Schizophrenia Research-Cognition最新文献

{"title":"Commentary on Ziermans, Hadjúk, Pinkham et al. “Call to action on social cognition measures in clinical research” and on Happé's commentary to the call to action","authors":"Silvia Corbera , Michal Assaf","doi":"10.1016/j.scog.2026.100421","DOIUrl":"10.1016/j.scog.2026.100421","url":null,"abstract":"","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"44 ","pages":"Article 100421"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premorbid functioning trajectories and the one-year course of cognitive performance in first-episode psychosis: a cluster analysis in PSYSCAN","authors":"Margot I.E. Slot ,&nbsp;Hendrika H. van Hell ,&nbsp;Inge Winter-van Rossum ,&nbsp;George Gifford ,&nbsp;Paola Dazzan ,&nbsp;Arija Maat ,&nbsp;Lieuwe De Haan ,&nbsp;Benedicto Crespo-Facorro ,&nbsp;Birte Y. Glenthøj ,&nbsp;Colm McDonald ,&nbsp;Thérèse van Amelsvoort ,&nbsp;Celso Arango ,&nbsp;Irina Falkenberg ,&nbsp;Barnaby Nelson ,&nbsp;Silvana Galderisi ,&nbsp;Mark Weiser ,&nbsp;Gabriele Sachs ,&nbsp;Anke Maatz ,&nbsp;Jun Soo Kwon ,&nbsp;the PSYSCAN Consortium ,&nbsp;René S. Kahn","doi":"10.1016/j.scog.2025.100391","DOIUrl":"10.1016/j.scog.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>We examined the course of cognitive performance in first-episode psychosis (FEP) compared to healthy controls (HC), and whether this varied across subgroups of patients defined by premorbid functioning (PMF) trajectories, using a clustering approach.</div></div><div><h3>Methods</h3><div>Data were collected in 302 FEP and 136 HC subjects participating in PSYSCAN (HEALTH.2013.2.2.1-2-FEP). K-means clustering (Euclidean distance) was used to cluster longitudinal trajectories of different PMF domains simultaneously. Since PMF was assessed retrospectively using the Premorbid Adjustment Scale (PAS), findings should be interpreted with caution, although PAS ratings have shown reasonable validity against prospective data.</div></div><div><h3>Results</h3><div>As expected, FEP showed impaired performance across all cognitive domains compared to HC. We identified four trajectories of PMF: a normal premorbid developmental trajectory (globally-normal, 21 %), stable intermediate PMF across domains (stable-intermediate, 29 %), stable poor or deteriorating PMF in the academic domain (normal-social/poor-academic, 29 %), and a globally impaired group with poor/deteriorating PMF across domains (globally-poor, 21 %). These clusters showed distinct levels of post-onset impairments in sustained visual attention, visual working memory and emotion recognition.</div></div><div><h3>Conclusions</h3><div>This study confirms a positive association between PMF and cognitive performance in the early years following psychosis onset. It aligns with findings that individuals later diagnosed with schizophrenia already show developmental deficits/lags from childhood to early adolescence compared to normally developing children. As PMF can be considered a proxy for cognitive reserve, our results suggest that higher reserve acts as a buffer against cognitive decline and supports better performance on sustained visual attention, complex visual working memory, and aspects of emotion recognition.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100391"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call to action on social cognition measures in clinical research","authors":"T.B. Ziermans ,&nbsp;M. Hajdúk ,&nbsp;A.E. Pinkham ,&nbsp;SIRS Social Cognition Research Harmonization Group","doi":"10.1016/j.scog.2025.100400","DOIUrl":"10.1016/j.scog.2025.100400","url":null,"abstract":"<div><h3>Objective</h3><div>To describe current practices and key barriers in social cognition (SC) assessment, given its central role in psychiatric and neurological disorders and the limitations of existing measures.</div></div><div><h3>Methods</h3><div>Fifty-two SC experts from 20 countries completed an online survey regarding SC tests and questions about their usage frequency and perceived obstacles.</div></div><div><h3>Results</h3><div>Only facial emotion recognition tasks were used frequently, while the Hinting task and Reading the Mind in the Eyes Test (RMET) were used by over half of participants. However, 10 experts also urged discontinuation of RMET, mostly due to validity concerns. Major obstacles included lack of culture-appropriate norms and poor psychometric properties.