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Factor Structure of Neurocognition and Functional Capacity in Schizophrenia: A Multidimensional Examination of Temporal Stability

Published online by Cambridge University Press:  21 February 2013

Philip D. Harvey ,
Tenko Raykov ,
Elizabeth W. Twamley ,
Lea Vella ,
Robert K. Heaton  and
Thomas L. Patterson
Philip D. Harvey*
Affiliation:
Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida Research Service, Miami VA Medical Center, Miami, Florida
Tenko Raykov
Affiliation:
Department of Education and Measurement, Michigan State University, East Lansing, Michigan
Elizabeth W. Twamley
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California Psychiatry Service, San Diego VA Medical Center, La Jolla, California
Lea Vella
Affiliation:
Department of Psychology, UCSD-SDSU Joint Doctoral Program, San Diego, California
Robert K. Heaton
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California
Thomas L. Patterson
Affiliation:
Department of Psychiatry, UCSD Medical Center, La Jolla, California
*
Correspondence and reprint requests to: Philip D. Harvey, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1450, Miami, FL 33136. E-mail: [email protected]
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Abstract

Although neurocognition is commonly described in terms of different functional domains, some factor analytic studies have suggested a simpler dimensional structure for neuropsychological (NP) tests in patients with schizophrenia. Standardized tasks of everyday functioning, or tests of “functional capacity” (FC), are viewed differently from traditional NP tests, and are hence used as a co-primary measure in treatment studies. However, FC and NP tests have been found to be highly correlated. In fact, a recent study of ours suggested that performances on these different types of tasks constituted a single latent trait in a cross-sectional analysis. The current study examined the longitudinal factor structure of a combined set of NP and FC tests. Patients with schizophrenia (n = 195) were examined at two assessment occasions separated by periods ranging from 6 weeks to 6 months. Participants were assessed with the MATRICS Consensus Cognitive Battery (MCCB) and two performance-based assessments of FC. A single latent trait was extracted using full information maximum likelihood procedures, and its temporal stability was examined in terms of: stability of the latent trait scores, the inter-correlations of the three indicators of the latent trait, and the stability of loadings for the FC and NP items underlying the latent trait at the two measurement occasions. All indices of temporal stability were confirmed, with stability not related to follow-up duration. Variation in clinical symptoms and treatments across the measurement occasions was negligible. These findings raise the question of whether cognitive abilities measured by NP tests and FC instruments are tapping a single ability construct, which might have shared causal influences as well. (JINS, 2013, 19, 1–8)

Keywords

NeuropsychologyDisabilityLatent traitsLongitudinal studiesFunctional capacityLinear models
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 6 , July 2013 , pp. 656 - 663
Copyright
Copyright © The International Neuropsychological Society 2013 

