Self-report versus performance based executive functioning in people with psychotic disorders

IF 2.3 Q2 PSYCHIATRY Schizophrenia Research-Cognition Pub Date : 2023-10-20 DOI:10.1016/j.scog.2023.100293
B.C. van Aken , R. Rietveld , A.I. Wierdsma , Y. Voskes , G.H.M. Pijnenborg , J. van Weeghel , C.L. Mulder
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Abstract

Background

Although executive functioning is often measured using performance-based measures, these measures have their limits, and self-report measures may provide added value. Especially since these two types of measures often do not correlate with one another. It thus has been proposed they might measure different aspects of the same construct. To explore the differences between a performance-based measure of executive functioning and a self-report measure, we examined their associations in patients with a psychotic disorder with the following: other neurocognitive measures; psychotic symptoms; anxiety and depression symptoms, and daily-life outcome measures.

Method

This cross-sectional study consisted of baseline measures collected as part of a cohort study of people with a psychotic disorder (the UP'S study; n = 301). The Behavioral Rating Inventory of Executive Functioning Adult version (BRIEF-A) was used to assess self-rated executive functioning, and the Tower of London (TOL) to assess performance-based executive functioning. Generalized linear models (GLM) were used with the appropriate distribution and link function to study the associations between TOL and BRIEF-A, and the other variables, including the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Symptoms Scale-Remission (PANSS-R), the General Anxiety Disorder – 7 (GAD-7), the Patient Health Questionnaire – 9 (PHQ-9) and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Model selection was based on the Wald test.

Results

The TOL was associated with other neurocognitive measures, such as verbal list learning (β = 0.24), digit sequencing (β = 0.35); token motor task (β = 0.20); verbal fluency (β = 0.24); symbol coding (β = 0.43); and a screener for intelligence (β = 2.02). It was not associated with PANNS-R or WHO-DAS scores. In contrast, the BRIEF-A was associated not with other neurocognitive measures, but with the PANSS-R (β = 0.32); PHQ-9 (β = 0.52); and GAD-7 (β = 0.55); and with all the WHODAS domains: cognition domain (β = 0.54), mobility domain (β = 0.30) and selfcare domain (β = 0.22).

Conclusion

Performance-based and self-report measures of executive functioning measure different aspects of executive functioning. Both have different associations with neurocognition, symptomatology and daily functioning measures. The difference between the two instruments is probably due to differences in the underlying construct assessed.

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精神病患者的自我报告与基于表现的执行功能
背景尽管执行功能通常使用基于绩效的衡量标准来衡量,但这些衡量标准有其局限性,自我报告的衡量标准可能会带来附加值。特别是因为这两种类型的度量通常彼此不相关。因此有人提出,它们可以测量同一结构的不同方面。为了探索基于绩效的执行功能测量和自我报告测量之间的差异,我们研究了它们在精神病患者中与以下方面的关系:其他神经认知测量;精神病症状;焦虑和抑郁症状以及日常生活结果测量。方法这项横断面研究包括作为精神病患者队列研究的一部分收集的基线测量(UP研究;n=301)。成人版执行功能行为评定量表(BRIEF-A)用于评估自我评定的执行功能,伦敦塔(TOL)用于评估基于绩效的执行功能。使用具有适当分布和链接函数的广义线性模型(GLM)来研究TOL和BRIEF-A以及其他变量之间的关系,包括精神分裂症认知简要评估(BACS)、阳性和阴性症状量表缓解(PANSS-R)、一般性焦虑症-7(GAD-7),患者健康问卷-9(PHQ-9)和世界卫生组织残疾评估表2.0(WHODAS 2.0)。模型选择基于Wald检验。结果TOL与其他神经认知指标相关,如言语列表学习(β=0.24)、数字排序(β=0.35);表征运动任务(β=0.20);语言流利度(β=0.24);符号编码(β=0.43);与PANNS-R或WHO-DAS评分无关。相反,BRIEF-A与其他神经认知指标无关,但与PANSS-R相关(β=0.32);PHQ-9(β=0.52);β=0.55);以及WHODAS的所有领域:认知领域(β=0.54)、行动领域(β0.30)和自我照顾领域(β0.22)。两者都与神经认知、症状学和日常功能测量有不同的联系。这两种工具之间的差异可能是由于所评估的基本结构存在差异。
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来源期刊
CiteScore
5.60
自引率
10.70%
发文量
54
审稿时长
67 days
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