INITIAL AND FINAL WORK PERFORMANCE IN SCHIZOPHRENIA: COGNITIVE AND SYMPTOM PREDICTORS
Abstract
Studies have shown that cognitive functioning may limit the rate, tenure, and type of work performed by people with schizophrenia. The present study tested the hypothesis that cognitive abilities needed for initial improvement in work performance would differ from those needed in later vocational development. Ninety-six outpatients with schizophrenia or schizoaffective disorder who participated in a work rehabilitation program were administered neuropsychological testing at intake. Their work performance was evaluated biweekly for 26 weeks. Cognitive test variables were entered into regressions predicting the slope of individual performance curves from weeks 1 to 13 and 13 to 26. Neuropsychological variables accounted for 28% of the variance in slope during the initial period. The strongest predictor was a Continuous Performance Task variable that measures inattentiveness. Other important variables were measures of idiosyncratic thinking, cognitive flexibility, and verbal memory. Neuropsychological variables accounted for 19% of the variance in the slope during the final period. The strongest predictor was verbal learning, while measures of cognitive impulsivity and psychomotor functioning were also significant contributors. There was no relationship between work performance and symptoms for weeks 1 to 13 or 13 to 26. These findings suggest that while attention is more important for initial success, verbal memory becomes more important for sustained improvement. Remediating or accommodating such deficits in a time-sensitive fashion may be a necessary feature for successful rehabilitation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
These impairments have been shown to be associated with various impaired functional outcomes.
“These impairments have been shown to be associated with various impaired functional outcomes.4,5”
From Clinical trials of potential cognitive-enhancing drugs in schizophrenia: what have we learned so far? (2013) · cites this paper as [5]
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
What are the functional consequences of neurocognitive deficits in schizophrenia?
(1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.3.321 · Cited by 3,516 · see citing works
The hopkins verbal learning test: Development of a new memory test with six equivalent forms
Brandt, J. (1991) · Clinical Neuropsychologist · doi:10.1080/13854049108403297 · Cited by 1,317 · see citing works
The Prediction of Outcome in Schizophrenia
Strauss, J. S. (1974) · Archives of General Psychiatry · doi:10.1001/archpsyc.1974.01760130021003 · Cited by 645 · see citing works
Bell, M. D., Lysaker, P. H., Goulet, J. L., Milstein, R. M., & Lindenmayer, J. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90075-2 · Cited by 422 · see citing works
Self-citationThe Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale
Bell, M. D., Milstein, R. M., Goulet, J. L., Lysaker, P. H., & Cicchetti, D. V. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199211000-00007 · Cited by 261 · see citing works
Self-citationBell, M. D., BRYSON, G. J., & Lysaker, P. H. (1997) · Psychiatry Research · doi:10.1016/s0165-1781(97)00111-x · Cited by 260 · see citing works
Self-citationWork Rehabilitation in Schizophrenia: Does Cognitive Impairment Limit Improvement?
Bell, M. D., & BRYSON, G. J. (2001) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a006873 · Cited by 164 · see citing works
Self-citationUse of the Proverbs Test for differentiating schizophrenics from normals.
