scholarly journals Causal pathways to social and occupational functioning in the first episode of schizophrenia: uncovering unmet treatment needs

2021 ◽  
pp. 1-9
Author(s):  
Kathleen Miley ◽  
Piper Meyer-Kalos ◽  
Sisi Ma ◽  
David J. Bond ◽  
Erich Kummerfeld ◽  
...  
Keyword(s):  
Structural Equation ◽  
Equation Model ◽  
Validation Dataset ◽  
First Episode ◽  
Treatment Needs ◽  
Occupational Functioning ◽  
Causal Pathways ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Early Schizophrenia

Abstract Background We aimed to identify unmet treatment needs for improving social and occupational functioning in early schizophrenia using a data-driven causal discovery analysis. Methods Demographic, clinical, and psychosocial measures were obtained for 276 participants from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) trial at baseline and 6-months, along with measures of social and occupational functioning from the Quality of Life Scale. The Greedy Fast Causal Inference algorithm was used to learn a partial ancestral graph modeling causal relationships across baseline variables and 6-month functioning. Effect sizes were estimated using a structural equation model. Results were validated in an independent dataset (N = 187). Results In the data-generated model, greater baseline socio-affective capacity was a cause of greater baseline motivation [Effect size (ES) = 0.77], and motivation was a cause of greater baseline social and occupational functioning (ES = 1.5 and 0.96, respectively), which in turn were causes of their own 6-month outcomes. Six-month motivation was also identified as a cause of occupational functioning (ES = 0.92). Cognitive impairment and duration of untreated psychosis were not direct causes of functioning at either timepoint. The graph for the validation dataset was less determinate, but otherwise supported the findings. Conclusions In our data-generated model, baseline socio-affective capacity and motivation are the most direct causes of occupational and social functioning 6 months after entering treatment in early schizophrenia. These findings indicate that socio-affective abilities and motivation are specific high-impact treatment needs that must be addressed in order to promote optimal social and occupational recovery.

scholarly journals Causal association pathways between fetuin-A and kidney function: A mediation Analysis

2020 ◽  
Author(s):  
Philip Etabee Macdonald Bassey ◽  
Pawin Numthavaj ◽  
Sasivimol Rattanasiri ◽  
Piyamitr Srit ◽  
Mark McEvoy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Function ◽  
Structural Equation ◽  
Equation Model ◽  
Study Cohort ◽  
Mediation Effects ◽  
Fetuin A ◽  
Causal Pathways ◽  
Causal Pathway ◽  
Negative Effect

Abstract BackgroundBody mass index (BMI), uric acid (UA) diabetes mellitus (DM) and hypertension (HT) are known risk factors of declined kidney function, and are associated with fetuin-A. However, the causal pathways of these associations are unclear. We therefore used cohort data to explore possible causal pathways of fetuin-A and kidney function. MethodologyWe used data of the Electricity Generating Authority of Thailand cohort 2009 (n= 2305). A causal pathway was constructed, which considered fetuin-A as study factor, BMI, UA, DM, and HT as mediators, and eGFR as the outcome. A generalized-structural equation model (GSEM) with 1000-replication bootstrapping was applied to assess the causal effects adjusting for covariates. ResultsThe fetuin-A → eGFR pathway showed a direct association of fetuin-A on eGFR with the coefficient of -0.0072 (95% CI: -0.0119, -0.0025). In addition, the indirect effects of fetuin-A→ BMI → eGFR was also significant with the coefficient of 0.00086 (0.00025, 0.0016; implying that every one unit of BMI increased, resulting from increasing fetuin-A, would significantly increase eGFR 0.00086 (0.00025, 0.0016) mL/min/1.73m2. There was a negative effect of fetuin-A on eGFR through BMI and UA pathway (Fetuin-A→BMI→UA→eGFR ) as well as the HT pathway (Fetuin-A→BMI→HT→eGFR ) with average casual mediation effects (ACME) of -0.00132 (-0.00177, -0.00092) and -0.00139 (-0.00237, -0.00069). Fetuin-AàDMàHTàeGFR was also statistically significant with the ACME of -0.00223 (-0.00535, -0.00066).ConclusionOur study has shed some light on the possible role of fetuin-A in the etiology of declining renal function through the mediatory roles of BMI, UA, DM and HT in the various complex causal pathways leading to declining kidney function in our study cohort. Further studies are however recommended to examine the pathomechanisms involved in the mediational processes of these studied risk factors in the etiology of declining kidney function.

