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Environmental Adaptations Improve Everyday Action in Schizophrenia

Published online by Cambridge University Press:  01 June 2015

Rachel K. Kessler ,
Emma Rhodes  and
Tania Giovannetti
Rachel K. Kessler
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Emma Rhodes
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Tania Giovannetti*
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
*
Correspondence and reprint requests to: Tania Giovannetti, Temple University, Department of Psychology, 1701 N. 13th Street, Philadelphia, PA 19122. E-mail: tgio@temple.edu.
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Abstract

Cognitive functioning, particularly executive functioning, is a strong predictor of functional outcomes in people with schizophrenia. Cognitive remediation has been shown to improve specific cognitive processes, but adjunctive interventions are required for meaningful gains in adaptive functioning, particularly in people with chronic illness. This study examined whether (and how) environmental adaptations, used without training, may circumvent cognitive difficulties and facilitate everyday task performance in individuals with chronic schizophrenia. Forty-two individuals with chronic schizophrenia/schizoaffective disorder were administered cognitive measures and two versions of the Naturalistic Action Test (NAT)—a standard version (ST-NAT), and a user-centered version (UC-NAT) that incorporated environmental adaptations designed to facilitate task performance. The NAT conditions were counterbalanced across participants. Analyses compared performance between the NAT versions and examined the cognitive correlates of each NAT condition. Individuals with schizophrenia made fewer errors on the UC-NAT as compared to the ST-NAT; this between-group difference was significant for all error types. Compared to the ST-NAT, the UC-NAT performance was not significantly associated with an executive function measure of planning. Environmental adaptations may be implemented without extensive training to improve everyday action in individuals with chronic schizophrenia. Environmental adaptations that reduce planning demands may be most effective in this population. (JINS, 2015, 21, 319–329)

Keywords

SchizophreniaCognitionEveryday actionCognitive remediationExecutive functionsEnvironmental adaptations
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 5 , May 2015 , pp. 319 - 329
Copyright
Copyright © The International Neuropsychological Society 2015 

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