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Adaptive functioning in schizophrenia: Behavioral executive functioning beyond negative symptoms.
Javier Pérez-Flores1, Antonieta Nieto1, Elena García-Cerdeña1
1Department of Psychobiology, Clinical Psychology, and Methodology, School of Psychology, Universidad de La Laguna, Tenerife, Spain.
Applied Neuropsychology. Adult
|February 23, 2026
Summary
Behavioral ratings of executive functioning (EF) offer valuable insights into adaptive functioning in schizophrenia, beyond negative symptoms. These ratings provide clinically meaningful, non-redundant information for individuals with residual-phase schizophrenia.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Negative symptoms are key predictors of adaptive functioning in schizophrenia.
- Executive functioning (EF) impacts adaptive functioning but may capture distinct self-regulatory processes.
- Previous research primarily used performance-based EF measures in structured settings.
Purpose of the Study:
- To investigate if behavioral ratings of EF offer additional explanatory value for adaptive functioning in adults with residual-phase schizophrenia, beyond negative symptoms.
- To assess the incremental contribution of informant-reported executive functioning to adaptive functioning.
- To determine the clinical utility of behavioral EF measures in schizophrenia research.
Main Methods:
- Forty outpatients with residual-phase schizophrenia were evaluated.
- Life Skills Profile (LSP-39) measured adaptive functioning.
- Scale for the Assessment of Negative Symptoms (SANS) and Dysexecutive Questionnaire (DEX) assessed negative symptoms and behavioral EF, respectively.
- Hierarchical regression models with permutation tests and bootstrap confidence intervals were used.
Main Results:
- Behavioral EF ratings (DEX) demonstrated strong associations with global adaptive functioning and all its domains.
- Negative symptoms (SANS) were also related to functioning, but with generally smaller associations.
- Hierarchical models showed DEX scores explained significant additional variance in adaptive functioning beyond negative symptoms, with larger standardized coefficients than negative symptoms.
Conclusions:
- Behavioral ratings of executive functioning provide unique and clinically significant information about adaptive functioning in schizophrenia.
- Informant-reported EF measures offer non-redundant insights beyond negative symptoms for individuals with residual-phase schizophrenia.
- These findings support the use of behavioral EF assessments in understanding and potentially improving adaptive functioning in schizophrenia.
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