Introdução: O desempenho neurocognitivo é considerado como potencial endofenótipo do transtorno bipolar. As baterias de avaliação totalmente informatizadas representam uma alternativa interessante aos testes neuropsicológicos tradicionais porque oferecem vantagens como correção e armazenagem automatizada dos dados, redução do tempo de aplicação e diminuição da interferência subjetiva do aplicador. No Brasil ainda é raro o número de baterias totalmente computadorizadas disponíveis para uso em pesquisa, portanto, o objetivo deste trabalho foi verificar a aplicabilidade da Bateria Computadorizada da Universidade da Pensilvânia em uma amostra de adultos com Transtorno Bipolar. Métodos: Avaliamos o desempenho da Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia contra uma Bateria Neurocognitiva Tradicional em uma amostra de 30 pacientes com Transtorno Bipolar eutímicos versus 27 controles saudáveis pareados por idade, gênero e educação parental. Resultados: Os pacientes apresentaram desempenho pior do que controles saudáveis no controle inibitório/controle executivo, velocidade de processamento e tarefas de aprendizagem visuoespacial da Bateria Neurocognitiva Tradicional, enquanto que nenhuma diferença significativa foi observada com a Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia. Dentro do grupo de pacientes, os sintomas afetivos subclínicos se correlacionaram inversamente com a flexibilidade mental na Bateria Neurocgnitiva Tradicional e, com a memória operacional e o raciocínio visuoespacial na Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia. Paralelamente, os desempenhos dessas tarefas estão diretamente correlacionados com o funcionamento sócio-ocupacional. Limitações: O tamanho modesto da amostra e o fato de que estudamos um grupo misto de pacientes com Transtorno Bipolar tipo I e tipo II podem ter aumentado o risco de erros estatísticos de tipo II. Conclusões: Os resultados desta investigação preliminar sugerem que os testes tradicionais com uma bateria neuropsicológica abrangente proporcionam maior sensibilidade para detectar diferenças entre grupos. No entanto, as tarefas da Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia correlacionaram-se com variáveis clínicas específicas no grupo de pacientes, fornecendo informações adicionais relevantes que não foram detectadas com a Bateria Neurocognitiva Tradicional. Assim, a seleção de testes adequada dependeria das funções cognitivas específicas que se pretende analisar e da questão sob investigação / Background: Neurocognitive performance is considered a potential endophenotype of bipolar disorder (BD) and fully computerized batteries represent an interesting alternative to traditional neuropsychological testing because they offer advantages such as automated correction and storage of data, reduction of application time and decrease of the applicator\'s subjective interference. In Brazil, the number of fully computerized batteries available for research use is still rare, so the purpose of this study was to verify the applicability of the Computerized Neurocognitive Battery of the University of Pennsylvania in a sample of adults with Bipolar Disorder. Methods: We assessed the performance of the Computerized Neurocognitive Battery of the University of Pennsylvania against a Traditional Neurocognitve Battery in a sample of 30 euthymic bipolar disorder patients versus 27 healthy controls matched for age, gender and parental education. Results: The patients performed worse than healthy controls in executive control/ response inhibition, processing speed and visuospatial learning tasks of the Traditional Neurocognitve Battery, while no significant differences were observed with the Computerized Neurocognitive Battery of the University of Pennsylvania. Within the Bipolar Disorder group, subclinical affective symptoms inversely correlated with mental flexibility in the Traditional Neurocognitve Battery, and with working memory and visuospatial reasoning in the Computerized Neurocognitive Battery of the University of Pennsylvania. Concurrently, performances on these tasks directly correlated with social/ occupational functioning. Limitations: The modest sample size and the fact that we studied a mixed group of patients with type I and type II Bipolar Disorder might have increased the risk of type II statistical errors. Conclusions: The results of this preliminary investigation suggest that traditional testing with a comprehensive neuropsychological battery affords better sensitivity to detect between-group differences. Nevertheless, Computerized Neurocognitive Battery of the University of Pennsylvania tasks correlated with specific clinical variables in the Bipolar Disorder group, providing relevant additional information that was not detected with the Traditional Neurocognitve Battery. Thus, adequate test selection would depend on the specific neurocognitive functions to be analyzed and the question under investigation

