Cognitive Flexibility and Positive Psychotic Symptoms in Individuals with Schizophrenia

Abstract

This research aimed to examine the relationship between cognitive flexibility and positive psychotic symptom severity among individuals with schizophrenia and to determine whether cognitive flexibility significantly predicts the severity of positive psychotic symptoms in this population. A cross-sectional was employed. Data were collected from 150 adults with a clinical diagnosis of schizophrenia recruited from psychiatric clinical settings in Pakistan using a purposive sampling technique. Demographic and clinical characteristics (age, gender, education, and duration of illness) were recorded using a structured form. Cognitive flexibility was assessed using the Cognitive Flexibility Inventory (CFI), and positive psychotic symptom severity was assessed using the positive symptom subscale of the Positive and Negative Syndrome Scale (PANSS). Data were analyzed using descriptive statistics, frequency and percentage distributions, reliability analysis (Cronbach's alpha), Pearson product-moment correlation, and simple linear regression. Pearson correlation revealed a significant, moderate, negative relationship between cognitive flexibility and positive psychotic symptom severity, r(148) = −.42, p < .001. Simple linear regression confirmed that cognitive flexibility significantly predicted positive symptom severity, β = −.42, p < .001, accounting for 17.6% of the variance in positive symptom scores (R² = .176). Lower cognitive flexibility is significantly and robustly associated with greater severity of positive psychotic symptoms in schizophrenia. Cognitive flexibility appears to be a clinically meaningful psychological correlate of positive symptom severity, with implications for psychological assessment and for the design of cognitively oriented interventions delivered alongside antipsychotic treatment.