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24-10-2020 | Original Article

Does Self-Efficacy Predict Functioning in Older Adults with Schizophrenia? A Cross-Sectional and Longitudinal Mediation Analysis

Auteurs: Abigail C. Wright, Julia Browne, Corinne Cather, Sarah I. Pratt, Stephen J. Bartels, Kim T. Mueser

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 1/2021

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Abstract

Background

Self-efficacy (belief in one’s ability to complete activities or manage symptoms) is often poor in people with schizophrenia. Low self-efficacy is associated with negative symptoms and neurocognition which, together, may worsen psychosocial functioning. This study explores causal patterns between these variables by assessing their temporal associations and their combined role in predicting functioning using cross-sectional and longitudinal data.

Methods

This study is a secondary analysis of data from 103 older adults with schizophrenia-spectrum disorders engaged in a randomized controlled trial (Helping Older People Experience Success or Treatment As Usual). Cross-sectional and longitudinal measures included neurocognition, positive and negative symptoms, self-efficacy, and three measures of functioning (Independent Living Skills Survey [ILSS], The Multnomah Community Ability Scale (MCAS), University of California, San Diego Performance-Based Skills Assessment [UPSA]).

Results

Self-efficacy was associated with self-reported functional skills (ILSS) only. The impact of self-efficacy on functioning was partially mediated by negative symptoms. This mediation was also present when predicting functioning at one year, unaffected when depression and positive symptoms were controlled.