Ce travail aborde la question de la dichotomie kraepelinienne entre les troubles bipolaires et schizophréniques et présente une étude du dysfonctionnement exécutif et de la cognition sociale, en particulier de la théorie de l'esprit dans ces pathologies, caractérisées par un pronostic différent. Une première partie a été consacrée à l'évaluation de la théorie de l'esprit chez les sujets bipolaires en phase euthymique, en vue de la comparaison avec les résultats connus chez les patients schizophrènes. Nos résultats indiquent l'atteinte préférentielle de la composante cognitive de la théorie de l'esprit, avec une tendance vers la sur-mentalisation, alors que la composante émotionnelle paraît indemne, en contraste avec les données dans la schizophrénie. A la lumière des résultats retrouvés chez ces deux types de patients lors d'une étude comparative de l'hypofrontalité en IRMf, en faveur d'une implication différente des neurocircuits respectifs, on s'est proposé par la suite de confirmer ces différences en explorant de manière plus complexe les deux troubles psychiatriques. Le développement d'un paradigme explorant de manière conjointe la dysfonction frontale, exécutive et la théorie de l'esprit dans le contexte de l'interaction sociale a permis de mieux approcher en IRMf les mécanismes soustendant l'adaptation sociale. Une première étude avec ce paradigme en IRMf a été consacrée à l'identification des régions cérébrales du système exécutif modulées par la théorie de l'esprit dans le cadre d'une interaction sociale de compétition dans un groupe de sujets sains. Ensuite l'application du même paradigme lors d'une autre étude chez les deux types de patients versus un groupe contrôle a montré une modulation anormale du réseau exécutif par le processus de théorie de l'esprit et souligné les différences entre les bipolaires et schizophrènes. Le profil d'activation dysfonctionnel présentait un degré intermédiaire de sévérité pour les patients bipolaires par rapport aux sujets sains et schizophrènes. Malgré certaines similitudes phénotypiques décrites plus récemment au niveau clinique, neuropsychologique, génétique, l'ensemble de nos résultats en imagerie fonctionnelle confirme une implication différente des neurocircuits soustendant le fonctionnement neurocognitif et de cognition sociale. Ceci peut ainsi rendre compte de la différence de pronostic social dans les troubles bipolaires et schizophréniques, de même que de l'intérêt de leur distinction catégorielle dans les prochaines versions des classifications internationales en cours d'élaboration.

Introdução: O desempenho neurocognitivo é considerado como potencial endofenótipo do transtorno bipolar. As baterias de avaliação totalmente informatizadas representam uma alternativa interessante aos testes neuropsicológicos tradicionais porque oferecem vantagens como correção e armazenagem automatizada dos dados, redução do tempo de aplicação e diminuição da interferência subjetiva do aplicador. No Brasil ainda é raro o número de baterias totalmente computadorizadas disponíveis para uso em pesquisa, portanto, o objetivo deste trabalho foi verificar a aplicabilidade da Bateria Computadorizada da Universidade da Pensilvânia em uma amostra de adultos com Transtorno Bipolar. Métodos: Avaliamos o desempenho da Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia contra uma Bateria Neurocognitiva Tradicional em uma amostra de 30 pacientes com Transtorno Bipolar eutímicos versus 27 controles saudáveis pareados por idade, gênero e educação parental. Resultados: Os pacientes apresentaram desempenho pior do que controles saudáveis no controle inibitório/controle executivo, velocidade de processamento e tarefas de aprendizagem visuoespacial da Bateria Neurocognitiva Tradicional, enquanto que nenhuma diferença significativa foi observada com a Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia. Dentro do grupo de pacientes, os sintomas afetivos subclínicos se correlacionaram inversamente com a flexibilidade mental na Bateria Neurocgnitiva Tradicional e, com a memória operacional e o raciocínio visuoespacial na Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia. Paralelamente, os desempenhos dessas tarefas estão diretamente correlacionados com o funcionamento