When functional capacity and real-world functioning converge: the role of self-efficacy.
Although functional capacity is typically diminished, there is substantial heterogeneity in functional outcomes in schizophrenia. Motivational factors likely play a significant role in bridging the capacity-to-functioning gap. Self-efficacy theory suggests that although some individuals may have the capacity to perform functional behaviors, they may or may not have confidence they can successfully perform these behaviors in real-world settings. We hypothesized that the relationship between functional capacity and real-world functioning would be moderated by the individual's self-efficacy in a sample of 97 middle-aged and older adults with schizophrenia (mean age = 50.9 ± 6.5 years). Functional capacity was measured using the Brief UCSD Performance-based Skills Assessment (UPSA-B), self-efficacy with the Revised Self-Efficacy Scale, and Daily Functioning via the Specific Level of Functioning (SLOF) scale and self-report measures. Results indicated that when self-efficacy was low, the relationship between UPSA-B and SLOF scores was not significant (P = .727). However, when self efficacy was high, UPSA-B scores were significantly related to SLOF scores (P = .020). Similar results were observed for self-reported social and work functioning. These results suggest that motivational processes (ie, self-efficacy) may aid in understanding why some individuals have the capacity to function well but do not translate this capacity into real-world functioning. Furthermore, while improvement in capacity may be necessary for improved functioning in this population, it may not be sufficient when motivation is absent.
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0993, USA. vcardenas@ucsd.edu
Veronica
V
Cardenas
Stephanie
S
Abel
Christopher R
CR
Bowie
Denisse
D
Tiznado
Colin A
CA
Depp
Thomas L
TL
Patterson
Dilip V
DV
Jeste
Brent T
BT
Mausbach
D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011618:Psychotic Disorders / Q000523:psychology*; D020127:Recovery of Function; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D020377:Self Efficacy