</div></div><div><h3>Conclusions</h3><div>SC assessment is limited by cultural bias and weak psychometrics. Developing and validating culturally sensitive tools, harmonizing protocols, and securing funding are essential to advance research, enable international trials, and improve clinical outcomes.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"43 ","pages":"Article 100400"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equivalence verification of the electronic version of the Chinese Brief Cognitive Test (C-BCT): Focus on Chinese schizophrenia populations","authors":"Han Han ,&nbsp;Shuling Ye ,&nbsp;Mengjuan Xie ,&nbsp;Xin Yu ,&nbsp;Renrong Wu ,&nbsp;Dengtang Liu ,&nbsp;Shaohua Hu ,&nbsp;Yong Xu ,&nbsp;Huanzhong Liu ,&nbsp;Xijin Wang ,&nbsp;Gang Zhu ,&nbsp;Huaning Wang ,&nbsp;Shaohong Zou ,&nbsp;Tao Li ,&nbsp;Wanjun Guo ,&nbsp;Xiufeng Xu ,&nbsp;Yuqi Cheng ,&nbsp;Yi Li ,&nbsp;Juan Yang ,&nbsp;Min Peng ,&nbsp;Chuan Shi","doi":"10.1016/j.scog.2025.100386","DOIUrl":"10.1016/j.scog.2025.100386","url":null,"abstract":"<div><h3>Objective</h3><div>To complete the preparation of the electronic version of C-BCT, verifying the criterion validity of the electronic version of C-BCT.</div></div><div><h3>Methods</h3><div>747 healthy subjects and 139 schizophrenics completed the electronic version of C-BCT and MCCB. To measure psychotic symptoms and severity, patients with schizophrenia completed the PANSS scale. Mean, standard deviation, percentage, etc. were used to describe demographic variables. One-way analysis of variance and independent sample <em>t-</em>test were used to compare differences between groups. MCCB as a calibration tool, criterion validity was examined using Pearson product moment correlations.</div></div><div><h3>Results</h3><div>In the equivalence analysis of the healthy group, all tests have good calibration validity (<em>p</em> &lt; 0.01). SC and TMT-A showed moderate correlation (r- value ranged from 0.572 to 0.651, <em>p</em> &lt; 0.01), DS showed a weak correlation(<em>r</em> = 0.373, <em>p</em> &lt; 0.01), CPT showed a weak correlation (r- value ranged from 0.219 to 0.444, <em>p</em> &lt; 0.01), the comprehensive scores of the two sets of cognitive tools showed a strong correlation (<em>r</em> = 0.739, p &lt; 0.01). In the equivalence analysis of the patient group, TMT-A and SC showed strong correlation (r- value ranged from 0.754 to 0.803, p &lt; 0.01), DS showed a weak correlation (<em>r</em> = 0.381, <em>p</em> &lt; 0.01), the cognitive tools comprehensive score was significantly strong correlation (<em>r</em> = 0.755, p &lt; 0.01), there was no correlation between CPT(<em>p</em> &gt; 0.05). In the healthy group, there was a correlation between the scores of each subtest of the electronic version of C-BCT and the comprehensive scores of the two cognition tools, (r- value ranged from 0.261 to 0.824, <em>p</em> &lt; 0.01). In the patient group, there was a correlation between the scores of each subtest and the comprehensive scores of the two tools,(r- value ranged from 0.266 to 0.778, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The electronic version of C-BCT has been compiled. The electronic version of the C-BCT performs well in overall calibration validity and could be used to assess the cognitive function of schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100386"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the relationships between Early Childhood Adversity, Social Cognition, and Aggression in a South African Study of People Living with Schizophrenia","authors":"K. van der Walt ,&nbsp;O. Wootton ,&nbsp;J. Rokicki ,&nbsp;A. Vaskinn ,&nbsp;D. Jonker ,&nbsp;M. Campbell ,&nbsp;E. Susser ,&nbsp;U.K. Haukvik ,&nbsp;R.C. Gur ,&nbsp;D.J. Stein ,&nbsp;C. Friestad","doi":"10.1016/j.scog.2025.100382","DOIUrl":"10.1016/j.scog.2025.100382","url":null,"abstract":"<div><div>People living with schizophrenia (PLS) are at increased risk of being both victims and perpetrators of violence. Recent research suggests that social cognitive impairments may contribute to heightened aggression in schizophrenia. Childhood trauma, a well-established risk factor for both schizophrenia and