Long, Maria Anna;
(2025)
An exploration of the concept of social functioning and its relationship to antipsychotic treatment in people with schizophrenia-spectrum disorder diagnoses.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background and aim: Social functioning outcomes remain poor in people with schizophrenia-spectrum disorders and difficulties with defining and measuring the construct challenge research efforts. Service user and carer understandings of social functioning have been underexplored. Antipsychotic medication is the main treatment for schizophrenia-spectrum disorders and reduces symptoms and prevents relapse. However, antipsychotics are associated with adverse health outcomes and some evidence suggests that side effects may impact social functioning. Symptoms and cognition predict social functioning, but the patterning of association with different domains and the relationship with side effects is unclear. Methods: Study one involved a systematic review to identify new and popular measures of social functioning in schizophrenia-spectrum disorders and used content analysis and quality assessment to assess content and usability. Study two used semi-structured interviews and reflexive thematic analysis to explore priorities and aspirations for social functioning in a mixed sample of 20 service users and carers. Study three used multivariate linear regression statistical analysis to investigate social functioning domains, side effects and other variables in 253 service users. Results: Many social functioning measures exist but limited psychometric evaluation has been done with regard to criteria important for intervention research, and a lack of content related to the Internet challenges validity. There is considerable overlap between the content of social functioning measures and lived experience understandings. After adjusting for other variables, better social functioning was associated with fewer negative symptoms and younger age. Other variables were associated with individual domains of social functioning. Measuring total score social functioning may obscure nuance in effects between domains. Social acceptance was more important for service users than achieving functional milestones. Conclusion: Findings suggest recommendations for research to improve the measurement of social functioning. Interventions are needed for negative symptoms. Researchers should measure individual social functioning domains as these are associated with different clinical and demographic variables.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | An exploration of the concept of social functioning and its relationship to antipsychotic treatment in people with schizophrenia-spectrum disorder diagnoses |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10204131 |
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