sócio-ocupacional. Limitações: O tamanho modesto da amostra e o fato de que estudamos um grupo misto de pacientes com Transtorno Bipolar tipo I e tipo II podem ter aumentado o risco de erros estatísticos de tipo II. Conclusões: Os resultados desta investigação preliminar sugerem que os testes tradicionais com uma bateria neuropsicológica abrangente proporcionam maior sensibilidade para detectar diferenças entre grupos. No entanto, as tarefas da Bateria Neurocognitiva Computadorizada da Universidade da Pensilvânia correlacionaram-se com variáveis clínicas específicas no grupo de pacientes, fornecendo informações adicionais relevantes que não foram detectadas com a Bateria Neurocognitiva Tradicional. Assim, a seleção de testes adequada dependeria das funções cognitivas específicas que se pretende analisar e da questão sob investigação / Background: Neurocognitive performance is considered a potential endophenotype of bipolar disorder (BD) and fully computerized batteries represent an interesting alternative to traditional neuropsychological testing because they offer advantages such as automated correction and storage of data, reduction of application time and decrease of the applicator\'s subjective interference. In Brazil, the number of fully computerized batteries available for research use is still rare, so the purpose of this study was to verify the applicability of the Computerized Neurocognitive Battery of the University of Pennsylvania in a sample of adults with Bipolar Disorder. Methods: We assessed the performance of the Computerized Neurocognitive Battery of the University of Pennsylvania against a Traditional Neurocognitve Battery in a sample of 30 euthymic bipolar disorder patients versus 27 healthy controls matched for age, gender and parental education. Results: The patients performed worse than healthy controls in executive control/ response inhibition, processing speed and visuospatial learning tasks of the Traditional Neurocognitve Battery, while no significant differences were observed with the Computerized Neurocognitive Battery of the University of Pennsylvania. Within the Bipolar Disorder group, subclinical affective symptoms inversely correlated with mental flexibility in the Traditional Neurocognitve Battery, and with working memory and visuospatial reasoning in the Computerized Neurocognitive Battery of the University of Pennsylvania. Concurrently, performances on these tasks directly correlated with social/ occupational functioning. Limitations: The modest sample size and the fact that we studied a mixed group of patients with type I and type II Bipolar Disorder might have increased the risk of type II statistical errors. Conclusions: The results of this preliminary investigation suggest that traditional testing with a comprehensive neuropsychological battery affords better sensitivity to detect between-group differences. Nevertheless, Computerized Neurocognitive Battery of the University of Pennsylvania tasks correlated with specific clinical variables in the Bipolar Disorder group, providing relevant additional information that was not detected with the Traditional Neurocognitve Battery. Thus, adequate test selection would depend on the specific neurocognitive functions to be analyzed and the question under investigation

The diploma thesis deals with the topic of neurocognitive changes in schizophrenia and the possibility of non-pharmacological interventions. It first summarizes current knowledge about schizophrenia, in connection with interdisciplinary overlaps enabling orientation in the topic. The thesis describes the individual cognitive disorders that are part of the disease. The main focus of the work is to inform about the possibilities of cognitive remediation. We focus on cognitive training and transcranial direct current stimulation in more detail. In particular, the use of stimulation methods has not yet been described in Czech literature. The work should thus contribute to the mapping of this issue. The theoretical part is followed by an empirical presentation of the results of our pilot study. In the study, we use a quantitative-qualitative methodology to map objective and subjective changes in cognitive functions before and after the application of stimulation and cognitive training in patients with schizophrenia. We included 9 patients who met the entry criteria. The results of the quantitative part did not reveal significant changes after the application of active tDCS stimulation in combination with cognitive training. The qualitative part of the study described subjectively perceived changes and...

