Award Date

2009

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Department

Psychology

Advisor 1

Daniel N. Allen, Committee Chair

First Committee Member

Jeffrey Kern

Second Committee Member

Jefferson Kinney

Graduate Faculty Representative

Chad Cross

Number of Pages

180

Abstract

Bipolar disorder affects approximately 1% of the population. It is a severe and debilitating illness, causing serious impairment of interpersonal, occupational and social functioning. The disorder is characterized by marked mood swings as well significant neurocognitive deficits. Based on work with other psychiatric and neurological disorders, neurocognitive deficits in bipolar disorder are expected to be strong predictors of functional capacity. However, few studies have evaluated the consequences of neurocognitive deficits in this disorder. Most available studies have focused on the clinical correlates of functional outcome, such as number of hospitalizations, age of disorder onset, and severity of symptoms. While useful, these studies provide only limited information regarding more complex functional domains, and their associations with neurocognitive functioning. To address this limitation, the current study examined the relationship between neurocognitive deficits and the psychosocial and occupational functioning of individuals with bipolar disorder. Forty-seven individuals with bipolar disorder received a standard battery of neuropsychological and functional outcome measures. Functional outcome measures were designed to assess presence and quality of activities, as well as patient satisfaction in various domains of functioning. These measures are both self-report format and performance-based in order to provide a comprehensive view of the patients' functioning. Results indicated that functional outcome as measured by a performance-based assessment was significantly predicted by a global neurocognitive impairment rating (R 2 = .160, F = 8.59, df = 1,45, p = .005). Significant correlations were found between areas of functioning and neurocognitive domains. There were significant relationships between finance ability and the working memory and visual constructional/spatial domains, between communication ability and the verbal memory and learning domain, and between household skills and the attention/psychomotor speed and working memory domains. However, subhypotheses examining the prediction of specific areas of functional outcome by specific neurocognitive domains based on the literature in schizophrenia were not supported by the current study. Furthermore, mediator-moderator analyses examining the role of neurocognitive impairment as a mediator or moderator between chronicity and functional outcome as well as between mood symptoms and functional outcome were not supported by the current study. The current study adds additional support that neurocognitive deficits were related to functional outcome in bipolar disorder. Further, neurocognitive deficits are a significant predictor of functioning as measured by the ability to perform functional activities. Specific areas of functioning were related to neurocognitive domains, which can serve as a basis for future research.

Keywords

Bipolar disorder; Cognitive deficits; Functional outcome; Neurocognitive functioning; Neuropsychology

Disciplines

Clinical Psychology | Cognitive Psychology | Neuroscience and Neurobiology

Language

English


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