Towards an integrative hope-dysfunctional beliefs perspective to personal recovery in schizophrenia: a path analysis

Daniel Fu Keung Wong; Yves Cho Ho Cheung; Xiaoyu Zhuang; Yat-Nan Petrus Ng; Lindsey G Oades; Shengquan Sam Ye

doi:10.1186/s12888-023-05135-7

Towards an integrative hope-dysfunctional beliefs perspective to personal recovery in schizophrenia: a path analysis

BMC Psychiatry. 2023 Sep 4;23(1):651. doi: 10.1186/s12888-023-05135-7.

Authors

Daniel Fu Keung Wong¹, Yves Cho Ho Cheung², Xiaoyu Zhuang³, Yat-Nan Petrus Ng¹, Lindsey G Oades⁴, Shengquan Sam Ye⁵

Affiliations

¹ Department of Social Work, Baptist University of Hong Kong, AAB1035, 10/F, Academic and Administration Building, 15 Baptist University Road, Baptist University Road Campus, Kowloon Tong, Hong Kong.
² Department of Social Work, Baptist University of Hong Kong, AAB1035, 10/F, Academic and Administration Building, 15 Baptist University Road, Baptist University Road Campus, Kowloon Tong, Hong Kong. yvesresilience@gmail.com.
³ Sociology Research Center, School of Humanities, Jinan University, 601, Huangpu Avenue West, Tianhe District, Guangzhou City, Guangdong Province, China.
⁴ Melbourne Graduate School of Education, The University of Melbourne, Melbourne Graduate School of Education, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia.
⁵ Department of Social and Behavioural Sciences, City University of Hong Kong, Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.

Abstract

Background: Evidence shows that negative symptoms of schizophrenia and underlying dysfunctional cognition are related to persistently low functioning and quality of life. However, despite the abundance of existing recovery programs for people with schizophrenia, few have examined whether and how the widely-adopted hope-motivation recovery pathway and the deficit-oriented cognitive pathway might converge to influence functioning and quality of life.

Methods: A cross-sectional, quantative survey recruited a convenient sample of adult outpatients with DSM-5 schizophrenia spectrum disorders and low social functioning (n = 124). Self-reported measurements included personal recovery (30-item Mental Health Recovery Measure), social functioning (8-item Social Functioning Questionnaire), hope (12-item Hope Scale), quality of life (28-item World Health Organization Quality of Life Scale-Abbreviated Version-Hong Kong), defeatist beliefs (15-item extracted from Dysfunctional Attitude Scale), and asocial beliefs (15-item extracted from Revised Social Anhedonia Scale). Correlation analysis and structural equation modelling was applied to investigate how the two pathways intertwined to predict social functioning and quality of life.

Results: Asocial beliefs and hope separately mediated two partial mediation pathways from defeatist beliefs to recovery outcomes (social functioning and personal recovery). Meanwhile, defeatist beliefs, social functioning, and personal recovery further predicted quality of life.

Conclusions: This is one of the very few studies that provides empirical evidence of a deficit-strength linkage in the recovery from schizophrenia. Remediation of dysfunctional beliefs and the injection of hope and successful experiences should be undertaken concurrently in recovery as they are associated with differential effects on enhancing social functioning and personal recovery, which then converge and contribute to a better quality of life.

Keywords: Asocial beliefs; Cognitive-behavioral therapy; Defeatist beliefs; Negative symptoms; Recovery; Schizophrenia; Strength-based.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anhedonia
Cognition
Cross-Sectional Studies
Humans
Quality of Life
Schizophrenia* / therapy