aggression, is also linked to more severe cognitive deficits in PLS. Few studies have explored the relationships between childhood trauma, social cognition, and aggression in large sample sizes, particularly in low- and middle-income settings, where varying socioeconomic factors and exposure to violence may influence these associations. In this study, a subsample of participants (PLS = 585; controls = 882) from the <em>Genomics of Schizophrenia in the South African Xhosa People</em> study completed The Childhood Trauma Questionnaire (CTQ), Penn Emotion Identification Test (ER), Life History of Aggression Questionnaire (LHA), and Structured Diagnostic Interview for DSM-IV Axis I Disorders. Group differences in CTQ, ER, LHA, and selected demographic and clinical factors were assessed using <em>t</em>-tests and chi-square tests. Multivariable linear regressions were employed to test for associations among CTQ, ER, and LHA. We found that PLS had significantly higher childhood trauma and lifetime aggression scores and poorer emotion recognition performance than controls. Higher childhood trauma was associated with higher lifetime aggression and worse emotion recognition performance. However, emotion recognition performance was not associated with lifetime aggression. In this setting, childhood trauma predicts lifetime aggression and poorer emotion recognition, but there is no evidence that emotion recognition ability is related to aggression.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100382"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theory-of-mind improvement in schizophrenia after integrative cognitive remediation: which patients benefit more?","authors":"Agurne Sampedro ,&nbsp;Javier Peña ,&nbsp;Pedro Sánchez ,&nbsp;Naroa Ibarretxe-Bilbao ,&nbsp;Nagore Iriarte-Yoller ,&nbsp;Cristóbal Pavón ,&nbsp;Natalia Ojeda","doi":"10.1016/j.scog.2025.100380","DOIUrl":"10.1016/j.scog.2025.100380","url":null,"abstract":"<div><div>Social cognition, and specifically theory of mind, is considered a key factor in predicting functional outcomes and quality of life in schizophrenia. Although cognitive remediation is an effective intervention for improving theory of mind, little is known about the factors that moderate this improvement. Therefore, the aim of this study is to identify moderators of theory-of-mind improvement in schizophrenia after integrative cognitive remediation (REHACOP). Data from two randomized controlled trials were used in this secondary analysis. The sample included 182 patients (experimental group = 94; active control group = 88) from the Mental Health Network in Álava (Spain). A comprehensive assessment of clinical symptoms, neurocognition, theory of mind, and functional outcome at baseline and follow-up was carried out. Hierarchical regression analyses were used to identify moderators of theory-of-mind improvement. Regardless of the patients' initial profiles, the REHACOP was effective in improving theory of mind (<em>F</em> = 27.00, <em>p</em> &lt; .001). Regression analyses, however, revealed that baseline neurocognition (<em>β</em> = −0.223, <em>t</em> = −2.075, <em>p</em> = .039), baseline theory of mind (<em>β</em> = −0.325, <em>t</em> = −3.100, <em>p</em> = .002), and baseline positive symptoms (<em>β</em> = −0.243, <em>t</em> = −2.296, <em>p</em> = .023) played a moderating role in the improvement of theory of mind after the REHACOP. Results showed that those participants with lower baseline neurocognition and theory-of-mind scores and less positive symptoms obtained greater theory-of-mind benefits. Determining the factors that account for the different patterns of improvement after cognitive remediation could be helpful in the implementation of personalized cognitive remediation plans and for the appropriate use of healthcare resources.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100380"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired effort allocation in schizophrenia","authors":"Elodie Blouzard ,&nbsp;Fabien Cignetti ,&nbsp;Florent Meyniel ,&nbsp;Arnaud Pouchon ,&nbsp;Mircea Polosan ,&nbsp;Julien Bastin ,&nbsp;Clément Dondé","doi":"10.1016/j.scog.2025.100378","DOIUrl":"10.1016/j.scog.2025.100378","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>Effort allocation is a crucial component of amotivation in schizophrenia. This study investigates the hypothesis that schizophrenia is associated with impairments in dynamic cost/benefit decision-making processes.