The diploma thesis deals with the topic of neurocognitive changes in schizophrenia and the possibility of non-pharmacological interventions. It first summarizes current knowledge about schizophrenia, in connection with interdisciplinary overlaps enabling orientation in the topic. The thesis describes the individual cognitive disorders that are part of the disease. The main focus of the work is to inform about the possibilities of cognitive remediation. We focus on cognitive training and transcranial direct current stimulation in more detail. In particular, the use of stimulation methods has not yet been described in Czech literature. The work should thus contribute to the mapping of this issue. The theoretical part is followed by an empirical presentation of the results of our pilot study. In the study, we use a quantitative-qualitative methodology to map objective and subjective changes in cognitive functions before and after the application of stimulation and cognitive training in patients with schizophrenia. We included 9 patients who met the entry criteria. The results of the quantitative part did not reveal significant changes after the application of active tDCS stimulation in combination with cognitive training. The qualitative part of the study described subjectively perceived changes and...

Several avenues of investigation through which the 'labyrinths' of schizopsychotic diagnosis may be examined, are offered by the consideration of the 'beacons' of symptom-profiles and biomarkers. Neurodevelopmental issues and risk assessment, neurocognitive factors of predictive necessity, supersensitivity in neurotransmitter systems, the implications of prodromal expressions of the disorder, functional dysconnectivity arising from prefrontal to diverse regional patterns and circuits with a neurodevelopmental origin, and heritable gene characteristics are viewed against the backdrop of the schizophrenia spectrum disorders. The associations between adolescent-adult use of cannabis, on the one hand, and, alternatively, the prevalence of chromosomal abnormalities, e.g., GRIK4 and NPAS3, and mental retardation, on the other hand, with the symptom-profiles of schizopsychosis provide further evidence of emerging biomarkers of biological inheritance factors. The involvement of dopamine D1 and D2 receptors, particularly in prefrontal region, with regard to functional integrity of cognitive systems is reviewed. It would appear that considerations of these disorders imply that one essential hub around which much of the neuropathology revolves may be observed in the various expressions of the cognitive and structural insufficiency.

No description available.

Codirection / Bien que la communauté scientifique soit toujours à la recherche d'une caractéristique déterminante du trouble développemental du langage (TDL), les difficultés d'accord sujet-verbe, et par extension morphosyntaxiques, ont été identifiées comme un marqueur du TDL chez les enfants anglophones, autant chez les enfants du préscolaire que les plus vieux. Cependant, des études sur les enfants francophones d'âge préscolaire suggèrent que les déficits morphosyntaxiques ne seraient pas un marqueur fiable du TDL. Puisque que certains aspects de la morphosyntaxe en français ne sont acquis que vers l’âge de huit ans chez les enfants au développement typique, tels que l'accord en nombre des verbes sous-réguliers et irréguliers, ci-après SOUSIRR, les déficits morphosyntaxiques pourraient être un marqueur du TDL en français uniquement vers la (pré-)adolescence. Cette thèse a pour objectifs de déterminer si les (pré-)adolescents francophones au développement typique ont acquis l'accord en nombre des verbes SOUSIRR, si les (pré)adolescents francophones avec un TDL ont des déficits d'accord en nombre des verbes SOUSIRR, et à établir si la morphosyntaxe est un domaine de faiblesse par rapport à la lexico-sémantique dans cette population. L'accord en nombre des verbes SOUSIRR et les compétences morphosyntaxiques ont été évalués à l'aide de tâches ciblant les niveaux comportemental et neurocognitif en utilisant des tâches linguistiques et des potentiels évoqués (PÉ). De plus, nous avons développé des prédictions basées sur deux théories touchant les compétences morphosyntaxiques chez les (pré-)adolescents atteints de TDL : l'hypothèse du déficit procédural (Ullman & Pierpont, 2005 ; Ullman et al., 2020), et l'hypothèse du ralentissement généralisé (Kail, 1994). Cette thèse est composée de trois manuscrits pour publication. Le premier évalue les compétences des participants dans plusieurs domaines linguistiques, à l'aide de tâches comportementales typiquement utilisées en orthophonie et dans la recherche sur l’acquisition du langage. Les données révèlent des déficits lexico-sémantiques et morphosyntaxiques chez les participants avec un TDL, mais suggèrent qu'une tâche d'accord en nombre des