Cognitive Profile Difference Between Allen Cognitive Levels 4 and 5 in Schizophrenia

Headnote

KEY WORDS

* cognition

* cognition disorders

* memory

* mental processes

* schizophrenia

OBJECTIVE. We compared the pattern of cognitive deficits exhibited by people with schizophrenia at Allen Cognitive Level (ACL) 4 with that of people at Level 5.

METHOD. Participants were classified into two groups on the basis of their ACL Screen scores: ACL 4 (n5 35) and ACL 5 (n = 41). We assessed cognitive functions and psychotic symptoms in all participants.

RESULTS. Multivariate analysis of covariance controlling for gender and negative symptoms revealed that people at ACL 4 performed significantly worse than those at ACL 5 on processing speed, verbal memory, and working memory. The discriminant analysis with all cognitive variables produced a classification accuracy of 78% in differentiation of cognitive levels.

CONCLUSION. We verified the validity of the hierarchy of cognitive disability for ACLs 4 and 5 in people with schizophrenia.

Su, C.-Y., Tsai, P.-C., Su,W.-L., Tang, T.-C., & Tsai, A. Y.-J. (2011). Cognitive profile difference between Allen Cognitive Levels 4 and 5 in Schizophrenia. American Journal of Occupational Therapy, 65, 453-461. doi: 10.5014/ajot.2011.000711

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Schizophrenia is characterized by impairments in a wide range of cognitive domains, including speed of processing, attention, memory, executive function, and social cognition (Nuechterlein et al., 2004). In both cross-sectional and longitudinal analyses, these cognitive deficits, either individually or in combination, have been shown to have a negative effect on multiple aspects of functional outcome, such as work performance and maintenance, instrumental activities of daily living (IADLs), skill acquisition, and social problem solving (Green, 1996, 2006; Green, Kern, & Heaton, 2004; Lipkovich et al., 2009). Thus, it is important for clinicians to screen people with schizophrenia for cognitive problems and to select an appropriate intervention accordingly.

The Allen Cognitive Level Screen (ACLS; Allen, 1990, 1996) has been used extensively by occupational therapists across cultures and settings as a quick screening tool to derive a view of cognitive function in people with psychiatric or geriatric disabilities (Lindstedt, Ivarsson, & Söderlund, 2006; McAnanama, Rogosin-Rose, Scott, Joffe, & Kelner, 1999; Yeung & Chan, 2006). The ACLS requires the person to perform three leather-stitching tasks of increasing difficulty and yields a single score that can be used to determine what type of environment...