Self-reported cognitive functioning on the behavior rating inventory of executive function in psychotic disorders: Effects of gender, education and cognitive functioning.

Introduction: Psychotic disorders (PD) are among the most severe mental disorders and cognitive impairment contributes to this. Few studies have investigated self-reported executive function (srEF)in PD using the Behavior Rating Inventory of Executive Function Adult version (BRIEF-A) and have found varying results. Population characteristics could contribute to this heterogeneity. The current study thus reported BRIEF-A scores in a sample with PD, and how this was affected by gender, education and cognitive function measured by The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Methods: BRIEF-A consist of 9 scales, two indices (Behavioral Regulation Index [BRI] and Metacognition Index [MI]), ands a summary score Global Executive Composite (GEC). T-scores (high score = difficulties) from 260 patients (99 women, mean age 24.58) was included. Independent samples t-tests were used to compare means between genders. Gender, RBANS Total Scale scores and years of education were used to predict BRIEF-A scores in general linear mixed models. Results: For the full sample, the BRIEF-A the GEC showed a marginally impaired T-score (T >60) and the MI showed highest scores. Females had a GEC and MI score above clinical cutoff (T ≥65), and had significantly more srEF difficulties on all scales except Inhibit and Self-Monitor. Gender and global cognition showed some multivariate interactions, but these effects were small. Conclusions: The current study indicates srEF marginally impaired meta-cognition in PD, enhanced by gender. Future studies should investigate srEF longitudinally to see how this develops following psychosis onset and identify groups in need of targeted treatments like cognitive remediation.