verbes SOUSIRR était la meilleure pour discriminer les participants avec et sans TDL. Le deuxième article présente une étude innovante de PÉs utilisant uniquement des phrases grammaticales, présentées simultanément avec des images sémantiquement ou grammaticalement congruentes et incongruentes, afin d'évaluer le traitement morphosyntaxique et lexico-sémantique des phrases au niveau neurocognitif. Les résultats provenant de vingt-huit adultes francophones montrent qu'ils ont présenté les composantes PÉs attendues et comparables aux études utilisant des phrases agrammaticales. Ces données ont servi de référence pour établir si nos participants avec et sans TDL avaient un traitement linguistique mature. Le troisième article a testé cette nouvelle expérimentation avec nos participants (pré )adolescents. Les résultats suggèrent que, contrairement à la morphosyntaxe, la lexico-sémantique est une force relative chez les adolescents avec un TDL lors du traitement de l'information linguistique au niveau neurocognitif. Dans l'ensemble, cette thèse révèle que la morphosyntaxe est particulièrement altérée chez les adolescents francophones avec un TDL. Nous discutons les résultats en relation avec la pratique clinique orthophonique et soulignons l'importance d'examiner les processus neurocognitifs dans l'étude du TDL. / Although the scientific community is still searching for a defining characteristic of developmental language disorder (DLD), problems with subject-verb agreement, and by extension morphosyntax, have been identified as a hallmark of English-speaking preschoolers and older children with DLD. However, in studies of French-speaking preschoolers with DLD, morphosyntax has not been found to be a specific linguistic weakness. Since there is evidence that some aspects of morphosyntax in French are acquired by children with typical language (TL) development only later in childhood, such as subregular and irregular subject-verb number agreement, henceforth SUBIRR, morphosyntax has been argued to be a French marker for DLD only in older childhood and adolescence. The present thesis aimed to determine if French speaking (pre-)teenagers with TL have acquired SUBIRR number agreement, resolve whether French-speaking (pre-)teenagers with DLD are impaired on SUBIRR number agreement, and establish whether morphosyntax is an area of weakness as compared to lexico-semantics in this population. SUBIRR number agreement and morphosyntactic skills were evaluated with tasks targeting the behavioural and neurocognitive levels using linguistics tasks and event-related potentials (ERP). Furthermore, we contrasted two theories’ predictions on morphosyntactic skills in (pre-)teens with DLD : the procedural deficit hypothesis (Ullman & Pierpont, 2005; Ullman et al., 2020), and the generalized slowing hypothesis (Kail, 1994). This thesis is composed of three manuscripts for publication. The first evaluated our participants’ skills in multiple linguistic domains with behavioural tasks typical of clinical and research settings. Data reveal impairments in the DLD group in both lexico-semantic and morphosyntactic domains but suggest that a SUBIRR number agreement task was best at discriminating DLD from controls. The second article presents a novel ERP experimental design using only grammatical sentences, presented simultaneously with semantically and grammatically congruent or incongruent images, to assess morphosyntactic and lexico-semantic sentence processing at the neurocognitive level. Data from twenty-eight French-speaking adults show that they elicited the expected ERP components found in previous studies using ungrammatical sentences. These data served as a reference to establish whether our participants with and without TL process sentences in a mature way. The third article tested this novel ERP experiment with our (pre-)teen participants. We tested predictions of the procedural deficit hypothesis which states that children with DLD should have impaired morphosyntax due to an underlying procedural memory deficit, and the generalized slowing hypothesis, which proposes that all linguistic domains should be impaired due to an underlying processing deficit. This experimental design was run on teens with and without DLD. Although some processing delays were found in the DLD group, results on most conditions better fit the procedural deficit hypothesis. This study suggests that, in contrast with morphosyntax, lexico-semantics is a relative strength in teenagers with DLD when processing linguistic information at the neurocognitive level. Overall, this thesis reveals that morphosyntax, tested through SUBIRR number agreement, is especially impaired in French-speaking teens with DLD when compared to their TL peers. We discuss the findings in relation to clinical practice and highlight the importance of examining neurocognitive processes in language assessment.

