Date of Submission

2018

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Robert A DiTomasso, PhD, ABPP

First Advisor

Stephen Poteau, PhD

Second Advisor

Robert DiTomasso, PhD, ABPP

Third Advisor

Christopher Barker, PhD

Abstract

Schizophrenia has long been characterized solely by positive and negative symptoms of psychosis. It has also been typified by its widespread heterogeneity, which has impeded treatment outcomes. Previous attempts at reducing this heterogeneity via identifying symptom-based subtypes has been unhelpful and unreliable. More recently, cognitive deficits have been identified as prominent features of the disorder and are now included as necessary diagnostic criteria. The present study aimed to identify the unique relationships between cognitive deficits and psychotic symptoms and to establish subtypes based on these profiles. The findings suggest two distinct subtypes: (a) a deficit subtype wherein individuals display more severe psychotic symptoms and more severe cognitive deficits overall, and (a) a nondeficit subtype wherein individuals have less severe psychotic symptoms, as well as less severe cognitive deficits overall. These subtypes also differed on the following variables of interest: race, employment, education, and history of antipsychotic medication. Specifically, the Deficit subtype was composed of more Black participants than White, had fewer years of education, and had a longer duration since first prescribed antipsychotic medication. The Nondeficit subtype, conversely, was composed of more White participants, a longer work history, more education, and fewer years since first prescribed antipsychotic medication. These findings have potential implications for the efficacy of diagnosis, treatment, and prevention strategies.

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