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References

Addington, J., Addington, D., Maticka-Tyndale, E. (1991). Cognitive functioning and positive and negative symptoms in schizophrenia. Schizophrenia Research, 4, 123–134.CrossRefGoogle Scholar
Bowie, C.R., Leung, W.W., Reichenberg, A., McClure, M.M., Patterson, T.L., Heaton, R.K., Harvey, P.D. (2008). Predicting schizophrenia patients’ real-world behavior with specific neuropsychological and functional capacity measures. Biological Psychiatry, 63, 505–511.CrossRefGoogle ScholarPubMed
Bowie, C.R., Reichenberg, A., Patterson, T.L., Heaton, R.K., Harvey, P.D. (2006). Determinants of real world functional performance in schizophrenia: Correlations with cognition, functional capacity, and symptoms. American Journal of Psychiatry, 163, 418–425.CrossRefGoogle ScholarPubMed
Chapman, L.J., Chapman, J.M. (1973). Disordered thought in schizophrenia. New York: Appleton-Century-Crofts.Google Scholar
Dickinson, D., Harvey, P.D. (2009). Systemic hypotheses for generalized cognitive deficits in schizophrenia: A new take on an old problem. Schizophrenia Bulletin, 35, 403–414.CrossRefGoogle Scholar
Fett, A.K., Viechtbauer, W., Dominguez, M.D., Penn, D.L., van Os, J., Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: Meta-analysis. Neuroscience and Biobehavioral Review, 35, 573–588.CrossRefGoogle Scholar
Green, M.F., Schooler, N.R., Kern, R.D., Frese, F.J., Granberry, W., Harvey, P.D.., Marder, S.R. (2011). Evaluation of functionally-meaningful measures for clinical trials of cognition enhancement in schizophrenia. American Journal of Psychiatry, 168, 400–407.CrossRefGoogle ScholarPubMed
Greenwood, T.A., Braff, D.L., Light, G.A., Cadenhead, K.S., Caulkins, M.E., Dorcas, D.J., Schork, N.J. (2007). Initial heritability analyses of endophenotypic measures for schizophrenia: The consortium on the genetics of schizophrenia. Archives of General Psychiatry, 64, 1242–1250.CrossRefGoogle Scholar
Greenwood, T.A., Lazzeroni, L.C., Murray, S.S., Cadenhead, K.S., Caulkins, M.E., Dorcas, D.J., Braff, D.L. (2011). Analysis of 94 candidate genes and twelve endophenotypes for schizophrenia from the Consortium on the Genetics of Schizophrenia. American Journal of Psychiatry, 168, 930–946.CrossRefGoogle Scholar
Gur, R.E., Calkins, M.E., Gur, R.C., Horan, W.P., Nuechterlein, K.H., Seidman, L.J., Stone, W.S. (2007). The Consortium on the Genetics of Schizophrenia: Neurocognitive endophenotypes. Schizophrenia Bulletin, 33, 49–68.CrossRefGoogle Scholar
Harvey, P.D., Docherty, N.M., Serper, M.R., Rasmussen, M. (1990). Cognitive deficits and thought disorder: II. An eight-month follow-up study. Schizophrenia Bulletin, 16, 147–156.CrossRefGoogle Scholar
Harvey, P.D., Helldin, L., Bowie, C.R., Heaton, R.K., Olsson, A.K., Hjärthag, F., Patterson, T.L. (2009). Performance-based measurement of functional disability in schizophrenia: A cross-national study in the United States and Sweden. American Journal of Psychiatry, 166, 821–827.CrossRefGoogle ScholarPubMed
Harvey, P.D., McClure, M.M., Patterson, T.L., McGrath, J.A., Pulver, A.E., Bowie, C.R., Siever, L.J. (2012). Impairment in functional capacity as an endophenotype candidate in severe mental illness. Schizophrenia Bulletin, 38, 1318–1326.CrossRefGoogle ScholarPubMed
Harvey, P.D., Raykov, T., Twamley, E.W., Vella, L., Heaton, R.K., Patterson, T.L. (2011). Validating the measurement of real-world functional outcome: Phase I results of the VALERO study. American Journal of Psychiatry, 168, 1195–1201.CrossRefGoogle ScholarPubMed
Harvey, P.D., Reichenberg, A., Bowie, C.R., Patterson, T.L., Heaton, R.K. (2010). The course of neuropsychological performance and functional capacity in older patients with schizophrenia: Influences of previous history of long-term institutional stay. Biological Psychiatry, 67, 933–939.CrossRefGoogle ScholarPubMed
Harvey, P.D., Velligan, D.I., Bellack, A.S. (2007). Performance-based measures of functional skills: Usefulness in clinical treatment studies. Schizophrenia Bulletin, 33, 1138–1148.CrossRefGoogle ScholarPubMed
Heaton, R.K., Gladsjo, J.A., Palmer, B.W., Kuck, J., Marcotte, T.D., Jeste, D.V. (2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry, 58, 24–32.CrossRefGoogle ScholarPubMed
Heaton, R.K., Marcotte, T.D., Mindt, M.R., Sadek, J., Moore, D.J., Bentley, H., Grant, I. (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10, 317–331.CrossRefGoogle ScholarPubMed
Heinrichs, R.W., Ammari, N., Miles, A.A., McDermid Vaz, S. (2010). Cognitive performance and functional competence as predictors of community independence in schizophrenia. Schizophrenia Bulletin, 36, 381–387.CrossRefGoogle ScholarPubMed