</div></div><div><h3>Study design</h3><div>We employed a modified version of the effort allocation task developed by Meyniel et al. (2013). Participants were asked to allocate effort during 30-s intervals to maximize their gains. We examined the effects of task difficulty and incentive levels on participants' effort allocation on a trial-by-trial basis.</div></div><div><h3>Study results</h3><div>Individuals with schizophrenia (<em>N</em> = 25) showed decreased capacity to adapt dynamically to task parameters, as compared to healthy controls (N = 25). (1) Both populations increased the duration of each effort based on difficulty. Only healthy controls decreased rest duration based on incentive. The magnitude of these adaptations was significantly decreased in people with schizophrenia (difficulty: d = 1.25, incentive: d = 0.91). (2) Both groups decreased effort re-initiations with increasing difficulty with significant differences in the magnitude of adaptation between groups. (3) Participants with schizophrenia spent less time exerting effort above the required threshold, resulting in lower overall gains compared to healthy controls (η² = 0.17).</div></div><div><h3>Conclusions</h3><div>Individuals with schizophrenia exhibit a selective impairment in effort-cost decision-making. This deficit may contribute to maladaptive behavior patterns characterized by suboptimal effort allocation and reduced goal-direct activities.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100378"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a cognitive function assessment tool based on psychomotor function tests in patients with schizophrenia","authors":"Yuma Shimizu ,&nbsp;Ippei Takeuchi ,&nbsp;Masakazu Hatano ,&nbsp;Manako Hanya ,&nbsp;Kiyoshi Fujita ,&nbsp;Nakao Iwata ,&nbsp;Hiroyuki Kamei","doi":"10.1016/j.scog.2025.100390","DOIUrl":"10.1016/j.scog.2025.100390","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive dysfunction has a significant impact on social functioning, such as employment, in patients with schizophrenia. However, existing cognitive assessments are time-consuming, impose a significant burden on patients, and require specialized training for evaluators, making them impractical for routine clinical use. Therefore, the present study investigated whether a simple and novel assessment tool, called Psychomotor Function Tests (PFT), correlates with existing Neuropsychological Tests (NT) and assessments with the Life Assessment Scale for the Mentally Ill (LASMI), which evaluates social functioning, including employment.</div></div><div><h3>Methods</h3><div>Cognitive function was examined in 24 patients with schizophrenia using NT (the Japanese Adult Reading Test, Trail Making Test (TMT), and word fluency test) and tablet-based PFT, while social functioning was evaluated using LASMI. Twenty-four healthy controls (HCs) underwent the same cognitive assessments.</div></div><div><h3>Results</h3><div>Psychomotor function, as evaluated by the choice reaction time, compensatory tracking test, and rapid visual information processing, was significantly worse in patients with schizophrenia than in HCs (<em>p</em> &lt; 0.001). Furthermore, the composite score of PFT correlated with the time required for TMT (<em>r</em> = −0.707, −0.637) and LASMI subscales related to work, endurance &amp; stability, self-recognition, required skills, and retention skills (<em>r</em> = −0.640, −0.689, −0.634, −0.420, −0.548).</div></div><div><h3>Conclusion</h3><div>PFT correlated with existing NT, which are widely used in cognitive function assessments. Cognitive function examined by PFT was closely associated with social functioning. These results suggest the potential of PFT for evaluating cognitive function in routine clinical settings for patients with schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100390"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness","authors":"Susan R. McGurk ,&nbsp;Renata Botello ,&nbsp;Daniel Fulford ,&nbsp;Kim T. Mueser","doi":"10.1016/j.scog.2025.100381","DOIUrl":"10.1016/j.scog.2025.100381","url":null,"abstract":"<div><h3>Objective</h3><div>Performance on reading tests is often used as an indicator of premorbid intellectual disability in individuals with serious mental illness (SMI), but independent evidence validating their use is lacking. This study evaluated the accuracy of the Wide Range Achievement Test Word Reading Subtest in predicting history of intellectual disability in people with SMI.