Title

Validation of the Biber Cognitive Estimation Test for persons with schizophrenia involved in a vocational rehabilitation program

Date of Completion

January 2001

Keywords

Health Sciences, Rehabilitation and Therapy|Psychology, Clinical|Psychology, Psychometrics

Degree

Ph.D.

Abstract

People with schizophrenia have cognitive impairments. However, little is known about how these cognitive impairments compromise community functioning. Cognitive estimation is a skill that is hypothesized to be impaired in people with schizophrenia, to be associated with other executive abilities, and to be a predictor of functional outcome. The Biber Cognitive Estimation Test (BCET) is a recently developed test of executive functioning which requires a person to make reasonable judgments about everyday things. Cognitive tests, including the BCET, were administered to 30 outpatients with a diagnosis of schizophrenia or schizoaffective disorder who were also involved in a 2-year vocational rehabilitation project. The three vocational models included brokered services from a professional vendor of vocational rehabilitation (Standard), participation in a clubhouse modeled after Fountain House (Clubhouse), and intensive vocational support integrated with psychiatric treatment (Supported Employment). ^ A number of hypotheses were evaluated in the present study. First, we compared this group of people with schizophrenia to a non-psychiatrically impaired control group to test the hypothesis that people with schizophrenia have impaired cognitive estimation skills. Next, we conducted correlational analyses to test the hypothesis that cognitive estimation is associated with executive functioning. Finally, we conducted a number of logistic regression and survival analyses to test the hypothesis that deficits in cognitive estimation are associated with poorer functional outcomes. ^ The people with schizophrenia were impaired on the BCET relative to the Information-matched control group. In addition, scores on the BCET were significantly correlated with performance on the WCST above and beyond age, education and Information-scaled scores. None of the cognitive variables were able to uniquely predict either prospective or retrospective vocational outcomes. However, impairment on the BCET did predict poor vocational outcome for those people enrolled in the Clubhouse Program. Consistent with previous findings, performance on the WCST was negatively correlated with duration of lifetime hospitalizations. Findings suggest that although cognitive estimation skills are correlated with executive abilities, they seem to predict different outcomes and may be more sensitive to other areas of brain dysfunction present in people with schizophrenia. ^