Conclusions

This study suggests direct and indirect effects of self-efficacy, via negative symptoms, on functioning in older adults with schizophrenia. Self-efficacy and negative symptoms should be intervention targets to improve functional difficulties in older adults with schizophrenia.
Literatuur
go back to reference American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.CrossRef American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.CrossRef
go back to reference Andreasen, N. C. (1989). The Scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundations. British Journal of Psychiatry, Suppl(7), 49–58. Andreasen, N. C. (1989). The Scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundations. British Journal of Psychiatry, Suppl(7), 49–58.
go back to reference Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMed Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMed
go back to reference Bartels, S. J., Pratt, S. I., Mueser, K. T., Forester, B. P., Wolfe, R., Cather, C., et al. (2014). Long-term outcomes of a randomized trial of integrated skills training and preventive healthcare for older adults with serious mental illness. American Journal of Geriatric Psychiatry, 22(11), 1251–1261. https://doi.org/10.1016/j.jagp.2013.04.013.CrossRef Bartels, S. J., Pratt, S. I., Mueser, K. T., Forester, B. P., Wolfe, R., Cather, C., et al. (2014). Long-term outcomes of a randomized trial of integrated skills training and preventive healthcare for older adults with serious mental illness. American Journal of Geriatric Psychiatry, 22(11), 1251–1261. https://​doi.​org/​10.​1016/​j.​jagp.​2013.​04.​013.CrossRef
go back to reference Carpenter, W. T., & Strauss, J. S. (1991). The prediction of outcome in schizophrenia IV: Eleven-year follow-up of the Washington IPSS cohort. The Journal of Nervous and Mental Disease, 179(9), 517–525.PubMed Carpenter, W. T., & Strauss, J. S. (1991). The prediction of outcome in schizophrenia IV: Eleven-year follow-up of the Washington IPSS cohort. The Journal of Nervous and Mental Disease, 179(9), 517–525.PubMed
go back to reference Corrigan, P. W., Larson, J. E., & Rüsch, N. (2009). Self-stigma and the “why try” effect: Impact on life goals and evidence-based practices. World Psychiatry : Official Journal of the World Psychiatric Association (WPA), 8(2), 75–81. https://doi.org/10.1002/j.2051-5545.2009.tb00218.x. Corrigan, P. W., Larson, J. E., & Rüsch, N. (2009). Self-stigma and the “why try” effect: Impact on life goals and evidence-based practices. World Psychiatry : Official Journal of the World Psychiatric Association (WPA), 8(2), 75–81. https://​doi.​org/​10.​1002/​j.​2051-5545.​2009.​tb00218.​x.​
go back to reference de Leon, C. F. M., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 51B(4), S183–S190. https://doi.org/10.1093/geronb/51b.4.s183. de Leon, C. F. M., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 51B(4), S183–S190. https://​doi.​org/​10.​1093/​geronb/​51b.​4.​s183.
go back to reference Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). Examiner’s manual, Delis Kaplan executive function system. San Antonio: Psychological Corporation. Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). Examiner’s manual, Delis Kaplan executive function system. San Antonio: Psychological Corporation.
go back to reference Dong, Y., & Peng, C.-Y. J. (2013). Principled missing data method the researchers. Springer Plus, 2(222), 1–17. Dong, Y., & Peng, C.-Y. J. (2013). Principled missing data method the researchers. Springer Plus, 2(222), 1–17.
go back to reference Evans, J. D., Negron, A. E., Palmer, B. W., Paulsen, J. S., Heaton, R. K., & Jeste, D. V. (1999). Cognitive deficits and psychopathology in institutionalized versus community-dwelling elderly schizophrenia patients. Journal of Geriatric Psychiatry and Neurology, 12(1), 11–15. https://doi.org/10.1177/089198879901200104.PubMed Evans, J. D., Negron, A. E., Palmer, B. W., Paulsen, J. S., Heaton, R. K., & Jeste, D. V. (1999). Cognitive deficits and psychopathology in institutionalized versus community-dwelling elderly schizophrenia patients. Journal of Geriatric Psychiatry and Neurology, 12(1), 11–15. https://​doi.​org/​10.​1177/​0891988799012001​04.PubMed
