Poster #M92 PREDICTING FUNCTIONAL CAPACITY AND REAL-WORLD FUNCTIONING IN SCHIZOPHRENIA: THE ROLE OF COGNITION AND NEGATIVE SYMPTOMS

AbstractPurposeThis study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia.MethodsNaturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. Assessment: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. Statistics: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores.ResultsFunctional capacity: scores on the PSP and PANSS-GP entered first and second at P < 0.0001 and accounted for 21% of variance (R2 = 0.208, model df = 2, F = 15.724, P < 0.0001). Real-world functioning: scores on the CGI-S (B = −5.406), PANSS-N (B = −0.657) and Sp-UPSA (B = 0.230) entered first, second and third, and accounted for 51% of variance (model df = 3, F = 37.741, P < 0.0001).ConclusionIn patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.

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Predicting Real-World Functioning in Schizophrenia: The Relative Contributions of Neurocognition, Functional Capacity, and Negative Symptoms

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.639536 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zixu Yang ◽

Soon Hong Lee ◽

Nur Amirah Abdul Rashid ◽

Yuen Mei See ◽

Justin Dauwels ◽

...

Keyword(s):

Functional Capacity ◽

Real World ◽

Employment Status ◽

Negative Symptoms ◽

Symptom Assessment ◽

Brief Assessment ◽

Multnomah Community Ability Scale ◽

Logistic Regressions ◽

Objective Outcome ◽

Additional Variance

Neurocognition and functional capacity are commonly reported predictors of real-world functioning in schizophrenia. However, the additional impact of negative symptoms, specifically its subdomains, i.e., diminished expression (DE) and avolition-apathy (AA), on real-world functioning remains unclear. The current study assessed 58 individuals with schizophrenia. Neurocognition was assessed with the Brief Assessment of Cognition in Schizophrenia, functional capacity with the UCSD Performance-based Skills Assessment (UPSA-B), and negative symptoms with the Negative Symptom Assessment-16. Real-world functioning was assessed with the Multnomah Community Ability Scale (MCAS) with employment status as an additional objective outcome. Hierarchical regressions and sequential logistic regressions were used to examine the associations between the variables of interest. The results show that global negative symptoms contribute substantial additional variance in predicting MCAS and employment status above and beyond the variance accounted for by neurocognition and functional capacity. In addition, both AA and DE predict the MCAS after controlling for cognition and functional capacity. Only AA accounts for additional variance in employment status beyond that by UPSA-B. In summary, negative symptoms contribute substantial additional variance in predicting both real-world functioning and employment outcomes after accounting for neurocognition and functional capacity. Our findings emphasize both DE and AA as important treatment targets in functional recovery for people with schizophrenia.

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T226. CLINICAL PREDICTORS OF FUNCTIONAL CAPACITY IN TREATMENT RESISTANT SCHIZOPHRENIA PATIENTS: COMPARISON WITH RESPONDER PATIENTS, ROLE OF NEGATIVE SYMPTOMS, PROBLEM SOLVING DYSFUNCTIONS, AND NEUROLOGICAL SOFT SIGNS

Schizophrenia Bulletin ◽

10.1093/schbul/sby016.502 ◽

2018 ◽

Vol 44 (suppl_1) ◽

pp. S204-S204

Author(s):

Felice Iasevoli ◽

Luigi D’Ambrosio ◽

Danilo Notar Francesco ◽

Eugenio Razzino ◽

Camilla Avagliano ◽

...

Keyword(s):

Problem Solving ◽

Functional Capacity ◽

Negative Symptoms ◽

Treatment Resistant ◽

Clinical Predictors ◽

Neurological Soft Signs

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Intertheatricality and Propaganda

10.1093/oso/9780198806813.003.0009 ◽

2017 ◽

Author(s):

Laurence Publicover

Keyword(s):

Early Modern ◽

Real World ◽

The Political ◽

Merchant Of Venice ◽

The Merchant Of Venice ◽

Political Background ◽

Controversial Nature

This chapter analyses the ways in which the collaborative drama The Travels of the Three English Brothers defends the Sherley brothers’ real-world political endeavours across Europe and Persia through its intertheatrical negotiations. Explaining the political background of those endeavours and their controversial nature, it illustrates how the playwrights liken the Sherleys to the heroes of dramas that had been popular on the early modern stage over the preceding twenty years, in particular Tamburlaine and The Merchant of Venice. It also examines the significance of Francis Beaumont’s specific parody, in The Knight of the Burning Pestle, of an episode in Travels in which the Persian Sophy acts as godfather to the child of Robert Sherley. The chapter concludes with a discussion of the role of playing companies in shaping dramatic output.

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Assessing social preferences in reimbursement negotiations for new Pharmaceuticals in Oncology: an experimental design to analyse willingness to pay and willingness to accept

BMC Health Services Research ◽

10.1186/s12913-021-06231-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dominik J. Wettstein ◽

Stefan Boes

Keyword(s):

