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Commissions and Omissions Are Dissociable Aspects of Everyday Action Impairment in Schizophrenia

Published online by Cambridge University Press:  30 July 2014

Kathryn N. Devlin
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Tania Giovannetti*
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Rachel K. Kessler
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Molly J. Fanning
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Correspondence and reprint requests to: Tania Giovannetti, Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, Pennsylvania 19122. E-mail:


Prior research using performance-based assessment of functional impairment has informed a novel neuropsychological model of everyday action impairment in dementia in which omission errors (i.e., failure to complete task steps) dissociate from commission errors (i.e., inaccurate performance of task steps) and have unique neuropsychological correlates. However, this model has not been tested in other populations. The present study examined whether this model extends to schizophrenia. Fifty-four individuals with schizophrenia or schizoaffective disorder were administered a neuropsychological protocol and the Naturalistic Action Test (NAT), a performance-based measure of everyday action. A principal component analysis (PCA) was performed to examine the construct(s) comprising everyday action impairment, and correlations between the resultant component(s) and neuropsychological tests were examined. Results showed that omissions and a subset of commissions were distinct components of everyday action. However, results did not support unique associations between these components and specific neuropsychological measures. These findings extend the omission-commission model to schizophrenia and may have important implications for efficient assessment and effective rehabilitation of functional impairment, such as the potential efficacy of targeted interventions for the rehabilitation of omission and commission deficits in everyday functioning. Larger studies with prospective designs are needed to replicate the present preliminary findings. (JINS, 2014, 20, 1–10)

Research Articles
Copyright © The International Neuropsychological Society 2014 

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