symbol, digit span, and arithmetic). The psychosocial variables were measures of symptomatology, independent living, work, and social functioning. The results suggested that higher symptoms were associated with higher resting arousal, lower stress reactivity, status as an electrodermal responder, and deficits in verbal fluency and visuo-motor functioning. The pattern for better social functioning was higher resting arousal, lower stress reactivity, and more responses to orienting stimuli. Higher levels of independent living were associated with better visuo-motor and verbal processing. Increased work functioning was associated with better complex visuo-spatial processing. These findings are discussed in terms of (1) the specificity of associations between psychosocial, psychophysiological, and neuropsychological variables and (2) a holistic perspective toward understanding these relationships and their relevance to rehabilitation in schizophrenia.
本研究检验了精神分裂症患者神经心理学和心理生理学变量与临床及心理社会功能的并发水平之间的假设关系。样本包括40名被诊断患有慢性精神分裂症谱系障碍且生活在社区环境中的受试者。心理生理学变量包括静息皮肤电导率(SC)水平、对压力源的SC反应性以及对定向刺激的SC反应。神经心理学测量包括斯特鲁普测验、受控词语联想测验以及韦氏成人智力量表修订版的四个子测验(积木图案、数字符号、数字广度和算术)。心理社会变量包括症状学、独立生活、工作和社会功能的测量。结果表明,较高的症状与较高的静息唤醒水平、较低的应激反应性、作为皮肤电反应者的状态以及言语流畅性和视觉运动功能缺陷有关。更好的社会功能模式是较高的静息唤醒水平、较低的应激反应性以及对定向刺激的更多反应。较高的独立生活水平与更好的视觉运动和言语加工能力有关。工作功能的提高与更好的复杂视觉空间加工能力有关。这些发现从以下两个方面进行了讨论:(1)心理社会、心理生理和神经心理变量之间关联的特异性;(2)理解这些关系及其与精神分裂症康复相关性的整体视角。