Misinformation, oder „Fake News“, ist in der Online-Kommunikation weit verbreitet und beeinflusst Diskurs und Zusammenleben. Es ist jedoch wenig darüber bekannt, wie wir auf individueller Ebene beeinflusst werden, wenn wir Meinungen bilden und Urteile ableiten. Diese Dissertation untersucht die kognitiven und Gehirn Mechanismen, die der Verarbeitung sozialer, personenbezogener Misinformation zugrunde liegen. Proband*innen wurden mit negativen, positiven oder relativ neutralen personenbezogenen Nachrichten konfrontiert, die entweder verbal als unglaubwürdig gekennzeichnet waren, z.B. "angeblich", oder aus bekannten Medienquellen stammten, die als glaubwürdig oder unglaubwürdig wahrgenommen wurden. Die Ergebnisse zeigten, dass soziale Urteile stark vom emotionalen Gehalt beeinflusst waren, unabhängig von der Glaubwürdigkeit. Elektrophysiologische Korrelate früher emotionaler und erregungsbezogener Prozesse sowie Korrelate späterer evaluierender Verarbeitung waren verstärkt für Personen, die mit emotionalen Inhalten assoziiert wurden—unabhängig von der Glaubwürdigkeit der Information. Emotionale Inhalte wirken also nicht nur auf die unwillkürliche und früher Reaktion auf Nachrichten, sondern sogar auf Prozesse, für die erwartet wurde, dass sie die Information aufgrund ihrer Glaubwürdigkeit evaluieren würden. Um zu intervenieren, bewerteten die Proband*innen vor der Konfrontation mit Schlagzeilen explizit die Glaubwürdigkeit der Quelle. Dies half teilweise, die Glaubwürdigkeit positiver Nachrichteninhalte zu verarbeiten. Die Einsicht in die fehlende Glaubwürdigkeit hatte jedoch keinen Einfluss auf die Effekte negativer Nachrichteninhalte. Unsere Ergebnisse zeigen, wie der emotionale Gehalt sozialer Misinformation das Gehirn und das Urteilsvermögen beeinflussen kann, selbst wider besseres Wissen über die fehlende Glaubwürdigkeit. Perspektivisch helfen diese Erkenntnisse, uns den Herausforderungen von Misinformation aus Sicht der individuellen Kognition zu stellen. / Misinformation, also called “fake news”, is highly prevalent in online communication affecting public discourse and social coexistence. However, little is known about how we are affected by it on the individual level when we derive opinions and judgments. This dissertation investigates the cognitive and brain mechanisms underlying the processing of social, person-related misinformation. Participants were exposed to negative, positive, or relatively neutral news about other persons that was either verbally marked as untrustworthy by adding e.g., “allegedly”, or stemmed from well-known media sources perceived as trusted or distrusted. We found that social person judgments strongly relied on the emotional content independent of the credibility, showing how social misinformation affects person evaluation although it is perceived as untrustworthy. Electrophysiological indexes of early emotional and arousal-related processes, as well as correlates of later evaluative processing were enhanced for persons associated with emotional contents regardless of the credibility of the information. This shows the pronounced influence of emotional contents not only on the initial and early response to news, but even on processes that were expected to evaluate the information on merit of its credibility. In a first attempt to intervene, participants explicitly evaluated the credibility of the source before reading the headlines. This helped to overcome the bias for positive news and process its credibility to some degree. However, the insight into the lack of credibility had no influence on the effects of negative news on brain responses and social judgments. Our results demonstrate how emotional content in social misinformation can affect mind, brain, and judgments even against better knowledge of its lacking credibility. In perspective, these insights help to face the challenges of misinformation from the perspective of the individual’s cognition.