Willingness To Pay ◽

Real World ◽

Cognitive Biases ◽

Social Preferences ◽

Standard Of Care ◽

Added Value ◽

Amazon Mechanical Turk ◽

Patient Organisation ◽

Patient Benefit

Abstract Background Price negotiations for specialty pharmaceuticals take place in a complex market setting. The determination of the added value of new treatments and the related societal willingness to pay are of increasing importance in policy reform debates. From a behavioural economics perspective, potential cognitive biases and other-regarding concerns affecting outcomes of reimbursement negotiations are of interest. An experimental setting to investigate social preferences in reimbursement negotiations for novel, oncology pharmaceuticals was used. Of interest were differences in social preferences caused by incremental changes of the patient outcome. Methods An online experiment was conducted in two separate runs (n = 202, n = 404) on the Amazon Mechanical Turk (MTurk) platform. Populations were split into two (run one) and four (run two) equally sized treatment groups for hypothetical reimbursement decisions. Participants were randomly assigned to the role of a public price regulator for pharmaceuticals (buyer) or a representative of a pharmaceutical company (seller). In run two, role groups were further split into two different price magnitude framings (“real world” vs unconverted “real payoff” prices). Decisions had real monetary effects on other participants (in the role of premium payers or investors) and via charitable donations to a patient organisation (patient benefit). Results 56 (run one) and 59 (run two) percent of participants stated strictly monotone preferences for incremental patient benefit. The mean incremental cost-effectiveness ratio (ICER) against standard of care (SoC) was higher than the initial ICER of the SoC against no care. Regulators stated lower reservation prices in the “real world” prices group compared to their colleagues in the unconverted payoff group. No price group showed any reluctance to trade. Overall, regulators rated the relevance of the patient for their decision higher and the relevance of their own role lower compared to sellers. Conclusions The price magnitude of current oncology treatments affects stated preferences for incremental survival, and assigned responsibilities lead to different opinions on the relevance of affected stakeholders. The design is useful to further assess effects of reimbursement negotiations on societal outcomes like affordability (cost) or availability (access) of new pharmaceuticals and test behavioural policy interventions.

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COVID-19, Social Media, and the Role of the Public Physician

Blood Purification ◽

10.1159/000512707 ◽

2021 ◽

pp. 1-7

Author(s):

Joel M. Topf ◽

Paul N. Williams

Keyword(s):

Social Media ◽

Real World ◽

The Public ◽

Large Segment ◽

Core Part ◽

Audience Size

The COVID-19 pandemic has resulted in an avalanche of information, much of it false or misleading. Social media posts with misleading or dangerous opinions and analyses are often amplified by celebrities and social media influencers; these posts have contributed substantially to this avalanche of information. An emerging force in this information infodemic is public physicians, doctors who view a public presence as a large segment of their mission. These physicians bring authority and real-world experience to the COVID-19 discussion. To investigate the role of public physicians, we interviewed a convenience cohort of physicians who have played a role in the infodemic. We asked the physicians about how their roles have changed, how their audience has changed, what role politics plays, and how they address misinformation. The physicians noted increased audience size with an increased focus on the pandemic. Most avoided confronting politics, but others found it unavoidable or that even if they tried to avoide it, it would be brought up by their audience. The physicians felt that confronting and correcting misinformation was a core part of their mission. Public physicians on social media are a new occurrence and are an important part of fighting online misinformation.

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Being Peer Gynt: How students collaboratively make meaning of a digital game about a literature classic

E-Learning and Digital Media ◽

10.1177/20427530211022928 ◽

2021 ◽

pp. 204275302110229

Author(s):

Magnus H Sandberg ◽

Kenneth Silseth

Keyword(s):

Real World ◽

Meaning Making ◽

Computer Game ◽

Digital Game ◽

Virtual Self ◽

Dialogic Approach

Henrik Ibsen’s play Peer Gynt digs deep into the question of what it means to be oneself. An upcoming computer game version invites players to take on the role of Peer and thereby raises new questions about identity and identification. By recording dyads of students who play an early version of the game and analysing their interaction during gameplay, we examine how students collaboratively make meaning of the computer game. This study employs a sociocultural and dialogic approach to meaning making. In the analysis, we draw on Gee’s theory on multiple player identities and see the dyads playing together as two real-world selves negotiating on creating one virtual self through a co-authorship of situated meaning in what Gee calls the projective stance. To better understand their cooperation in this undertaking, we also apply Goffman’s term activity frames. The analysis shows how the dyads approach the game in different ways by establishing frames in which they interpret, impersonate or recreate Peer, in order to make meaning of their gameplay.

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The role of negative symptoms in the context of cognitive remediation for schizophrenia

Schizophrenia Research ◽

10.1016/j.schres.2013.08.008 ◽

2013 ◽

Vol 150 (1) ◽

pp. 58-63 ◽

Cited By ~ 19

Author(s):

Aida Farreny ◽

Jaume Aguado ◽

Susana Ochoa ◽

Josep Maria Haro ◽

Judith Usall

Keyword(s):

Negative Symptoms ◽

Cognitive Remediation

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Camp stability predicts patterns of hunter–gatherer cooperation

Royal Society Open Science ◽

10.1098/rsos.160131 ◽

2016 ◽

Vol 3 (7) ◽

pp. 160131 ◽

Cited By ~ 22

Author(s):

Daniel Smith ◽

Mark Dyble ◽

James Thompson ◽

Katie Major ◽

Abigail E. Page ◽

...

Keyword(s):

Real World ◽

Ecological Context ◽

Hunter Gatherers ◽

Ecological Conditions ◽

Resource Transfers ◽

Experimental Games ◽

Using Data ◽

Over Time ◽

Do So

Humans regularly cooperate with non-kin, which has been theorized to require reciprocity between repeatedly interacting and trusting individuals. However, the role of repeated interactions has not previously been demonstrated in explaining real-world patterns of hunter–gatherer cooperation. Here we explore cooperation among the Agta, a population of Filipino hunter–gatherers, using data from both actual resource transfers and two experimental games across multiple camps. Patterns of cooperation vary greatly between camps and depend on socio-ecological context. Stable camps (with fewer changes in membership over time) were associated with greater reciprocal sharing, indicating that an increased likelihood of future interactions facilitates reciprocity. This is the first study reporting an association between reciprocal cooperation and hunter–gatherer band stability. Under conditions of low camp stability individuals still acquire resources from others, but do so via demand sharing (taking from others), rather than based on reciprocal considerations. Hunter–gatherer cooperation may either be characterized as reciprocity or demand sharing depending on socio-ecological conditions.

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