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LONGITUDINAL RELATIONSHIPS OF COGNITIVE DEFICITS, SYMPTOMS,
AND SOCIAL FUNCTIONING OUTCOMES IN COMMUNITY-BASED
PSYCHOSOCIAL REHABILITATION PROGRAMS: MECHANISMS OF
LONGITUDINAL CHANGE
by
Maanse Hoe
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(SOCIAL WORK)
August 2007
Copyright 2007 Maanse Hoe
Object Description
| Title | Longitudinal relationships of cognitive deficits, symptoms, and social functioning outcomes in community-based psychosocial rehabilitation programs: mechanisms of longitudinal change |
| Author | Hoe, Maanse |
| Author email | hoe@usc.edu |
| Degree | Doctor of Philosophy |
| Document type | Dissertation |
| Degree program | Social Work |
| School | School of Social Work |
| Date defended/completed | 2007-06-07 |
| Date submitted | 2007 |
| Restricted until | Unrestricted |
| Date published | 2007-07-26 |
| Advisor (committee chair) | Brekke, John S. |
| Advisor (committee member) |
Zebrack, Bradley Chou, Chi-Ping Bola, John |
| Abstract | The present study investigated longitudinal relationships among cognition, symptoms and functioning in individuals diagnosed with schizophrenia for better understating the mechanisms of psychosocial functional change in community-based psychosocial rehabilitation programs. There are 2.97 million people suffering form schizophrenia in the United States, and the economic burden of schizophrenia is approximately $62.7 billion per year. Community-based treatment programs for individuals diagnosed with schizophrenia have established intensive clinical services to support and maintain these individuals in communities. The outstanding success of the programs has resulted in the clinical outcomes of reducing relapse and hospitalization, improving social functioning and improving housing stability. However, this success has been controversial because there is no clear understanding of how individual change is caused by the treatments and of why the change occurs or does not occur in individuals. This is a gap of knowledge in practice and research.; Two specific aims of this study were 1) to investigate longitudinal relationships among change in neurocognition, change in psychiatric symptoms and change in psychosocial functional outcomes given community-based psychosocial rehabilitation programs; and 2) to explore unobserved heterogeneous sub-groups (latent classes) in psychosocial functioning change. All research hypotheses were derived from two cognitive rehabilitation models (restorative and compensatory), and from Green and Nuechterlein's model of neurocognition and functional outcomes. The sample consists of 130 individuals diagnosed with schizophrenia or schizoaffective disorder from five rehabilitation programs. Subjects were assessed every six months over 12 months regarding psychosocial functioning and psychiatric symptoms and neurocognition. Structural equation modeling based on longitudinal data analysis methods was used (e.g., Growth Mixture Modeling).; Findings revealed three treatment mechanisms of community-based psychosocial rehabilitation programs: 1) Psychosocial functioning can be improved through increase in neurocognition (i.e., a therapeutic mediator); 2) Improvement in psychosocial functioning is not related to change in psychiatric symptoms; and 3) Effects of service intensity on the functional improvement are more distinctive in individuals who are younger, have more social contacts, have better neurocognition and show less symptomatology. The implication of these findings was discussed in terms of social work practice and research, and suggestions for future research were presented. |
| Keyword | schizophrenia; functional outcome; cognitive rehabilitation; treatment mechanism; latent trajectory class; growth mixture analysis |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Type | texts |
| Legacy record ID | usctheses-m681 |
| Rights | Hoe, Maanse |
| Repository name | Libraries, University of Southern California |
| Repository address | Los Angeles, California |
| Repository email | http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/ |
| Filename | etd-Hoe-20070726 |
| Archival file | uscthesesreloadpub_Volume26/etd-Hoe-20070726.pdf |
Description
| Title | Page 1 |
| Full text | LONGITUDINAL RELATIONSHIPS OF COGNITIVE DEFICITS, SYMPTOMS, AND SOCIAL FUNCTIONING OUTCOMES IN COMMUNITY-BASED PSYCHOSOCIAL REHABILITATION PROGRAMS: MECHANISMS OF LONGITUDINAL CHANGE by Maanse Hoe A Dissertation Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY (SOCIAL WORK) August 2007 Copyright 2007 Maanse Hoe |
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