Type of Document	Dissertation
Author	Reardon, Maureen Y. Lyons
URN	etd-06072004-182009
Title	Prediction of Comorbid Alcohol Use Disorders Using Factors Derived from the Positive and Negative Syndrome in an Inpatient Psychiatric Hospital
Degree	Doctor of Philosophy
Department	Psychology, Department of
Advisory Committee	Advisor Name Title Alan R. Lang, Ph.D. Committee Chair Friedrich Stephan, Ph.D. Committee Member James Orcutt, Ph.D. Committee Member Jeanette Taylor, Ph.D. Committee Member Thomas Joiner, Ph.D. Committee Member
Keywords	PANSS Cognitive Psychotic Substance Schizophrenia Schizophrenic
Date of Defense	2004-04-27
Availability	unrestricted
Abstract The present study examined the relationship of schizophrenia-related cognitive deficits and comorbid alcohol use disorders (AUD) among inpatients with psychotic disorders. Relevant research has implicated the role of cognitive impairment in the development of AUD in general population and other psychiatric samples, and preliminary evidence lends credibility to associations between the positive (hallucinations, delusions) and negative (flat affect, lack of motivation) symptoms of schizophrenia and variations in cognitive deficits. Accordingly, it was hypothesized that any increased likelihood of AUD as a function of positive and negative symptomatology would be better accounted for by systematic variations in cognitive functions as they generally relate to the development of AUD. To test this association, a Principal Components Analysis was applied to the Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein, & Opler, 1987) using data collected from a large sample of inpatients with schizophrenia or schizoaffective disorder. The resultant five component solution included the key Positive (POS), Negative (NEG) and Cognitive (COG) components needed to test the predicted mediation by COG on the relationship between AUD and POS/NEG. Next, interview and archival data pertaining to AUD were collected from 132 (23 female) randomly selected inpatient volunteers, with chart-ratings of AUD serving as the dependent measure in a planned logistic regression analysis. Although support for the primary prediction was not obtained, intriguing post-hoc analyses revealed a significant POS by COG interaction [Chi-Square(1) = 5.94, p<.05]. Follow-up of this interaction indicated that whereas there was no association between COG and AUD for those with fewer POS symptoms, each unit increase in the severity of COG was associated with a nearly four times decreased likelihood of problematic alcohol use for persons with worse POS, Chi-Square(1) = 7.20, p<.01. These results are thought to stem from a “floor effect” in cognitive functioning, such that poor reality-testing acts to limit efforts to compensate for dysfunction and associated distress by drinking. Such findings, though unexpected, should nonetheless spur the dual-diagnosis literature, which at present provides little evaluation of the effects of schizophrenic symptomatology on the development of alcohol problems.
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