The evolution of insight, paranoia and depression during early schizophrenia

2004 ◽  
Vol 34 (2) ◽  
pp. 285-292 ◽  
Author(s):  
R. J. DRAKE ◽  
A. PICKLES ◽  
R. P. BENTALL ◽  
P. KINDERMAN ◽  
G. HADDOCK ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Structural Equation ◽  
Clinical Importance ◽  
Self Esteem ◽  
First Episode ◽  
Affective Psychosis ◽  
Episode Psychosis ◽  
First Episode Of Schizophrenia ◽  
Early Schizophrenia

Background. How insight, paranoia and depression evolve in relation to each other during and after the first episode of schizophrenia is poorly understood but of clinical importance.Method. Serial assessments over 18 months were made using multiple instruments in a consecutive sample of 257 patients with first episode DSM-IV non-affective psychosis. Repeated measures of paranoia, insight, depression and self-esteem were analysed using structural equation modelling, to examine the direction of relationships over time after controlling for confounds.Results. Depression was predicted directly by greater insight, particularly at baseline, and by greater paranoia at every stage of follow-up. Neither relationship was mediated by self-esteem, although there was a weak association of lower self-esteem with greater depression and better insight. Paranoia was not strongly associated with insight. Duration of untreated psychosis and substance use at baseline predicted depression at 18 months.Conclusions. In first-episode psychosis, good insight predicts depression. Subsequently, paranoia is the strongest predictor. Neither effect is mediated by low self-esteem. Effective treatment of positive symptoms is important in preventing and treating low mood in early schizophrenia.

The centrality of motivation in psychosocial functioning: Network and bifactor analysis of the Quality of Life Scale in first episode psychosis

2021 ◽  
Author(s):  
Samuel Abplanalp ◽  
Kim T. Mueser ◽  
Daniel Fulford
Keyword(s):  
Quality Of Life ◽  
Psychosocial Functioning ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Bifactor Modeling

Psychosocial functioning impairment is prevalent in first episode psychosis and chronic schizophrenia. The Quality of Life Scale (QLS) is a widely-used tool to measure psychosocial functioning; however, given the overlap between negative symptoms and functioning, along with the QLS being conceptualized initially as a measure of the deficit syndrome, it is unclear whether summing QLS items into a total score is an appropriate measure of overall psychosocial functioning. This study aimed to examine the centrality of QLS items and the appropriateness of using a QLS total score. Participants with first episode psychosis (n = 404) completed the QLS. Item centrality was assessed using a network analysis approach, while reliability and dimensionality of the QLS total score and subscales were measured using bifactor modeling and related psychometric indices. Network analysis results showed that an item relating to motivation was the most central item within the scale. Moreover, bifactor modeling results found that motivation and other items relating to negative symptoms may reflect the QLS total score more strongly than other functioning (i.e., Interpersonal, Instrumental) domains. Based on these findings, we urge researchers to use caution when using a QLS total score, as it may unequally confound functional domains and motivation. Moreover, our results continue to underscore the importance of negative symptoms, particularly motivational impairment, in psychosocial functioning. Future studies should aim to examine the centrality of other functioning measures in psychosis and schizophrenia, as our results suggest that psychosocial functioning may be greatly influenced by motivation.

scholarly journals Measuring Individual Disaster Recovery: A Socioecological Framework

2010 ◽  
Vol 4 (S1) ◽  
pp. S46-S54 ◽  
Author(s):  
David M. Abramson ◽  
Tasha Stehling-Ariza ◽  
Yoon Soo Park ◽  
Lauren Walsh ◽  
Derrin Culp
Keyword(s):  
Mental Health ◽  
Hurricane Katrina ◽  
Disaster Recovery ◽  
Structural Equation ◽  
Ecological Model ◽  
Social Role ◽  
Equation Model ◽  
Causal Pathways ◽  
Comprehensive Framework ◽  
Psychological Strength

ABSTRACTBackground: Disaster recovery is a complex phenomenon. Too often, recovery is measured in singular fashion, such as quantifying rebuilt infrastructure or lifelines, without taking in to account the affected population's individual and community recovery. A comprehensive framework is needed that encompasses a much broader and far-reaching construct with multiple underlying dimensions and numerous causal pathways; without the consideration of a comprehensive framework that investigates relationships between these factors, an accurate measurement of recovery may not be valid. This study proposes a model that encapsulates these ideas into a single framework, the Socio-Ecological Model of Recovery.Methods: Using confirmatory factor analysis, an operational measure of recovery was developed and validated using the five measures of housing stability, economic stability, physical health, mental health, and social role adaptation. The data were drawn from a sample of displaced households following Hurricane Katrina. Measures of psychological strength, risk, disaster exposure, neighborhood contextual effects, and formal and informal help were modeled to examine their direct and indirect effects on recovery using a structural equation model.Findings: All five elements of the recovery measure were positively correlated with a latent measure of recovery, although mental health and social role adaptation displayed the strongest associations. An individual's psychological strength had the greatest association with positive recovery, followed by having a household income greater than $20 000 and having informal social support. Those factors most strongly associated with an absence of recovery included the time displaced since the hurricane, being disabled, and living in a community with substantial social disorder.Discussion: The socio-ecological framework provides a robust means for measuring recovery, and for testing those factors associated with the presence or absence of recovery.(Disaster Med Public Health Preparedness. 2010;4:S46-S54)

scholarly journals Life Satisfaction: Testing a Structural Equation Model Based on Authenticity and Subjective Happiness

