The Impact of Physical and Mental Health on Schizophrenia Patients' Daily Functioning

Ellaheh Gohari

Overview

Schizophrenia patients often generate self-reports of their activities and work that diverge from objective information. It is suggested that these participants may not base their reports on their daily experiences. In this study, ecological momentary assessment (EMA) was used to sample daily activities in schizophrenia and determine whether EMA responses were associated with self and observer-reported work skills and everyday activities as measured by Specific Level of Functioning (SLOF) scales. 112 participants were sampled 3 times a day for 30 days. Each survey asked where and with whom they were, what they were doing, and if they were experiencing mood changes or active psychotic symptoms. Participants and observers completed the SLOF scale at study end. Repeated measure statistical modeling was used to determine associations. Being home or alone was associated with self-reports of productive functioning in activities and work skills. Patients with paranoia self-reported their everyday activities as better than those without paranoia even when controlling for other predictors. They also overestimated their functioning when compared to observer reports. Patients who heard voices at least once were more likely to overestimate their work abilities, as did patients who reported delusions. Those with sadness or depression were more likely to underestimate their functioning. Schizophrenia was marked by a disconnect between momentary experiences and self-reports. Positive schizophrenia symptoms are associated with overestimating activities but not work skills. This study showed that schizophrenia patients have high introspective bias, but EMA methods can be used to provide a richer picture of the patient’s daily functioning.

From the student

I started my science research journey all the way back in 6th grade. My mother, a science researcher herself, told me about my school's excellent research program, open to 6th graders and beyond. As someone who always loved science, I decided to sign up, not knowing then what amazing ideas I would be exposed to.

My project in 6th grade was relatively simple, but I found a brand new love of learning and competition. The excitement when discovering an unexpected result, adrenaline when presenting my project to judges, and anticipation moments before finding out whether I placed in a competition gave me a high I sought to recreate in years to come.

The science research program I joined also gave me the opportunity to submit my research to FJAS, Florida's branch of AJAS. For three years in a row I competed, and for those three years I placed, but never first. That all changed with my 9th grade project, which analyzed how a new program called Ecological Momentary Assessment (EMA) could help predict physical functioning in schizophrenia patients.

University of Miami professor Dr. Philip Harvey gave me access to his database, which I was able to analyze using statistical models. I discovered that certain symptoms and situations made the patients more likely to overestimate their abilities. Not only did Dr. Harvey give me invaluable advice, he also paved the way for me to present my research at the 2021 Schizophrenia International Research Conference, pictured above.

Later that same year, I wrote my research paper for FJAS. I was in the high school division, which was even more competitive than the middle school one, but I didn't lose hope. I knew that if any of my projects could win FJAS, it was this one, as it takes such a personal and unique look on schizophrenia patients, an often overlooked condition. My hard work paid off when I won in my category. Now, I'm ready to become an AJAS member and share my research with the world. I'm also excited to learn from others, and I cannot wait to see what AJAS has in store!