Do Perceptions Change? Perceived Competency Appraisals for Neurocognitive Testing in Individuals with Early Psychosis

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Authors

Upfold, Casey

Date

2024-10-04

Type

thesis

Language

eng

Keyword

Early Psychosis , Perceived Competency , Behavioural Avoidance , Neurocognitive Functioning

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Abstract

Background: Early intervention and identification of factors underlying recovery are critical areas of concern in early psychosis. Neurocognitive deficits have consistently emerged as the primary ingredient for recovery in psychosis and cognitive remediation has proven to be the preferred intervention for this core feature of psychosis. However, room for improvement remains for full functional recovery following cognitive treatment. Research has primarily focused on motivation concerning treatment outcomes but has often overlooked constructs underlying motivation and individuals’ perceptions about their abilities. Theoretical models and prior research have proposed perceived competency as a concept underlying motivation; however, limited research has examined the mechanisms associated with perceived competency in early psychosis samples. The present study investigated perceived competency appraisals before and after a neurocognitive test battery in early psychosis and the associations between perceived competency, neurocognitive ability, behavioural avoidance, cognitive failures, and functioning. Methods: Individuals were recruited from an early psychosis program (N=63). Participants completed a neurocognitive test battery and self-report measures of behavioural avoidance, cognitive failures, and functioning. Participants appraised their perceived competency for completing the neurocognitive test battery both before and after. In a parallel mediation, behavioural avoidance and cognitive failures were investigated as underlying mechanisms of perceived competency to examine how participants baseline perceived competency before the neurocognitive test battery changed after completing the testing. Results: Perceived competency was significantly negatively associated with behavioural avoidance and cognitive failures but not with objective neurocognitive abilities or functioning. Significant positive associations were found between objective neurocognitive ability and self-perceptions of cognitive failures and functioning. Behavioural avoidance partially mediated the relationship between baseline and post-perceived competency appraisals, but cognitive failures did not. Conclusion: The current study advances the understanding of perceived competency in individuals with early psychosis, emphasizing the value of investigating the underlying mechanisms associated with this construct. By identifying behavioural avoidance as an underlying mechanism, the current study offers a potential target for intervention to increase perceived competency, and, ultimately, better treatment outcomes. The findings also highlight the utility of incorporating individuals’ self-perceptions of their abilities as an avenue to enhance outcomes following cognitive treatment for individuals with early psychosis.

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