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Neurocognition and Community Functioning: An Ethnographic Study

Deborah Gioia-Hasick
1319 Idaho Ave #4
Santa Monica CA 90403
dgioia@scf.usc.edu

Purpose: The purpose of this study is to understand “real-world” strategies of schizophrenic individuals who have completed prior neurocognitive test batteries assessing them for the presence of high or low neurocognitive functioning. Existing research has demonstrated a relationship between neurocognitve deficits and functional outcomes in schizophrenia, but we have yet to understand the ecological validity of these measures in community settings. This study utilizes ethnographic methods to determine whether there are differences in community functioning levels of individuals with high and low cognitive deficits.

Methods: The twenty adult subjects selected were participants in “Predicting Psychosocial Rehabilitation Service Outcomes” (RO1 MH53282-04) where they were administered two neurocognitive and psychophysiological batteries. The PI of the parent study (Brekke) selected high and low scorers. The PI of this study (Gioia-Hasick) remained blind to the scoring designations. An interview guide was developed as a framework for questions about observed activities and cognitive strategies. Attention will be given to observing complex daily tasks and breaking down the strategies used to negotiate these tasks in response to illness. Two quantitative measures of clinical functioning (BPRS & SANS) and a self-esteem measure (ISE) were selected. Audiotaping and transcribing of responses was used when appropriate.

Results: This study is in data collection and therefore results are not reported here. Complete data will be collected by Fall 2001 and preliminary findings can be reported at the SSWR annual meeting.

Implications for Practice: This study will yield important and understudied findings about the ecological validity of neurocognitive measures and observed in-vivo functioning. The ethnographic method represents a domain of inquiry that meshes with the social work approach to knowledge-gathering. The study will triangulate unique domains of neurocognitive functioning, community functional outcomes, and contextual influences. These areas are important to social work research and practice in the ongoing study of schizophrenia.