Related Experiment Video
Updated: Aug 14, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Negative symptom dimensions link cognitive impairment to global and social functioning in 22q11.2 deletion syndrome
David A Parker1, Marissa Chen2, Elaine F Walker3
1Atlanta Veterans Administration Health Care System, Mental Health 116/A, 1670 Clairmont Road, Decatur, GA, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, NE, 2nd Floor, Atlanta, GA, 30329, USA.
Background:
22q11.2 deletion syndrome (22q11DS) confers a 20-30% lifetime risk of schizophrenia, with negative symptoms associated with poorer outcomes and higher psychosis risk. High rates of neurocognitive deficits, autism spectrum traits (ASD), and attention-deficit/hyperactivity disorder (ADHD) may further complicate symptom profiles and functional outcomes. We examined relationships among positive and negative symptom severity, ASD traits, ADHD symptoms, and global functioning in 22q11DS.
Methods:
Individuals with 22q11DS (n = 38) and healthy comparison subjects (n = 34) completed clinical and cognitive assessments. Exploratory factor analysis (EFA) of the 19 items on the Structured Interview for Psychosis-Risk Syndromes (SIPS) derived empirical symptom dimensions. Group differences were evaluated using Mann-Whitney U tests. Mediation analyses examined whether SIPS-derived factors mediated relationships between cognition and three domains: global functioning, ASD traits, and ADHD symptom severity.
Results:
EFA identified three symptom dimensions: (1) Positive/Disorganized, (2) Negative-Motivational, and (3) Negative-Expressive. Compared to healthy comparisons, 22q11DS subjects showed elevated scores across all three symptom dimensions, ASD subscales, and ADHD domains (except hyperactivity/restlessness), alongside significant neurocognitive and global functioning impairments. The Negative-Expressive factor was the strongest mediator, showing the largest indirect effects for global functioning and ASD traits. The Negative-Motivational factor was the only dimension to significantly mediate all three outcomes. The Positive/Disorganized factor mediated effects only on global functioning and ASD traits.
Conclusion:
Negative-expressive symptoms represent a core pathway linking cognitive deficits to functional impairment in 22q11DS, while motivational and positive symptom dimensions contribute differentially across functional domains. Expressive and motivational symptoms may represent candidate targets for future longitudinal and intervention studies in 22q11DS.
Related Concept Videos
Negative and Cognitive Symptoms of Schizophrenia
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
Positive Symptoms of Schizophrenia: Hallucinations and Delusions
Thought Disorders
Disorganized and unusual thought processes mark thought disorders in schizophrenia. One key feature is disorganized speech, where an individual's conversation includes loosely...
Social Anxiety Disorder
Language and Cognition
Personality Disorders: Paranoid and Schizoid
Paranoid Personality Disorder
Paranoid personality disorder is...

