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The "Right Stuff" Revisited: What Have We Learned About the Determinants of Daily Functioning in Schizophrenia?
Michael F Green1, Katiah Llerena2, Robert S Kern2
1Desert Pacific Mental Illness Research, Education, and Clinical Center, Department of Veterans Affairs, Los Angels, CA; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angels, CA mgreen@ucla.edu.
Abstract:
It has been about 15 years since we published our article asking whether we are measuring the "Right Stuff" as we search for predictors and determinants of functional outcome in schizophrenia. At that time, we raised the question as to whether the neurocognitive assessments used to study outcome in schizophrenia were too narrow to capture the wide variability in factors that determine daily functioning. While the study of the determinants of functioning in schizophrenia has grown and matured, we are struck by 3 aspects of the article that evolved in different directions. First, the selection of outcome domains in the Right Stuff meta-analysis reflects a focus at that time on predictors of psychiatric rehabilitation. Second, expansion beyond traditional neurocognitive domains occurred in one suggested area (social cognition), but not another (learning potential). Third, the field has responded assertively to the recommendation to evaluate more informed and informative theoretical models.
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