Executive functioning in schizophrenia using a novel virtual reality-simulated workplace: validity, test-retest reliability, and links to competitive employment

利用新型虚拟现实模拟工作场所评估精神分裂症患者的执行功能:效度、重测信度及与竞争性就业的联系

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Abstract

Virtual reality offers a promising avenue for the assessment of executive functioning in complex workplace environments. However, its use in schizophrenia remains limited. For that reason, we investigated the validity and test-retest reliability of the Jansari assessment of Executive Functions (JEF(©)) in individuals with schizophrenia and its associations with competitive employment. A total of 69 participants with schizophrenia and 67 healthy controls completed JEF(©) and standard tests. A subsample of 58 patients was retested after an 8-week interval. Individuals with schizophrenia performed more poorly than controls on JEF(©) (p < 0.001) and standard tests (p < 0.05). JEF(©) scores correlated with standard measures (p < 0.05), except inhibition tests, and with clinician-report of everyday problems (p < 0.001). Total score showed a good test-retest reliability and the practice adjusted RCI indicated 87.9% of patients remained stable over 8 weeks. In logistic regression, higher JEF(©) total score significantly predicted competitive employment after adjusting for age (p = 0.004) and remained significant when years of education were added (p = 0.014). This comprehensive evaluation indicates that JEF(©) is a valid and reliable tool assessing executive functions required in office work and offers an ecologically relevant complement to standard measures in schizophrenia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-40643-y.

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