go back to reference Fortuna, K. L., Lohman, M. C., Bruce, M. L., & Bartels, S. J. (2018). Utility of functioning measures in the prediction of independent living status in older adults with serious mental illness. International Journal of Geriatric Psychiatry, 33(2), 423–431. https://doi.org/10.1002/gps.4764.PubMed Fortuna, K. L., Lohman, M. C., Bruce, M. L., & Bartels, S. J. (2018). Utility of functioning measures in the prediction of independent living status in older adults with serious mental illness. International Journal of Geriatric Psychiatry, 33(2), 423–431. https://​doi.​org/​10.​1002/​gps.​4764.PubMed
go back to reference Gallagher, M. W., Payne, L. A., White, K. S., Shear, K. M., Woods, S. W., Gorman, J. M., & Barlow, D. H. (2013). Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity. Behaviour Research and Therapy, 51(11), 767–777. https://doi.org/10.1016/j.brat.2013.09.001.PubMed Gallagher, M. W., Payne, L. A., White, K. S., Shear, K. M., Woods, S. W., Gorman, J. M., & Barlow, D. H. (2013). Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity. Behaviour Research and Therapy, 51(11), 767–777. https://​doi.​org/​10.​1016/​j.​brat.​2013.​09.​001.PubMed
go back to reference Granholm, E., Auslander, L. a., Gottlieb, J. D., McQuaid, J. R., & McClure, F. S. (2006). Therapeutic factors contributing to change in cognitive-behavioral group therapy for older persons with schizophrenia. Journal of Contemporary Psychotherapy, 36(1), 31–41. https://doi.org/10.1007/s10879-005-9004-7. Granholm, E., Auslander, L. a., Gottlieb, J. D., McQuaid, J. R., & McClure, F. S. (2006). Therapeutic factors contributing to change in cognitive-behavioral group therapy for older persons with schizophrenia. Journal of Contemporary Psychotherapy, 36(1), 31–41. https://​doi.​org/​10.​1007/​s10879-005-9004-7.
go back to reference Harvey, P. D., Howanitz, E., Parrella, M., White, L., Davidson, M., Mohs, R. C., et al. (1998). Symptoms, cognitive functioning, and adaptive skills in geriatric patients with lifelong schizophrenia: A comparison across treatment sites. American Journal of Psychiatry, 155(8), 1080–1086. https://doi.org/10.1176/ajp.155.8.1080. Harvey, P. D., Howanitz, E., Parrella, M., White, L., Davidson, M., Mohs, R. C., et al. (1998). Symptoms, cognitive functioning, and adaptive skills in geriatric patients with lifelong schizophrenia: A comparison across treatment sites. American Journal of Psychiatry, 155(8), 1080–1086. https://​doi.​org/​10.​1176/​ajp.​155.​8.​1080.
go back to reference Ikebuchi, E. (2015). Negative symptoms revisited – Toward the recovery of persons with schizophrenia. Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica, 117(3), 179–194.PubMed Ikebuchi, E. (2015). Negative symptoms revisited – Toward the recovery of persons with schizophrenia. Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica, 117(3), 179–194.PubMed
go back to reference Kurtz, M. M., Moberg, P. J., Mozley, L. H., Hickey, T., Arnold, S. E., Bilker, W. B., & Gur, R. E. (2001). Cognitive impairment and functional status in elderly institutionalized patients with schizophrenia. International Journal of Geriatric Psychiatry, 16(6), 631–638. https://doi.org/10.1002/gps.394.PubMed Kurtz, M. M., Moberg, P. J., Mozley, L. H., Hickey, T., Arnold, S. E., Bilker, W. B., & Gur, R. E. (2001). Cognitive impairment and functional status in elderly institutionalized patients with schizophrenia. International Journal of Geriatric Psychiatry, 16(6), 631–638. https://​doi.​org/​10.​1002/​gps.​394.PubMed
go back to reference McDermott, B. E. (1995). Development of an instrument for assessing self-efficacy in schizophrenia spectrum disorders. Journal of Clinical Psychology, 51(3), 320–331.PubMed McDermott, B. E. (1995). Development of an instrument for assessing self-efficacy in schizophrenia spectrum disorders. Journal of Clinical Psychology, 51(3), 320–331.PubMed
go back to reference McKnight, P. E., McKnight, K. M., Sidani, S., & Figueredo, A. J. (2007). Missing data: A gentle introduction. New York: The Guilford Press. McKnight, P. E., McKnight, K. M., Sidani, S., & Figueredo, A. J. (2007). Missing data: A gentle introduction. New York: The Guilford Press.
go back to reference Mitchell, T. R., Hopper, H., Daniels, D., George-falvy, J., & James, L. R. (1994). Predicting self-efficacy and performance during skill acquisition: Carlos Albizu virtual library. Journal of Applied Psychology, 79(4), 506–517. Mitchell, T. R., Hopper, H., Daniels, D., George-falvy, J., & James, L. R. (1994). Predicting self-efficacy and performance during skill acquisition: Carlos Albizu virtual library. Journal of Applied Psychology, 79(4), 506–517.
