Date of Award
Master of Arts (AM/MA)
Background and Hypothesis. Identifying the factors contributing to functional deficits in psychotic disorders is essential to developing effective interventions. To address gaps in the literature, the current study had several goals: examine whether there are differential relationships across domains of neurocognition and function, assess whether reinforcement learning is related to function, identify how and if predictors of function are transdiagnostic, determine whether depression and positive symptoms contribute to function, and to further explore whether the modality of assessing function impacts the observed relationships.
Study Design. We examined the neurocognitive and symptomatic predictors of individual functional domains across three measures of function using data from 274 participants with Schizophrenia/Schizoaffective Disorder (SZ; n=195) and Bipolar Disorder with psychosis (BD; n=79).
Results. Two neurocognitive components, one working and episodic memory and the other negative and positive reinforcement learning, predicted different functional domains. Predictors of function were largely transdiagnostic with two exceptions: reinforcement learning had a positive association with self-reported interpersonal relationships for SZ and a negative association for BD, and the negative association between positive symptoms and self-reported social acceptability was stronger for BD than for SZ. The predictors of self- and informant-reported function differed in significant ways. Most notably, depression robustly predicted self-reported but not informant-reported function, and anhedonia predicted all domains of informant-reported function.
Conclusions. These findings imply that depression plays a critical role in self-perceived functional impairments, traditional domains of neurocognition and symptoms may be effective transdiagnostic targets for interventions, and reinforcement learning may differentially relate to function across disorders.
Chair and Committee
Denise Head, Desiree White
Dalloul, Nada, "Transdiagnostic Predictors Of Everyday Functioning: Examining The Relationships Of Depression And Reinforcement Learning" (2023). Arts & Sciences Electronic Theses and Dissertations. 2963.