Quality-of-life for patients with Schizophrenia has been recognized as a crucial domain of outcome in schizophrenia treatment, and yet its determinants are not well understood.
Arielle Tolman ’10, who studied “Neurocognitive Predictors of Objective and Subjective Quality-of-Life in Individuals with Schizophrenia: A Meta-Analytic Investigation” as her senior honors thesis, will have the opportunity to share her research with other scientists interested in schizophrenia. This month, the editors of Schizophrenia Bulletin accepted Tolman’s paper for publication in an upcoming edition.
“This is a real achievement, particularly at the undergraduate level,” says the paper’s co-author and Tolman’s advisor Matthew Kurtz, assistant professor of psychology.
Although other researchers have demonstrated that “quality-of-life” is not a uniform construct, Tolman conducted the first meta-analytic study to directly compare elementary neurocognitive domains (attention, memory, processing-speed) to objective and subjective quality-of-life in schizophrenia.
Tolman, who double majored in sociology and neuroscience and behavior, received high honors from the Neuroscience and Behavior Department for her senior thesis.
“My contribution was finding that when you separate the findings in the field by scale type (objective, i.e. observable life condition v. subjective, i.e. life satisfaction), you see a completely divergent pattern of relationships between neurocognitive deficits and quality of life,” she explains. “More specifically, I found that across all the published studies in the field, neurocognition was linked positively to objective quality of life, but either unrelated, and in some cases, negatively related, to subjective quality of life.”
This finding, that cognition is either unrelated or negatively related to subjective quality of life, has some potentially serious implications for the massive nationwide research initiatives that are seeking to improve cognition in individuals with schizophrenia, under the assumption that improving people’s cognitive abilities would lead to an improvement in both their objective functioning, and subjective life-satisfaction.
Tolman’s study suggests that clinicians and researchers who aim to improve subjective quality-of-life for individuals with schizophrenia “will need to think about how to craft novel interventions that think outside psychiatric symptom reduction and improvement in neurocognitive functioning” if they hope to improve patient life-satisfaction.
Tolman and Kurtz used quantitative methods of meta-analysis to clarify the relationship between neurocognitive determinants of objective quality-of-life (i.e., observable, clinician-rated) and subjective quality-of-life (i.e., patient satisfaction) separately in individuals with schizophrenia. They examined 10 objective and 10 subjective studies consisting of 1,615 clients.
Tolman began her study in Spring 2009, while taking a research seminar with Professor Kurtz. That project grew into an investigation, which she received funding to pursue through the Howard Hughes Medical Institute summer fellowship program.
The recent Wesleyan alumna moved to Nairobi, Kenya on June 22 to volunteer full-time for Shining Hope for Communities, a non-profit co-founded by Kennedy Odede ’12 and Jessica Posner ’09.