The role of social cognition and neurocognition in functional outcomes in individuals with first episode psychosis

Griffiths, Siân Lowri (2018). The role of social cognition and neurocognition in functional outcomes in individuals with first episode psychosis. University of Birmingham. Ph.D.

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Abstract

Impaired cognition and poor functioning are closely linked in psychosis; findings from studies of individuals with first episode psychosis (FEP), where intervention may be most effective, are less conclusive. This thesis sought to clarify the contributing role of social cognition (SC) and neurocognition (NC), relative to symptoms, in understanding functional outcome in FEP.

Results showed that whilst individuals with poor functioning in FEP have greater SC and NC impairments, negative symptoms is the most robust predictor of later social and role outcomes, with SC and NC having a subordinate role. Exploratory analyses suggest that cognition directly impacts on negative symptoms which in turn may influence functional outcome, highlighting the importance of delineating this relationship.

When examining the predictors of treatment response (i.e. improved functioning) following a psychosocial intervention targeting social disability, individuals with 'good' SC were more likely to respond to the intervention. Functional magnetic resonance imaging also provided preliminary evidence of an underlying SC neural network that might be implicated in improved functioning following the intervention.

Overall findings show that cognition plays a key role in functional outcomes in FEP. Targeting impaired SC could improve the reach and impact of intervention, to reduce the chances of social disability becoming entrenched.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):