Jöreskog, K.G., Sörbom, D. (1996). Lisrel 8 user's reference guide. Lincolnwood, IL: Scientific Software International.Google Scholar
Keefe, R.S., Bilder, R.M., Davis, S.M., Harvey, P.D., Palmer, B.W., Gold, J.M., Lieberman, J.A. (2007). Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE Schizophrenia Trial. Archives of General Psychiatry, 64, 633–647.CrossRefGoogle Scholar
Keefe, R.S., Bilder, R.M., Harvey, P.D., Davis, S.M., Palmer, B.W., Gold, J.M., Lieberman, J.A. (2006). Baseline neurocognitive deficits in the CATIE Schizophrenia Trial. Neuropsychopharmacology, 31, 2033–2046.CrossRefGoogle ScholarPubMed
Keefe, R.S., Fox, K.H., Harvey, P.D., Cucchiaro, J., Siu, C., Loebel, A. (2011). Characteristics of the MATRICS Consensus Cognitive Battery in a 29-site antipsychotic schizophrenia clinical trial. Schizophrenia Research, 125, 161–168.CrossRefGoogle Scholar
Leifker, F.R., Bowie, C.R., Harvey, P.D. (2009). The determinants of everyday outcomes in schizophrenia: Influences of cognitive impairment, clinical symptoms, and functional capacity. Schizophrenia Research, 115, 82–87.CrossRefGoogle Scholar
Leifker, F.R., Patterson, T.L., Bowie, C.R., Mausbach, B.T., Harvey, P.D. (2010). Psychometric properties of performance-based measurements of functional capacity: Test-retest reliability, practice effects, and potential sensitivity to change. Schizophrenia Research, 119, 246–252.CrossRefGoogle ScholarPubMed
Leifker, F.R., Patterson, T.L., Heaton, R.K., Harvey, P.D. (2011). Validating measures of real-world outcome: The results of the VALERO Expert Survey and RAND Panel. Schizophrenia Bulletin, 37, 334–343.CrossRefGoogle ScholarPubMed
Little, R.J., Rubin, D.B. (2002). Statistical analysis with missing data. New York: Wiley.CrossRefGoogle Scholar
Mausbach, B.T., Harvey, P.D., Goldman, S.R., Jeste, D.V., Patterson, T.L. (2007). Development of a brief scale of everyday functioning in persons with serious mental illness. Schizophrenia Bulletin, 33, 1364–1372.CrossRefGoogle ScholarPubMed
McClure, M.M., Bowie, C.R., Patterson, T.L., Heaton, R.K., Weaver, C., Anderson, H., Harvey, P.D. (2007). Correlations of functional capacity and neuropsychological performance in older patients with schizophrenia: Evidence for specificity of relationships? Schizophrenia Research, 89, 330–338.CrossRefGoogle ScholarPubMed
McIntosh, B.J., Zhang, X.-Y., Kosten, T., Tan, S.P., Xiu, M.H., Rakofsky, J., Harvey, P.D. (2011). Performance based assessment of functional skills in severe mental illness: Results of a large-scale study in China. Journal of Psychiatric Research, 45, 1089–1094.CrossRefGoogle ScholarPubMed
Muthen, L.K., Muthen, B. (2010). Mplus user's guide. Los Angeles, CA: Muthen & Muthen.Google Scholar
Nuechterlein, K.H., Barch, D.M., Gold, J.M., Goldberg, T.E., Green, M.F., Heaton, R.K. (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research, 72, 29–39.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H., Green, M.F., Kern, R.S., Baade, L.E., Barch, D., Cohen, J., Stover, E. (2008). The MATRICS consensus cognitive battery, part 1: Test selection, reliability, and validity. American Journal of Psychiatry, 165, 203–213.CrossRefGoogle ScholarPubMed
Palmer, B.W., Heaton, R.K., Paulsen, J.S., Kuck, J., Braff, D., Harris, M.J., Jeste, D.V. (1997). Is it possible to be schizophrenic yet neuropsychologically normal? Neuropsychology, 11, 437–446.CrossRefGoogle ScholarPubMed
Raykov, T., Marcoulides, G.A. (2006). A first course in structural equation modeling. Mahwah, NJ: Lawrence Erlbaum and Associates.Google Scholar
Raykov, T., Marcoulides, G.A. (2008). An introduction to applied multivariate analysis. New York: Taylor & Francis.CrossRefGoogle Scholar
Satorra, A. (2000). Scaled and adjusted restricted tests in multi-sample analysis of moment structures. In R. D. H. Heijmans, D. S. G. Pollock, A. Satorra (Eds.), Innovations in multivariate statistical analysis. A festschrift for Heinz Neudecker (pp. 233–247). London: Kluwer Academic Publishers.CrossRefGoogle Scholar
Saykin, A.J., Shtasel, D.L., Gur, R.E., Kester, D.B., Mozley, L.H., Stafiniak, P. (1994). Neuropsychological deficits in neuroleptic naive patients with first episode schizophrenia. Archives of General Psychiatry, 51, 124–131.CrossRefGoogle ScholarPubMed
Schneider, L.C., Struening, E.L. (1983). SLOF: A behavioral rating scale for assessing the mentally ill. Social Work Research and Abstracts, 19, 9–21.CrossRefGoogle ScholarPubMed
Ventura, J., Wood, R.C., Hellemann, G.S. (2013). Symptom domains and neurocognitive functioning can help differentiate social cognitive processes in schizophrenia. Schizophrenia Bulletin, 39, 102–111.CrossRefGoogle ScholarPubMed