Schizophrenia Research
Volume 89, Issue 1 , Pages 110-118 , January 2007

Prevalence and correlates of adequate performance on a measure of abilities related to decisional capacity: Differences among three standards for the MacCAT-CR in patients with schizophrenia

  • Laura B. Dunn

      Affiliations

    • University of California, San Diego, Department of Psychiatry, United States
    • Veterans Affairs San Diego Healthcare System, United States
    • Corresponding Author InformationCorresponding author. Division of Geriatric Psychiatry, 116A-1, 3350 La Jolla Village Drive, San Diego, CA 92161, United States. Tel.: +1 858 642 1269; fax: +1 858 642 3425.
  • ,
  • Barton W. Palmer

      Affiliations

    • University of California, San Diego, Department of Psychiatry, United States
  • ,
  • Paul S. Appelbaum

      Affiliations

    • Department of Psychiatry, Columbia University, United States
  • ,
  • Elyn R. Saks

      Affiliations

    • University of Southern California, The Law School, United States
  • ,
  • Gregory A. Aarons

      Affiliations

    • University of California, San Diego, Department of Psychiatry, United States
    • Child and Adolescent Services Research Center, Children's Hospital San Diego, United States
  • ,
  • Dilip V. Jeste

      Affiliations

    • University of California, San Diego, Department of Psychiatry, United States
    • Veterans Affairs San Diego Healthcare System, United States

Received 24 April 2006 ,Revised 11 August 2006 ,Accepted 16 August 2006.