Gorham, D. R. (1956) · Journal of Consulting Psychology · doi:10.1037/h0042949 · Cited by 148 · see citing works
Wisconsin card sorting test and work performance in schizophrenia
Lysaker, P. H., Bell, M. D., & Goulet, J. L. (1995) · Psychiatry Research · doi:10.1016/0165-1781(94)02641-u · Cited by 143 · see citing works
Self-citationLysaker, P. H., Bell, M. D., Zito, W., & BIOTY, S. M. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199511000-00003 · Cited by 107 · see citing works
Self-citationCognitive dysfunction in patients treated for pituitary tumours
Peace, K., Orme, S., Thompson, A. R., Padayatty, S., Ellis, A. W., & Belchetz, P. E. (1997) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/01688639708403831 · Cited by 72 · see citing works
BRYSON, G. J., Bell, M. D., Kaplan, E., & Greig, T. C. (1998) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199810000-00004 · Cited by 57 · see citing works
Self-citationPsychiatric symptoms and work performance among persons with severe mental illness
Bell, M. D., & Lysaker, P. H. (1995) · Psychiatric Services · doi:10.1176/ps.46.5.508 · Cited by 51 · see citing works
Self-citationA Standardized Assessment of the Work Behaviour of Psychiatric Patients
Griffiths, R. D. P. (1973) · The British Journal of Psychiatry · doi:10.1192/bjp.123.4.403 · Cited by 50 · see citing works
Bell, M. D., Greig, T. C., Kaplan, E., et al. (1997) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/01688639708403774 · Cited by 47 · see citing works
Self-citationSuslow, T., Schonauer, K., Ohrmann, P., Eikelmann, B., & Reker, T. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200002000-00008 · Cited by 38 · see citing works
Fontana, D. (1990) · Cited by 31 · see citing works
Performance on Philadelphia Jevs Work Samples and Subsequent Employment Status
Berven, N. L., & Maki, D. R. (1979) · Journal of Applied Rehabilitation Counseling · doi:10.1891/0047-2220.10.4.214 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS
Green, M. F., Kern, R. S., & Heaton, R. K. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.09.009 · Cited by 1,422 · see citing works
How should DSM-V criteria for schizophrenia include cognitive impairment?
Keefe, R. S. E., & Fenton, W. S. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm046 · Cited by 394 · see citing works
Cognition in Schizophrenia: Impairments, Determinants, and Functional Importance
Bowie, C. R., & Harvey, P. D. (2005) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2005.05.004 · Cited by 280 · see citing works
Kern, R. S., Gold, J. M., Dickinson, D., Green, M. F., Nuechterlein, K. H., Baade, L. E., Keefe, R. S. E., Mesholam-Gately, R. I., Seidman, L. J., Lee, C., et al. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2010.11.008 · Cited by 251 · see citing works
Prediction of Functional Outcome in Individuals at Clinical High Risk for Psychosis
Carrión, R. E., McLaughlin, D., Goldberg, T. E., Auther, A. M., Olsen, R. H., Olvet, D. M., Correll, C. U., & Cornblatt, B. A. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.1909 · Cited by 250 · see citing works
Woo, Y. S., Rosenblat, J. D., Kakar, R., Bahk, W.-M., & McIntyre, R. S. (2016) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2016.14.1.1 · Cited by 183 · see citing works
Keefe, R. S. E., Buchanan, R. W., Marder, S. R., Schooler, N. R., Dugar, A., Zivkov, M., & Stewart, M. (2013) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr153 · Cited by 138 · see citing works
The muscarinic system, cognition and schizophrenia
Carruthers, S. P., Gurvich, C. T., & Rossell, S. L. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.05.011 · Cited by 90 · see citing works
Rao, N., Northoff, G., Tagore, A., Rusjan, P., Kenk, M., Wilson, A., Houle, S., Strafella, A., Remington, G., & Mizrahi, R. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sby076 · Cited by 67 · see citing works
Effect of mindfulness on vocational rehabilitation outcomes in stable phase schizophrenia
Davis, L. W., Lysaker, P. H., Kristeller, J. L., Salyers, M. P., Kovach, A. C., & Woller, S. (2015) · Psychological Services · doi:10.1037/ser0000028 · Cited by 43 · see citing works
- Authors
- BRYSON, G., & BELL, M. D.
- Affiliations
- Yale University (US)
- ORCID
- BELL, MORRIS D.
- Venue
- The Journal of Nervous and Mental Disease
- Published
- 2003-02
- Volume
- 191
- Issue
- 2
- Pages
- 87-92
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W1997146129
- Cited by
- 138
- References
- 19
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 10 · 2015: 7 · 2014: 7 · 2013: 7 · 2012: 12
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Safety Research › Disability Education and Employment
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- schizophrenia, schizoaffective disorder, employee performance, vocational rehabilitation, cognitive ability, inattention, verbal memory, cognitive flexibility, verbal learning, cognitive impulsivity, attention, neuropsychological predictors
- MeSH terms
- Adult, Age Factors, Ambulatory Care, Attention, Cognition Disorders, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychomotor Performance, Psychotic Disorders, Regression Analysis, Rehabilitation, Vocational, Schizophrenia, Schizophrenic Psychology, Sex Factors, Verbal Learning, Work, Outcome Assessment, Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
