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147. Exploring the Discrepancy between Competence and Performance in Schizophrenia: Contributions from Clinical and Cognitive Characteristics
Competence and performance in relation to functional outcomes are usually in synchrony, though a discrepancy between the two occurs in some individuals with schizophrenia. In this study, demographic, clinical, and cognitive characteristics that may influence this discrepancy were examined. Participants with schizophrenia or schizoaffective disorder (N=408) completed assessments of functional performance (ILSS), social competence (MASC), dysfunctional attitudes (DPAS), negative symptoms (SANS), and neurocognition. Participants were divided into four groups on the basis of the median scores on the ILSS and MASC: high competence and high performance (CP; n=91); high competence but low performance (Cp; n=83); low competence but high performance (cP; n=95); and low competence and low performance (cp; n=139). One-way ANOVAs yielded significant differences among the groups in education, dysfunctional attitudes, experiential and expressive negative symptoms, and global neurocognition. Post-hoc tests revealed poorer neurocognition and more severe experiential negative symptoms in the Cp group compared to the CP group, and more severe experiential and expressive negative symptoms in the cp group compared to the cP group. These findings suggest that more severe negative symptoms pertaining to motivation are a risk factor for underperforming whereas greater motivation is a resilience factor for overcoming low competence to achieve better functioning.