</div></div><div><h3>Methods</h3><div>Participants were 105 people with SMI (62.8 % schizophrenia) with either a confirmed history of intellectual disability based on medical record review (Confirmed ID; <em>n</em> = 18) or no such history (No ID; <em>n</em> = 87). Participants were administered the WRAT-III Reading Subtest, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and three other cognitive tests. A receiver operator characteristics (ROC) curve was fit to identify the optimal cutoff score on the WRAT for correctly classifying the Confirmed ID and No ID groups. <em>t</em>-tests and effect sizes were used to compare the two groups on the WRAT and cognitive tests.</div></div><div><h3>Results</h3><div>The ROC curve indicated that a cutoff score of 70 or below on the WRAT correctly identified 88.9 % of individuals with Confirmed ID (sensitivity) and incorrectly identified 5.6 % of individuals with No ID (Specificity) (<em>p</em> &lt; .001). Performance on the cognitive battery was worse in the Confirmed ID group than No ID group, but the effect size for the WRAT was higher than any of the cognitive tests.</div></div><div><h3>Conclusions</h3><div>A WRAT Word Reading Subtest score of ≤70 is a strong indicator of premorbid intellectual disability in people with SMI.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100381"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and administration of the flexible adapted cognitive test battery for schizophrenia (FACTS)","authors":"Bing Cai ,&nbsp;William S. Stone ,&nbsp;Xinyi Ouyang ,&nbsp;Fei Deng ,&nbsp;Hanhui Chen ,&nbsp;Min Qian ,&nbsp;Margaux M. Grivel ,&nbsp;Matcheri S. Keshavan ,&nbsp;Ezra S. Susser ,&nbsp;Lawrence H. Yang ,&nbsp;Michael R. Phillips","doi":"10.1016/j.scog.2025.100377","DOIUrl":"10.1016/j.scog.2025.100377","url":null,"abstract":"<div><h3>Background</h3><div>Age and educational eligibility criteria for administration of the most widely used cognitive battery for schizophrenia typically exclude 20 % of individuals with schizophrenia in high-income countries and 25–50 % in middle- and low-income countries.</div></div><div><h3>Methods</h3><div>We developed the Flexible Adapted Cognitive Test battery for Schizophrenia (FACTS) that can be administered to <em>all</em> individuals with schizophrenia, regardless of age or education. To evaluate the utility and validity of the nine tests in the FACTS, two process measures are assessed during the administration of each test: ‘test comprehension’ and ‘test completion’ (successful or unsuccessful). The FACTS was administered to 495 community-dwelling individuals with schizophrenia and 308 healthy controls, including 473 (58.9 %) older or undereducated individuals typically excluded from studies of cognition in schizophrenia. Inter-rater reliability of the test comprehension and completion measures was assessed.</div></div><div><h3>Findings</h3><div>Older, undereducated participants successfully completed 82 % (3499/4257) of the administered tests. The mean weighted Kappa value for the nine test comprehension measures was 0.90 (range: 0.82–0.96), and the mean unweighted Kappa for the 20 test and subtest completion measures was 0.94 (range: 0.85–1.00).</div></div><div><h3>Interpretation</h3><div>Cognitive functioning is a core symptom cluster of schizophrenia, so the comprehensive assessment of cognitive functioning must become a standard part of the assessment of <em>all</em> individuals with schizophrenia, regardless of age or education. The development of the FACTS, which can be successfully administered to most older, undereducated individuals with schizophrenia, provides a model for doing this.</div></div><div><h3>Funding</h3><div>This study was supported by National Institute of Mental Health grants MH108385-R01 and MH127631-R01.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100377"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}