Area-level socioeconomic status functions as a  predictor for cognitive flexibility in patients with  psychiatric disorders

Objective: Patients with psychiatric disorders often experience problems with executive functioning, including cognitive flexibility, planning, and working memory. Prior results on healthy subjects suggest that a low Socio-Economic Status (SES) might be related to such problems. However, little research has been done regarding the relationship between deficits in executive functioning and SES within psychiatric populations. Therefore, the current study aimed to investigate the possible relationships between the SES and three executive functions in patients with psychiatric disorders using a transdiagnostic approach. We also tentatively explored the relationship between SES and executive functions as a function of the different diagnostic groups to evaluate whether this relationship itself is transdiagnostic. Method: A total of 298 patients diagnosed with different psychiatric disorders were included in this study: schizophrenia and psychosis (103), major depressive disorders (100),...Show moreObjective: Patients with psychiatric disorders often experience problems with executive functioning, including cognitive flexibility, planning, and working memory. Prior results on healthy subjects suggest that a low Socio-Economic Status (SES) might be related to such problems. However, little research has been done regarding the relationship between deficits in executive functioning and SES within psychiatric populations. Therefore, the current study aimed to investigate the possible relationships between the SES and three executive functions in patients with psychiatric disorders using a transdiagnostic approach. We also tentatively explored the relationship between SES and executive functions as a function of the different diagnostic groups to evaluate whether this relationship itself is transdiagnostic. Method: A total of 298 patients diagnosed with different psychiatric disorders were included in this study: schizophrenia and psychosis (103), major depressive disorders (100), and obsessive-compulsive disorder (95). The participants’ cognitive flexibility, planning, and working memory was evaluated using the Cambridge Neuropsychological Test Automated Battery (CANTAB). The area-level SES (an index for SES) data were obtained from the Netherlands Institute for Social Research (SCP). Results: Area-level SES was significantly negatively related to cognitive flexibility (β = -.043, p = .007). However, area-level SES was not related to planning (p =.072) nor to working memory (p = .412). The relationship between area-level SES and executive functioning by diagnostic category was non-significant (p = .355). Conclusion: The results of the current study indicated that a high area-level SES was associated with a higher degree of cognitive flexibility. The study also suggests that the relationship between area-level SES and cognitive flexibility cuts across psychiatric disorders and could be considered as a transdiagnostic mechanism. Healthcare providers could use area-level SES to predict which patients might require extra attention regarding deficits in cognitive flexibility. This study can also function as a steppingstone for future research into the relationship between SES and executive functions in psychiatric populations as it provides insight into the pitfalls and possible remedies for applying aggregate (area-level) data at the individual level.Show less

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Area-level socioeconomic status functions as a predictor for cognitive flexibility in patients with psychiatric disorders