go back to reference Mueser, K. T., Bellack, A. S., Morrison, R. L., & Wixted, J. T. (1990). Social competence in schizophrenia: Premorbid adjustment, social skill, and domains of functioning. Journal of Psychiatric Research, 24(1), 51–63. https://doi.org/10.1016/0022-3956(90)90024-K.PubMed Mueser, K. T., Bellack, A. S., Morrison, R. L., & Wixted, J. T. (1990). Social competence in schizophrenia: Premorbid adjustment, social skill, and domains of functioning. Journal of Psychiatric Research, 24(1), 51–63. https://​doi.​org/​10.​1016/​0022-3956(90)90024-K.PubMed
go back to reference Mueser, K. T., Pratt, S. I., Bartels, S. J., Swain, K., Forester, B., Cather, C., & Feldman, J. (2010). Randomized trial of social rehabilitation and integrated health care for older people with severe mental illness. Journal of Consulting and Clinical Psychology, 78(4), 561–573. https://doi.org/10.1037/a0019629.PubMedPubMedCentral Mueser, K. T., Pratt, S. I., Bartels, S. J., Swain, K., Forester, B., Cather, C., & Feldman, J. (2010). Randomized trial of social rehabilitation and integrated health care for older people with severe mental illness. Journal of Consulting and Clinical Psychology, 78(4), 561–573. https://​doi.​org/​10.​1037/​a0019629.PubMedPubMedCentral
go back to reference Nakamura, H., Watanabe, N., & Matsushima, E. (2014). Structural equation model of factors related to quality of life for community-dwelling schizophrenic patients in Japan. International Journal of Mental Health Systems, 8(1), 1–12. https://doi.org/10.1186/1752-4458-8-32. Nakamura, H., Watanabe, N., & Matsushima, E. (2014). Structural equation model of factors related to quality of life for community-dwelling schizophrenic patients in Japan. International Journal of Mental Health Systems, 8(1), 1–12. https://​doi.​org/​10.​1186/​1752-4458-8-32.
go back to reference Palmer, B. W., Heaton, R. K., Gladsjo, J. A., Evans, J. D., Patterson, T. L., Golshan, S., & Jeste, D. V. (2002). Heterogeneity in functional status among older outpatients with schizophrenia: Employment history, living situation, and driving. Schizophrenia Research, 55(3), 205–215. https://doi.org/10.1016/S0920-9964(01)00218-3.PubMed Palmer, B. W., Heaton, R. K., Gladsjo, J. A., Evans, J. D., Patterson, T. L., Golshan, S., & Jeste, D. V. (2002). Heterogeneity in functional status among older outpatients with schizophrenia: Employment history, living situation, and driving. Schizophrenia Research, 55(3), 205–215. https://​doi.​org/​10.​1016/​S0920-9964(01)00218-3.PubMed
go back to reference Pajares, F., & Graham, L. (1999). Self-efficacy, motivation constructs, and mathematics performance of entering middle school students. Contemporary Educational Psychology, 24, 124–139. Pajares, F., & Graham, L. (1999). Self-efficacy, motivation constructs, and mathematics performance of entering middle school students. Contemporary Educational Psychology, 24, 124–139.
go back to reference Patterson, T. L., Goldman, S., McKibbin, C. L., Hughs, T., & Jeste, D. V. (2001). UCSD performance-based skills assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin, 27(0680), 235–245.PubMed Patterson, T. L., Goldman, S., McKibbin, C. L., Hughs, T., & Jeste, D. V. (2001). UCSD performance-based skills assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin, 27(0680), 235–245.PubMed
go back to reference Pratt, S. I., Bartels, S. J., Mueser, K. T., & Forester, B. (2008). Helping older people experience success: An integrated model of psychosocial rehabilitation and health care management for older adults with serious mental illness. American Journal of Psychiatric Rehabilitation, 11(1), 41–60. https://doi.org/10.1080/15487760701853193. Pratt, S. I., Bartels, S. J., Mueser, K. T., & Forester, B. (2008). Helping older people experience success: An integrated model of psychosocial rehabilitation and health care management for older adults with serious mental illness. American Journal of Psychiatric Rehabilitation, 11(1), 41–60. https://​doi.​org/​10.​1080/​1548776070185319​3.