2015 ◽  
Vol 46 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Hakan Sariçam
Keyword(s):  
Life Satisfaction ◽  
Correlation Analysis ◽  
Structural Equation Model ◽  
Structural Equation ◽  
Satisfaction With Life ◽  
Equation Model ◽  
Satisfaction With Life Scale ◽  
External Influence ◽  
Subjective Happiness ◽  
Life Scale

Abstract The aim of this research is to examine the relationships between authenticity, subjective happiness, and life satisfaction. The participants were 347 university students. In this study, the Authenticity Scale, the Subjective Happiness Scale, and Satisfaction with Life Scale were used. The relationships between authenticity, subjective happiness and life satisfaction were examined using correlation analysis and Structural Equation Model (SEM). In correlation analysis, authentic living was found positively related to subjective happiness. On the other hand, self-alienation, accepting external influence was found negatively correlated to subjective happiness. Besides subjective happiness and life satisfaction have positive relation. Structural Equation Model showed that self-alienation, accepting external influence results in a decrease subjective happiness on life satisfaction whereas rise in authentic living lead to subjective happiness, so subjective happiness also brings life satisfaction. According to standardized beta coefficients (β= -.49), the most significant predictor of subjective happiness was self-alienation. Results were discussed in the light of the related literature.

scholarly journals Ethical Consumer Behavior: Does Second-Hand Consumption Influence Satisfaction with Life?

2020 ◽  
Vol 8 (3) ◽  
pp. p62
Author(s):  
Adrienne Steffen
Keyword(s):  
Structural Equation ◽  
Satisfaction With Life ◽  
Equation Model ◽  
Happy Life ◽  
Lifestyle Choice ◽  
Online Study ◽  
Ethical Consumer ◽  
Life Scale ◽  
Economic Motives ◽  
The Relationship

What do we really need to live a happy life? Second-hand consumption has been proposed to be a lifestyle choice which is done voluntarily (Steffen, 2017, p. 204) and could increase peoples’ life satisfaction. Besides economic motives, many people consume second-hand for ethical reasons, e.g., to distance themselves from the consumption system, for ecological reasons, social reasons or have hedonic motivations (Guiot & Roux, 2010). Some consumers simply want to shop clever (Gregson & Crewe, 2003, p. 11), started to reduce their consumption or re-use to reduce their ecological footprint (Waight, 2013). This study assesses the relationship between second-hand consumption motivation and satisfaction with life in a structural equation model. 203 Germans participated in the online study and evaluated their motivation for second-hand consumption based on the scale of Guiot and Roux (2010). Satisfaction with life was measured with Diener, Emmons and Griffin’s (1985) Satisfaction of life scale which has been translated into German by Janke and Glöckner-Rist (2014). The findings indicate that consumers primarily buy second-hand to hunt for treasures, to find original products, to engage socially and for ethical reasons. Economic motives were also dominant. The study shows that second-hand consumption motivation does not influence satisfaction with life.

Reassessing the CASP-19 adapted for Brazilian Portuguese: insights from a population-based study

2021 ◽  
pp. 1-16
Author(s):  
Larissa Pruner Marques ◽  
João Luiz Bastos ◽  
Eleonora d'Orsi
Keyword(s):  
Structural Equation ◽  
Structural Equation Models ◽  
Population Based ◽  
Factor Analyses ◽  
Confirmatory Factor Analyses ◽  
Brazilian Version ◽  
Quality Of Life Scale ◽  
Exploratory Factor Analyses ◽  
Two Factors ◽  
Life Scale

Abstract The study reassessed the configural and metric structures of the Brazilian version of the Control, Autonomy, Self-realization and Pleasure (CASP-19) quality-of-life scale. Data came from the EpiFloripa Ageing Study, which included 1,131 respondents from Southern Brazil. The original and two recently factorial solutions for the Brazilian CASP-19 were initially examined. Exploratory Factor Analyses and Exploratory Structural Equation Models were estimated in the first half of the sample, selected at random. In the second half, Confirmatory Factor Analyses determined the most tenable configural and metric model for the instrument. Neither the original nor the two Brazilian solutions were supported by our data. Instead, we suggest that two factors underlie CASP-19's configural structure: while the first one groups the control and autonomy dimensions, the second combines self-realization and pleasure. Except for four items, all others presented moderate to strong loadings, and only two showed a theoretically meaningful and sufficiently large residual correlation, which was worthy of inclusion in the final model. Cross-loadings were not detected. When assessed in a population-based sample of older respondents, this Brazilian version of the CASP-19 appeared to have two factors, moderate to strong loadings and a pair of redundant items. Future studies should evaluate the consistency of these findings, examine the scalar structure of the instrument, and assess configural, metric and scalar invariance across social groups.

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