The aim of the present thesis was to examine the effectiveness of the Illness Management and Recovery (IMR) program for teaching clients with schizophrenia or schizoaffective disorder to better manage their illness and to promote recovery. This was accomplished through an examination of the program’s effects on psychosocial functioning and psychopathology, the evaluation of general and specific impact of neurocognition on learning the fundamentals of illness self-management, and the impact of symptom severity on outcome of the IMR program. The utility of the illness management and recovery scale to evaluate illness self-management of clients with schizophrenia and schizoaffective disorder was also investigated. The effects of the IMR program were evaluated in a randomized controlled trial that compared participants in the program to participants receiving treatment as usual. 41 participants were recruited at six psychiatric outpatient rehabilitation centers in Uppsala, Sweden, and were randomly assigned to IMR groups for approximately 40 sessions or to a treatment as usual control condition. The IMR program participants demonstrated greater improvement compared to participants in treatment as usual in illness self-management, reduced psychiatric symptoms, improved coping skills, and decreases in suicidal ideation. The findings suggest that the IMR program is effective in improving the ability of individuals with schizophrenia and schizoaffective disorder to better manage their illness. Possible association between neurocognitive functioning and the acquisition of illness self-management skills was investigated in a total of 53 participants who completed the IMR program. Speed of processing was related to client reported illness self-management skills acquisition, before and after controlling for psychiatric symptoms and medication, but neurocognitive functioning did not predict improvement in clinician ratings of client illness self-management skills. The findings suggest that compromised neurocognitive functioning does not reduce response to training in illness self-management. The impact of symptom severity on outcome of the IMR program was explored in 52 participants who completed the program. The results suggest that significantly more participants met the severity criterion of remission at post-treatment, and it appears that participants not reaching the severity criterion at post-treatment, also benefited from the IMR program, as indicated by the similar effect sizes of the two subgroups (meeting versus not meeting the severity criterion at post-treatment). The psychometric properties of the Illness Management and Recovery Scale (IMRS) were evaluated in 107 participants with a diagnosis of schizophrenia or schizoaffective disorder. And an item-by-item investigation was conducted in order to establish their utility in monitoring the clients' progress in the IMR program. Both the client and clinician version of the IMRS demonstrated satisfactory internal consistency, large test-retest reliability, and convergent validity with conceptually related measures of psychiatric symptoms, quality of life, and perception of recovery. The findings support the utility of the IMRS as a measure of illness self-management and recovery in clients with schizophrenia and schizoaffective disorder. The general findings of this thesis support the IMR program to be effective in improving the ability of the participants to manage their disorder. The impact of neurocognitive dysfunction on the participants’ ability to learn the fundamentals of illness self-management seems to be limited, and symptom severity did not limit the benefits of the IMR program. Support for the utility of the IMRS to monitor the participants’ progress in the program was also found, providing a brief and economical method for assessing outcome of the IMR program. / Syftet med föreliggande avhandlingsarbete var att undersöka Illness Management and Recovery (IMR) programmets effekter