Prediction of vocational participation and global role functioning in help-seeking young adults, from neurocognitive, demographic and clinical variables

Alice J Cairns; David J Kavanagh; Frances Dark; Steven M McPhail

doi:10.1016/j.jad.2017.06.008

Prediction of vocational participation and global role functioning in help-seeking young adults, from neurocognitive, demographic and clinical variables

J Affect Disord. 2017 Oct 15:221:158-164. doi: 10.1016/j.jad.2017.06.008. Epub 2017 Jun 13.

Authors

Alice J Cairns¹, David J Kavanagh², Frances Dark³, Steven M McPhail⁴

Affiliations

¹ School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Mount Isa Centre for Rural and Remote Health, James Cook University, Australia. Electronic address: alice.cairns@jcu.edu.au.
² Centre for Children's Health Research, School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
³ Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Services, Metro South Health, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
⁴ School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia.

PMID: 28646712
DOI: 10.1016/j.jad.2017.06.008

Abstract

Background: The purpose of this study was to investigate neurocognitive, demographic and clinical correlates of vocational participation among a sample of young help-seeking adults.

Methods: Young people (18-25 years) accessing an early intervention youth health service participated. The Global Functioning: Role scale and level of vocational participation, participant characteristics (age, gender, socioeconomic background and family history of serious mental illness), distress, psychotic-like experiences, substance use, and mental health diagnoses were recorded. The Cambridge Neuropsychological Testing Automated Battery was used to assess sustained attention, visual memory and executive function.

Results: Of the 107 participants, 33 (31%) were not working or studying and 52 (49%) had a diagnosis of affective disorder. Impairments in neurocognitive tests were evidenced in attention shift, sustained attention target sensitivity, impulsivity and spatial working memory errors. Univariate analyses indicated that information processing and target impulsivity were associated with both vocational participation and global functioning, and that spatial working memory strategy was also associated with vocational participation. After controlling for significant demographic and clinical predictors, strategy formation remained a significant correlate of vocational participation (coefficient (95%CI) = -0.08 (-0.17, -0.01)), but no neurocognitive measures remained significant in the multivariate prediction of global functioning.

Limitations: Neurocognitive outcomes were assessed at a single time point, factors such as fluctuations in motivation could impact on test results.

Conclusions: Interventions targeting work and education participation should consider the capacity of vulnerable young people to develop appropriate plans for role success and provide support accordingly. The study also emphasised the importance of high school completion and avoidance of cannabis use, especially in males.

Keywords: CANTAB; Early intervention; Neurocognition; Psychiatry; Vocational functioning; Youth.

MeSH terms

Adolescent
Adult
Attention / physiology
Cross-Sectional Studies
Educational Status
Employment / statistics & numerical data*
Executive Function / physiology*
Female
Help-Seeking Behavior*
Humans
Male
Memory, Short-Term / physiology
Mental Health Services / statistics & numerical data*
Neuropsychological Tests
Prospective Studies
Queensland
Risk Factors
Visual Perception / physiology
Young Adult