References 

  1. Appelbaum PS. Decisional capacity of patients with schizophrenia to consent to research: taking stock. Schizophr. Bull. 2006;32:22–25
  2. Appelbaum PS, Grisso T. MacCAT-CR: MacArthur Competence Assessment Tool for Clinical Research. Sarasota, FL: Professional Resource Press; 2001;
  3. Appelbaum PS, Roth LH. Competency to consent to research: a psychiatric overview. Arch. Gen. Psychiatry. 1982;39:951–958
  4. Benedict R. Brief Visual-Spatial Memory Test-Revised. Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.; 1997;
  5. Benedict R, Schretlen D, Groninger L, et al. Hopkins Verbal Learning Test-revised: normative data and analysis of inter-form and test–retest reliability. Clin. Neuropsychol. 1998;12:43–55
  6. Birchwood M, Smith J, Drury V, et al. A self-report insight scale for psychosis: reliability, validity and sensitivity to change. Acta Psychiatr. Scand. 1994;89:62–67
  7. Carpenter WT, Gold JM, Lahti AC, et al. Decisional capacity for informed consent in schizophrenia research. Arch. Gen. Psychiatry. 2000;57:533–538
  8. Christensen H, Kumar R. Cognitive changes and the ageing brain. In:  Sachdev PS editors. The Ageing Brain: the Neurobiology and Neuropsychiatry of Ageing. Lisse, The Netherlands: Swets and Zeitlinger; 2003;p. 75–95
  9. Dawes RM, Faust D, Meehl PE. Clinical versus actuarial judgment. Science. 1989;243:1668–1674
  10. Dunn LB, Lindamer LA, Palmer BW, et al. Improving understanding of research consent in middle-aged and elderly patients with psychotic disorders. Am. J. Geriatr. Psychiatry. 2002;10:142–150
  11. Dunn L, Palmer BW, Keehan M, et al. Assessment of therapeutic misconception in older schizophrenia patients with a brief instrument. Am. J. Psychiatry. 2006;163:500–506
  12. Dunn LB, Candilis PJ, Roberts LW. Emerging empirical evidence on the ethics of schizophrenia research. Schizophr. Bull. 2006;32:47–68
  13. Dunn LB, Nowrangi M, Palmer BW, et al. Assessing capacity to consent to treatment and research: a review of instruments. Am. J. Psychiatry. 2006;163:1323–1334
  14. Flory J, Emanuel E. Interventions to improve research participants' understanding in informed consent for research: a systematic review. JAMA. 2004;292:1593–1601
  15. Hamilton M. A rating scale for depression. J. Neurol. Neurosurg. Psychiatry. 1960;23:56–62
  16. Heaton RK, Gladsjo JA, Palmer BW, et al. The stability and course of neuropsychological deficits in schizophrenia. Arch. Gen. Psychiatry. 2001;58:24–32
  17. Jeste DV, Depp CA, Palmer BW. Magnitude of impairment in decisional capacity in people with schizophrenia compared to normal subjects: an overview. Schizophr. Bull. 2006;32:121–128
  18. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr. Bull. 1987;13:261–276
  19. Kim SY. When does decisional impairment become decisional incompetence? Ethical and methodological issues in capacity research in schizophrenia. Schizophr. Bull. 2006;32:92–97
  20. Kim SY, Caine ED, Currier GW, et al. Assessing the competence of persons with Alzheimer's disease in providing informed consent for participation in research. Am. J. Psychiatry. 2001;158:712–717
  21. Kongs S, Thompson L, Iverson G, et al. Wisconsin Card Sorting Test-64 Card Version. Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.; 2000;
  22. Kovnick JA, Appelbaum PS, Hoge SK, et al. Competence to consent to research among long-stay inpatients with chronic schizophrenia. Psychiatr. Serv. 2003;54:1247–1252
  23. Lidz CW, Appelbaum PS. The therapeutic misconception: problems and solutions. Med. Care. 2002;40:V55–V63
  24. Marson DC, Chatterjee A, Ingram KK, et al. Toward a neurologic model of competency: cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards. Neurology. 1996;46:666–672
  25. Mattis S. Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources, Inc.; 1973;
  26. McDermott BE, Gerbasi JB, Quanbeck C, et al. Capacity of Forensic Patients to Consent to Research: the Use of the MacCAT-CR. J. Am. Acad. Psychiatry Law. 2005;33:299–307
  27. Moser DJ, Schultz SK, Arndt S, et al. Capacity to provide informed consent for participation in schizophrenia and HIV research. Am. J. Psychiatry. 2002;159:1201–1207
  28. Moser DJ, Arndt S, Kanz JE, et al. Coercion and informed consent in research involving prisoners. Compr. Psychiatry. 2004;45:1–9
  29. Moye J, Karel MJ, Azar AR, et al. Capacity to consent to treatment: empirical comparison of three instruments in older adults with and without dementia. Gerontologist. 2004;44:166–175
  30. Moye, J., Gurrera, R.J., Karel, M.J., et al., in press. Empirical advances in the assessment of the capacity to consent to medical treatment: clinical implications and research needs. Clin. Psychol. Rev. (Epub ahead of print).
  31. Muthen B, Muthen LK. Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcohol., Clin. Exp. Res. 2000;24:882–891
  32. National Bioethics Advisory Commission . Research Involving Persons with Mental Disorders that may Affect Decision Making Capacity. Rockville, MD: National Bioethics Advisory Commission; 1998;
  33. Nayak GV, Moore DJ, Roesch SC, et al. An evaluation of longitudinal neurocognitive performance among middle-aged and older schizophrenia patients: use of mixed-model analyses. Schizophr. Res. 2006;83:215–223
  34. Palmer BW, Jeste DV. Relationship of individual cognitive abilities to specific components of decisional capacity among middle-aged and older patients with schizophrenia. Schizophr. Bull. 2006;32:98–106
  35. Palmer BW, Bondi MW, Twamley EW, et al. Are late-onset schizophrenia spectrum disorders neurodegenerative conditions? Annual rates of change on two dementia measures. J. Neuropsychiatry Clin. Neurosci. 2003;15:45–52
  36. Palmer BW, Dunn LB, Appelbaum PS, et al. Correlates of treatment-related decision-making capacity among middle-aged and older patients with schizophrenia. Arch. Gen. Psychiatry. 2004;61:230–236
  37. Palmer BW, Dunn LB, Appelbaum PS, et al. Assessment of capacity to consent to research among older persons with schizophrenia, Alzheimer disease, or diabetes mellitus: comparison of a 3-item questionnaire with a comprehensive standardized capacity instrument. Arch. Gen. Psychiatry. 2005;62:726–733
  38. Roberts LW, Dyer AR. Concise Guide to Ethics in Mental Health Care. Washington D.C: American Psychiatric Press, Inc.; 2004;
  39. Rund BR. A review of longitudinal studies of cognitive functions in schizophrenia patients. Schizophr. Bull. 1998;24:425–435
  40. Saks ER, Dunn LB, Palmer BW. Meta-consent in research on decisional capacity: a "catch-22"?. Schizophr. Bull. 2006;32:42–46
  41. Shore D, Hyman SE. An NIMH commentary on the NBAC report. Biol. Psychiatry. 1999;46:1013–1016
  42. Stroup TS, McEvoy JP, Swartz MS, et al. The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project: schizophrenia trial design and protocol development. Schizophr. Bull. 2003;29:15–31
  43. Stroup S, Appelbaum P, Swartz M, et al. Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial. Schizophr. Res. 2005;80:1–8
  44. Sturman ED. The capacity to consent to treatment and research: a review of standardized assessment tools. Clin. Psychol. Rev. 2005;25:954–974
  45. UCSD Human Research Protections Program . Decision Making Capacity Guidelines. 2004;Available online at: http://irb.ucsd.edu/decisional.shtml
  46. Vellinga A, Smit JH, van Leeuwen E, et al. Instruments to assess decision-making capacity: an overview. Int. Psychogeriatr. 2004;16:397–419
  47. Wechsler D. Wechsler Memory Scale. Third edition. San Antonio: The Psychological Corporation; 1997;WMS-III
  48. Wirshing DA, Wirshing WC, Marder SR, et al. Informed consent: assessment of comprehension. Am. J. Psychiatry. 1998;155:1508–1511
  49. Wirshing DA, Sergi MJ, Mintz J. A videotape intervention to enhance the informed consent process for medical and psychiatric treatment research. Am. J. Psychiatry. 2005;162:186–188

PII: S0920-9964(06)00366-5

doi: 10.1016/j.schres.2006.08.005

Schizophrenia Research
Volume 89, Issue 1 , Pages 110-118 , January 2007