Component mechanisms of executive function in schizophrenia and their contribution to functional outcomes

Abstract

Objective:In schizophrenia, scores reflecting deficits in different cognitive processes are strongly correlated, making it difficult to establish a solid relationship between different cognitive mechanisms and other features of this disorder. The objective of this study was to explore whether three frequently postulated executive functions (updating, shifting, and inhibition) could be compared between groups and considered independently in terms of their respective roles in functional outcome.Methods:This study relied on confirmatory factor analysis of schizophrenia patients (n=141) and healthy controls (n=119). The main analyses examined the degree to which three executive functions (updating, set-shifting, and inhibition) could be separated in schizophrenia and compared this model among groups. Structural equation modeling analysis was also performed to examine the extent to which executive function components contribute to functional outcome in schizophrenia.Results:Multiple-group confirmatory factor analysis with unconstrained model parameters indicated that the full three-factor model may fit the data in both groups (χ2 = 61.48, degrees of freedom = 34, p < 0.001, comparative fit index = 0.95; standardized root mean square residual = 0.037; root mean square error of approximation = 0.04; Akaike’s information criteria = 169.49; normed fit index = 0.90), although there was also a good data fit for the patient group with a two-factor model. In the patient group, structural equation modeling suggested that shifting and (principally) updating were associated with the general measure of functional outcome (regression path coefficients: 0.34, p < 0.005; 0.39, p < 0.005, respectively), although when combined the mechanisms fail to contribute.Conclusion:This data suggests that the factor structure may be similar but not identical between groups, and both updating and shifting may play an important role in functional outcome in schizophrenia.

Scrutinizing Domains of Executive Function in Binge Eating Disorder: A Systematic Review and Meta-Analysis

“…However, according to Friedman and Miyake (6), executive functions represent a set of control processes that regulate thoughts and behavior, dysfunctions in which are symptomatic of neuropsychiatric and behavioral disorders. Although there is some debate over which variables should be used to assess executive functioning, inhibitory control, working memory, decision-making, cognitive flexibility, planning, problemsolving are generally well established in neurocognitive research (6)(7)(8)(9)(10).…”

Executive functions in fibromyalgia: A systematic review.

“…An executive impairment, more specifically one in inhibition/attention, in FM patients could relate to their clinical management, since these skills are associated with different outcomes in clinical and healthy populations, including adherence to treatment (Alosco et al, 2012; Dominguez-Salas et al, 2016; Huerta et al, 2016; Kosilov et al, 2020), resilience, quality of life, and functionality (Berberian et al, 2019; Davis et al, 2010; Parsons et al, 2016). Inhibition seems to be a first and fundamental step to any self-regulated behavior (Baumeister, 2014), as it involves the selection of relevant information, the control of inappropriate responses, and the interruption of overbearing or habitual responses so that one can then engage in organization, planning and behavior change (Baggetta & Alexander, 2016; Diamond, 2013; Friedman & Miyake, 2017).…”

“…Investigating EF in these patients may be relevant because these skills are associated with outcomes of clinical relevance, such as adherence to treatment in patients with different diagnoses (Alosco et al, 2012; Dominguez-Salas et al, 2016; Huerta et al, 2016; Kosilov et al, 2020). Furthermore, EF have also been associated with resilience, quality of life, and functionality (Berberian et al, 2019; Davis et al, 2010; Parsons et al, 2016) in different healthy and clinical populations. These findings suggest that considering EF in FM research and the clinical practice may be relevant from the perspective of patient care.…”

Differences in the Functioning and Occupational Activity in People with Mental Disorders: A Gender Perspective

“…Although all functioning domains are affected in this population, the degree of differentiated involvement by domains is very notable, we find levels of severe disability (values of more than 50 % disability), in the domains of participation in society and interpersonal getting along (relationship), which have a logic with the way of presentation and evolution of mental disorders, especially in those considered serious as schizophrenia and other primary psychotic disorders [16], in which we observe a decrease in social functioning much earlier than symptomatic appearance, mainly the one that demands social interaction. We also found moderate disability (those domains with disability levels between 25 and 49%), in the domain of cognition and activities at home; regarding these observed data, we know that mental disorders are the cause of various cognitive dysfunctions (abilities to pay attention, remember, process information, solve problems, organize and reorganize information, communicate and react to received information) and are often the primary symptom in psychotic disorders [17], for example in the schizophrenia the executive functions components have been associated with the general measure of functional outcome, by the way, studies have suggested that cognitive task performance can be broken down into the same broad domains in both schizophrenic and other populations (like healthy population) [18].…”