Longitudinal Associations Between Negative Symptoms and Social Functioning in Schizophrenia: The Moderating Role of Employment Status and Setting

While research has demonstrated strong relationships between negative symptoms and social difficulties in schizophrenia, little is known about the possible role of employment status and setting in this relationship. Seventy-seven participants with a diagnosis of schizophrenia spectrum disorder, who were either unemployed (n = 34), employed within a specialty mental health setting (n = 23), or employed within a community setting (n = 20) were assessed twice, six weeks apart, as to their negative symptoms and social functioning. Work in community settings generally predicted an increase in the levels of social functioning over time. However, individuals with high levels of negative symptoms who were employed in community settings evinced substantial decline in social functioning over time compared to unemployment or to employment in specialty mental health settings. These results are consistent with action models of psychopathology and encourage heightened sensitivity to individual symptomatic profiles in the course of vocational rehabilitation.