The relationship between neuropsychological variables, psychiatric symptoms, and everyday functioning in independent living older adults with severe mental illness
Abstract
This cross-sectional correlational study proposed to investigate the relationship between neuropsychological variables, psychiatric symptoms, and everyday functioning in independent living older adults with severe mental illness, as well as the relationship between everyday functioning and community living in this sample. Study participants were older adults with severe mental illness receiving services from a community mental health center. A total of 48 participants comprised the full study sample and completed a diagnostic interview, symptom ratings, a brief cognitive screen, and a measure of real-world functioning. Real-world functioning was assessed via a performance-based measure of everyday living, the UPSA-IN. A subset of this larger sample ( n = 36) comprised the study sub-sample and did not show significant signs of cognitive impairment, as determined by a brief cognitive screening instrument. They completed additional neuropsychological tests and symptom ratings. Study participants' primary contact at the mental health center provided clinical background information on behalf of the study participants, as well as ratings of basic and instrumental activities of daily living, and the community living rating. It was hypothesized that global neuropsychological ability, followed by negative symptoms, would have the strongest associations with real-world functioning, and that the performance-based measure of everyday living would have the strongest association with community living. In the full study sample and study sub-sample, global neuropsychological functioning was found to have the strongest association with UPSA-IN, as compared to psychiatric symptoms. However, negative symptoms were not found to be more strongly associated with UPSA-IN, as compared to depressive symptoms, positive symptoms, or general psychopathology, in either sample. UPSA-IN, the performance-based measure of real-world functioning, was found to be more strongly associated with community living, as compared to the informant functional ratings, global cognitive ability, and negative symptoms. The importance of cognitive ability in successfully completing everyday tasks is highlighted in this study of independent living older adults with SMI. Preliminary support is provided for the utility of the performance-based measure of real-world functioning, the UPSA-IN. Future studies should target developing compensatory strategies to help older adults with SMI overcome their cognitive difficulties in order to manage independence in the community.
Degree
Ph.D.
Advisors
Evans, Purdue University.
Subject Area
Mental health|Gerontology|Psychotherapy
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