av att lära klienter att bättre hantera negativa konsekvenser av schizofreni eller schizoaffektiv sjukdom och att främja återhämtning. Detta åstadkoms genom en utvärdering av IMR programmets inverkan på psykosocial funktion och psykopatologi, en undersökning av specifik och generell påverkan av neurokognition avseende deltagarnas möjligheter att lära in grundläggande sjukdomshanteringsfärdigheter (illness self-management), samt en undersökning av huruvida schizofrenisymtomens svårighetsgrad inverkar på programutfallet. Vidare undersöktes Illness Management and Recovery Skalans (IMRS) användbarhet för att utvärdera sjukdomshantering och återhämtning (illness self-management and recovery) hos personer med schizofreni eller schizoaffektiv sjukdom. IMR programmets effekter utvärderades genom en randomiserad kontrollerad studie i vilken 41 programdeltagare jämfördes med deltagare i kontrollgrupp vilka fick enbart sedvanlig psykiatrisk behandling. Deltagarna rekryterades vid sex subspecialiserade psykiatriska öppenvårdsmottagningar och slumpades till att antingen delta i IMR programmet eller kontrollgrupp. IMR programmets deltagare uppvisade i jämförelse med kontrollgruppen förbättring i sjukdomshantering, minskade psykiatriska symtom, förbättrade coping-färdigheter samt minskade självmordsbeteenden. Resultaten stöder antagandet att IMR programmet är effektivt vad gäller att förbättra deltagarnas förmåga att hantera negativa effekter av schizofreni och schizoaffektiv sjukdom. Möjliga associationer mellan neurokognitiv funktion och förmågan att tillägna sig färdigheter för sjukdomshantering undersöktes hos 53 deltagare som genomförde IMR programmet. Resultaten pekar på att neurokognitiva svårigheter inte inverkar på deltagarnas möjligheter att lära sig sjukdomshantering enligt IMR modellen. Processhastighet var relaterad till klientrapporterad sjukdomshantering men inte till klinikerrapporterad sjukdomshantering. Processhastighet tycks vara relevant för klientens upplevelse av hur väl han eller hon tillägnat sig programmets strategier och färdigheter, snarare än sjukdomshantering per se. Huruvida schizofrenisymtomens svårighetsgrad inverkar på utfallet av IMR programmet undersöktes hos 52 deltagare som genomförde IMR programmet. Resultaten pekar på att signifikant fler deltagare uppfyllde svårighetsgradskriteriet för remission av schizofrenisymtom efter genomfört IMR program. Även deltagare som inte uppfyllde svårighetsgradskriteriet har nytta av IMR programmet något som indikeras av de båda gruppernas (uppfyllde jämfört med uppfyllde inte svårighetsgradskriteriet) likartade effektstorlekar. Illness Management and Recovery Skalans (IMRS) psykometriska egenskaper undersöktes för 107 deltagare med en schizofreni eller schizoaffektiv diagnos. Skalans enskilda frågor analyserades för att undersöka skalans användbarhet för att utvärdera deltagares progress och utfall i IMR programmet. Både klient och kliniker versionen av skalan uppvisade tillfredsställande intern konsistens, stor test-retest reliabilitet och konvergent validitet med konceptuellt relaterade instrument för psykiatriska symtom, livskvalité och återhämtning. Resultaten stöder antagandet att IMRS är ett användbart instrument för att utvärdera sjukdomskontroll och återhämtning för personer med schizofreni eller schizoaffektiv sjukdom. Avhandlingsarbetets resultat stöder antagandet att IMR programmet är effektivt vad gäller att förbättra deltagarnas förmåga att hantera de negativa konsekvenserna av schizofreni och schizoaffektiv sjukdom. Neurokognitiva svårigheter inverkar i begränsad utsträckning på deltagarnas möjligheter att lära sig sjukdomshantering och schizofrenisymtom tycks ha begränsad inverkan på programutfallet. Resultaten stöder även antagandet att IMRS är ett användbart instrument för att utvärdera sjukdomskontroll och återhämtning för personer med schizofreni eller schizoaffektiv sjukdom, vilket erbjuder en kortfattad och ekonomisk metod att utvärdera effekterna av IMR.