go back to reference Preacher, K., & Hayes, A. (2008). Assessing mediation in communication research. In A. F. Hayes, M. D. Slater, & L. B. Snyder (Eds.), The Sage sourcebook of advanced data analysis methods for communication research (pp. 13–54). Thousand Oaks: Sage. Preacher, K., & Hayes, A. (2008). Assessing mediation in communication research. In A. F. Hayes, M. D. Slater, & L. B. Snyder (Eds.), The Sage sourcebook of advanced data analysis methods for communication research (pp. 13–54). Thousand Oaks: Sage.
go back to reference Probst, T., Dehoust, M., Brütt, A. L., Schulz, H., Pieh, C., & Andreas, S. (2018). Mentalization and self-efficacy as mediators between psychological symptom severity and disabilities in activities and participation in psychotherapy patients. Psychopathology, 51(1), 38–46. https://doi.org/10.1159/000485980.PubMed Probst, T., Dehoust, M., Brütt, A. L., Schulz, H., Pieh, C., & Andreas, S. (2018). Mentalization and self-efficacy as mediators between psychological symptom severity and disabilities in activities and participation in psychotherapy patients. Psychopathology, 51(1), 38–46. https://​doi.​org/​10.​1159/​000485980.PubMed
go back to reference Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
go back to reference Rector, N. A., Beck, A. T., & Stolar, N. (2005). The negative symptoms of schizophrenia: A cognitive perspective. Canadian Journal of Psychiatry, 50(5), 247–257.PubMed Rector, N. A., Beck, A. T., & Stolar, N. (2005). The negative symptoms of schizophrenia: A cognitive perspective. Canadian Journal of Psychiatry, 50(5), 247–257.PubMed
go back to reference Stone, W. S., Giuliano, A. J., Tsuang, M. T., Braff, D. L., Cadenhead, K. S., Calkins, M. E., et al. (2011). Group and site differences on the California Verbal Learning Test in persons with schizophrenia and their first-degree relatives: Findings from the Consortium on the Genetics of Schizophrenia (COGS). Schizophrenia Research, 128(1–3), 102–110. https://doi.org/10.1016/j.schres.2011.01.005.PubMedPubMedCentral Stone, W. S., Giuliano, A. J., Tsuang, M. T., Braff, D. L., Cadenhead, K. S., Calkins, M. E., et al. (2011). Group and site differences on the California Verbal Learning Test in persons with schizophrenia and their first-degree relatives: Findings from the Consortium on the Genetics of Schizophrenia (COGS). Schizophrenia Research, 128(1–3), 102–110. https://​doi.​org/​10.​1016/​j.​schres.​2011.​01.​005.PubMedPubMedCentral
go back to reference Ventura, J., Lukoff, D., Nuechterlein, K. H., Liberman, R. P., Green, M., & Shaner, A. (1993). Appendix 1: Brief psychiatric rating scale BPRS expanded version 4.0 scales, anchorpoints and administration manual. International Journal of Methods in Psychiatric Research, 3, 227–243. Ventura, J., Lukoff, D., Nuechterlein, K. H., Liberman, R. P., Green, M., & Shaner, A. (1993). Appendix 1: Brief psychiatric rating scale BPRS expanded version 4.0 scales, anchorpoints and administration manual. International Journal of Methods in Psychiatric Research, 3, 227–243.
go back to reference Wallace, C. J., Liberman, R. P., Tauber, R., & Wallace, J. (1997). The independent living skills survey: A comprehensive measure of the community functioning of severely and persistently mentally 111 individuals. Schizophrenia Bulletin, 26(3), 631–658. Wallace, C. J., Liberman, R. P., Tauber, R., & Wallace, J. (1997). The independent living skills survey: A comprehensive measure of the community functioning of severely and persistently mentally 111 individuals. Schizophrenia Bulletin, 26(3), 631–658.
go back to reference White, L., Harvey, P. D., Parella, M., Knobler, H., Powchik, P., & Davidson, M. (1994). Empirical assessment of the factorial structure of clinical symptoms in schizophrenic patients: Symptom structure in geriatric and nongeriatric samples. New Trends in Experimental and Clinical Psychiatry, 10, 75–83. White, L., Harvey, P. D., Parella, M., Knobler, H., Powchik, P., & Davidson, M. (1994). Empirical assessment of the factorial structure of clinical symptoms in schizophrenic patients: Symptom structure in geriatric and nongeriatric samples. New Trends in Experimental and Clinical Psychiatry, 10, 75–83.
Metagegevens
Titel
Does Self-Efficacy Predict Functioning in Older Adults with Schizophrenia? A Cross-Sectional and Longitudinal Mediation Analysis
Auteurs
Abigail C. Wright
Julia Browne
Corinne Cather
Sarah I. Pratt
Stephen J. Bartels
Kim T. Mueser
Publicatiedatum
24-10-2020
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 1/2021
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-020-10171-8