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Prospective cohort study of the relationship between neuro-cognition, social cognition and violence in forensic patients with schizophrenia and schizoaffective disorder.

O'Reilly K, Donohoe G, Coyle C, O'Sullivan D, Rowe A, Losty M, McDonagh T, McGuinness L, Ennis Y, Watts E, Brennan L, Owens E, Davoren M, Mullaney R, Abidin Z, Kennedy HG - BMC Psychiatry (2015)

Bottom Line: Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender.Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size.Neurocognition operates as a distal risk factor mediated through more proximal factors.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Trinity College Dublin, Dublin, Ireland. oreillk5@tcd.ie.

ABSTRACT

Background: There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed.

Methods: We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB).

Results: Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). There was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 % of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence.

Conclusions: Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. Neurocognition operates as a distal risk factor mediated through more proximal factors. Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The neurocognitive impairment experienced by patients with schizophrenia spectrum disorders may create the foundation for the emergence of a range of risk factors for violence including deficits in social reasoning, symptoms, social functioning, and HCR-20 risk items, which in turn are causally related to violence.

No MeSH data available.


Related in: MedlinePlus

Mediation model 4: single mediator as in Table 4
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Fig1: Mediation model 4: single mediator as in Table 4

Mentions: SPSS PROCESS macro model 4 [70] was used to analyse mediation relationships between antecedent factors such as neurocognition, social cognition, and the dichotomous outcome violence (Fig. 1). Age and gender were entered as co-variants in all mediation analysis. SPSS PROCESS macro is a computational tool for path analysis-based moderation and mediation analysis. Various measures of effect size for indirect effects are generated in mediation models. Effect sizes were calculated as regression coefficients in the first instance and later as odds ratios to facilitate interpretation. Bootstrapping was used to estimate indirect effects, and 95 % bias-corrected confidence intervals were used for the indirect effects using 1,000 bootstrap samples. A confidence interval for an odds ratio that does not contain a score of one indicates statistically significant mediation.Fig. 1


Prospective cohort study of the relationship between neuro-cognition, social cognition and violence in forensic patients with schizophrenia and schizoaffective disorder.

O'Reilly K, Donohoe G, Coyle C, O'Sullivan D, Rowe A, Losty M, McDonagh T, McGuinness L, Ennis Y, Watts E, Brennan L, Owens E, Davoren M, Mullaney R, Abidin Z, Kennedy HG - BMC Psychiatry (2015)

Mediation model 4: single mediator as in Table 4
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4496853&req=5

Fig1: Mediation model 4: single mediator as in Table 4
Mentions: SPSS PROCESS macro model 4 [70] was used to analyse mediation relationships between antecedent factors such as neurocognition, social cognition, and the dichotomous outcome violence (Fig. 1). Age and gender were entered as co-variants in all mediation analysis. SPSS PROCESS macro is a computational tool for path analysis-based moderation and mediation analysis. Various measures of effect size for indirect effects are generated in mediation models. Effect sizes were calculated as regression coefficients in the first instance and later as odds ratios to facilitate interpretation. Bootstrapping was used to estimate indirect effects, and 95 % bias-corrected confidence intervals were used for the indirect effects using 1,000 bootstrap samples. A confidence interval for an odds ratio that does not contain a score of one indicates statistically significant mediation.Fig. 1

Bottom Line: Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender.Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size.Neurocognition operates as a distal risk factor mediated through more proximal factors.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Trinity College Dublin, Dublin, Ireland. oreillk5@tcd.ie.

ABSTRACT

Background: There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed.

Methods: We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB).

Results: Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). There was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 % of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence.

Conclusions: Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. Neurocognition operates as a distal risk factor mediated through more proximal factors. Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The neurocognitive impairment experienced by patients with schizophrenia spectrum disorders may create the foundation for the emergence of a range of risk factors for violence including deficits in social reasoning, symptoms, social functioning, and HCR-20 risk items, which in turn are causally related to violence.

No MeSH data available.


Related in: MedlinePlus