Cognitive deficits in schizophrenia : their nature and impact on daily life
This research provides further support for the existence of differential cognitive impairments in schizophrenia and especially for the presence of disproportionate attentional deficits. The results add credibility to the view that attentional disorders are responsible for many of the problems of everyday living in schizophrenia. Crucially these findings are the first to demonstrate in a schizophrenic sample a clear relationship between attentional deficits measured by objective tests and those measured by independent ratings. This project is also the first to show that attentional deficits account for a substantial proportion of the variance in social and interpersonal functioning even after controlling for the potential contribution of a comprehensive range of other factors, including negative symptoms. This study shows that schizophrenics are acutely aware of having cognitive difficulties. However the research confirms previous findings with a diverse range of samples showing that the subjective judgements do not correlate with performance on cognitive tests nor with independent ratings of cognitive functioning. However, as predicted it was also shown that self ratings of cognitive efficacy are related to dysphoric mood, greater use of avoidant coping methods, and a failure to use active coping strategies. This suggests a possible vicious cycle of helplessness which may be amenable to therapeutic interventions. The present findings indicate the potential value of using comprehensive assessments of cognitive functioning as a part of the routine clinical assessment procedure for schizophrenic patients. Assessments based on existing symptom rating scales do not adequately describe the impairments faced by someone living with schizophrenia, nor how these deficits interfere so profoundly with the tasks of daily life. Such detailed assessments of cognitive functioning may in the future help to guide cognitive and environmental interventions aimed at improving the well being, coping and functioning of those who have to endure this illness.