Discussion
schizophrenia symptoms, schizophrenia, schizophrenia experience difficulties, functioning disability
This study investigated the impact of schizophrenia symptoms on the association between EF and participation. The results indicate that low and mean PANSS scores (positive, negative, and psychopathology) moderate the relationship between the change in the WCPA outcomes (These results may shed light on the inconsistent associations found in previous studies between symptoms, metacognition, and participation. Whereas this study addresses the symptoms’ severity and characteristics, most previous studies related to the symptoms’ (positive or negative) nature and impact. Rollins et al. found differences in the impact of positive and negative symptoms on coping-strategy types and functional outcomes among people with schizophrenia [Similarly, in their meta-analysis, Ventura et al. found that only negative symptoms were associated with functional limitations and they mediated, at least partly, the association between cognitive limitations and function [Most studies that addressed and explored the unique symptoms of people with schizophrenia used the PANSS. Our study goes a step further, providing insight into the symptoms by distinguishing between their severity and characteristics. Similarly, Leutwyler et al. studied multiple factors that contribute to poor health among older adults with schizophrenia and found associations among symptoms of greater severity, poorer cognitive outcomes, and lower physical activity levels [In addition, the literature has shown that people with schizophrenia experience difficulties with EF, which affects their independence and participation levels in IADL [Our results support the use of the WCPA as an easy-to-use, ecologically valid measure of EF among people with schizophrenia. This type of assessment coincides with the broader definition of health and wellness conceptualized in the international classification of functioning disability and health, which recommends including measures for independence and participation in daily life activities [Our findings also have implications for interventions. Cognitive interventions have been criticized because cognition improvements typically do not generalize to daily life. This study’s results suggest symptoms moderate between EF and participation among people with schizophrenia. Therefore, symptom severity should be assessed before implementing cognitive interventions to maximize participation.