Studying cognitive functioning is important as these processes impact individual’s behavior and emotions (Heeramun-Aubeeluck et al., 2015). Various factors can impact cognitive functioning. A disorder known to impact cognition is psychosis. Thus, it is essential to examine psychosis and how these psychotic experiences effect cognitive functioning over time.  

How does psychosis effect cognitive functioning over time in patients who have experienced first-episode psychosis?

Psychosis is a mental state in which individuals experience a loss of touch with reality(Boychuk, Lysaght, & Stuart, 2018). Psychosis may lead to additional occurrences or may indicate signs of a mental health disorder. It is important to examine the cognitive impairment that is caused as a result of psychotic episodes. In addition, this would unfold information that may lead to the importance of treating psychosis when the first signs are noticed in hopes of decreasing the chances of psychosis leading to a mental disorder.    

Zaytseva, Korsokava, Agius, & Gurovich (2013) and Bora & Murray (2014) discovered altered cognitive functioning exists prior to onset or before the prodrome stage. In addition, Bohus & Miclutia (2014) indicate that cognitive functioning at first-episode psychosis was not as strong. Thus, it can be concluded that cognitive functioning impairment occurs prior to first-episode onset however, there is varying research that indicates the impact on cognitive functioning as time goes on. Popolo, Vinci, & Balbi (2010) conducted a year-long study on neurocognitive functioning amongst children and adolescent patients with first-episode psychosis. Cognitive impairment is indicated in early psychosis onset thus the study focused on examining cognitive impairments. Several cognitive assessments were given to patients and the results were evaluated. The results of the cognitive assessments indicated that adolescents with first-episode psychosis (FEP) have neurocognitive impairments. In addition, psychotic patient’s cognitive deficiencies do not decline over the course of the psychotic disorder. However, according to the article Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration? (2010), the results indicated that there is no decline in cognitive functioning during the first psychotic episode. This indicates a gap in research of the effect psychotic episodes has on cognitive functioning.

One study was published related to career-decision making of emergent adults with first-episode psychosis (Boychuk, Lysaght, & Stuart, 2018). Although this article may not directly relate to the research question used for the research proposal, the information obtained is relevant. It was discovered that during the onset of first-episode psychosis, symptoms worsened making it difficult to continue with various activities, primarily school and work. The article indicated the need for support and interventions amongst individuals with first-episode psychosis. This article was helpful in gaining a better understanding of psychosis and the effect it has on young adult’s lives.   

The other studies were not relevant to decision making or cognitive functioning, therefore another article was found to be relevant. The article studied how psychosis that is untreated effects cognitive functioning. It was discovered that there was no cognitive decline amongst Chinese patients with schizophrenia when psychosis is left untreated (Heeramun-Aubeeluck et. al., 2015). However, in the article, other research reports varying information on cognitive functioning. Some found that cognitive functioning was related to the length of untreated psychosis, while others found there was no relation. In addition, other research indicates some declining cognitive factors.

Although several potential methods exist, the following are most relevant and align with the research question:

Quasi-Experimental in which pre and post tests would be used. This method would be used to evaluate the effect of psychosis on cognitive functioning. Cognitive functioning is measured and the study is examining whether the differences in the results are directly caused by psychosis.  

Case study: this study provides a closer look at one test subjects, which would be patients with FEP. Collecting data from a variety of sources provides a better understanding of what is happening.

Sequential Explanatory: Quantitative data collection and analysis is conducted prior to collection and analysis of qualitative data. This would be useful in understanding and interpreting the results of a quantitative study.

In order to provide additional information to the research topic, a mixed methods approach will be used. Using a sequential explanatory method, selecting participants will be selected based on certain criteria. Using a quantitative approach such as the quasi-experimental method, data would be collected and analyzed. A qualitative method using case studies would then be conducted to collect and analyze data.  

Using a sequential explanatory mixed methods approach, provides additional information as results can be examined from both a quantitative and qualitative perspective. In addition, the design would allow to use larger and smaller samples. For example, a larger sample sized could be used for the quantitative method, while a smaller sample size could be used for the qualitative method. This design would provide a better understanding the effect psychosis has on cognitive functioning. Finally, the question would be addressed from various angles.

Researchers must be continuously aware of ethical issues while conducting a study. Informed consent is essential for all participants participating in the quantitative study followed by the qualitative study to give consent prior to conducting the study. It is imperative to maintain confidentiality and protect participant’s privacy. Ensuring the results of the study are accurate. Receiving approval for the study from proper entities. Assessments should be appropriate and aligned with the study. Staying within the boundaries of competence.

In order for the study to maintain its validity and accuracy, it is imperative for potential ethical concerns of the research to be addressed. The researcher should continuously be aware of their moral perspectives and continuously monitor by checking for potential ethical issues throughout the entire study. Having another individual check for potential bias or ethical concerns would be done as well. Ensuring data is not duplicated and credit is given to the appropriate researcher, and the researcher is not taking credit for another individual’s work. All participants must understand the study in its entirety what their role of participation as well as what they are consenting to. It is essential for researchers to stay within the scope of their competence and ensure the results are accurate. At times, researchers may need another individual that is competent in a specific area to interpret data. The tools used within the study should be evaluated and provide information specifically related to the study.  

Psychosis is a health concern that affects the lives of individuals. Cognitive functioning is important to study and gain a better understanding of potential causes for decline. Gaining information and knowledge may assist individuals with treatment options as well as guide health professionals. Additional knowledge is essential in this area of psychosis and cognitive functioning in order to be able to assist individuals enhance their health and well-being.  

Several studies have indicated cognitive functioning decline in the prodrome stage of psychosis. If cognitive functioning is shown to decline over time as a result of psychosis, health care may be able to design and implement effective treatment options. Using a mixed methods approach will allow researchers to interpret and compare results from the various methods in hopes of attaining the most accurate information. Continuously being aware and examining potential ethical concerns will help ensure accuracy and validity of the study.



Bora, E., & Murray, R. M. (2014). Meta-analysis of Cognitive Deficits in Ultra-high Risk to Psychosis and First-Episode Psychosis: Do the Cognitive Deficits Progress Over, or After, the Onset of Psychosis?. Schizophrenia Bulletin40(4), 744.

Boychuk, C., Lysaght, R., & Stuart, H. (2018). Career Decision-Making Processes of Young Adults With First-Episode Psychosis. Qualitative Health Research28(6), 1016. doi:10.1177/1049732318761864

Heeramun-Aubeeluck, A., Liu, N., Fischer, F., Huang, N., Chen, F., He, L., & … Lu, Z. (2015). Effect of time and duration of untreated psychosis on cognitive and social functioning in Chinese patients with first-episode schizophrenia: A 1-year study. Nordic Journal Of Psychiatry69(4), 254-261. doi:10.3109/08039488.2014.929738

Hesse-Biber, S. N. (2010). Mixed methods research: Merging theory with practice. New York, NY: Guilford Press.

Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration?. (2010). Psychological medicine, (10), 1599. doi:10.1017/s0033291710000048

Popolo, R., Vinci, G., & Balbi, A. (2010). Cognitive function, social functioning and quality of life in first-episode psychosis: A 1-year longitudinal study. International Journal Of Psychiatry In Clinical Practice14(1), 33-40. doi:10.3109/13651500903282881

Zaytseva, Y., Korsakova, N., Agius, M., & Gurovich, I. (2013). Neurocognitive Functioning in Schizophrenia and during the Early Phases of Psychosis: Targeting Cognitive Remediation Interventions. Biomed Research International20131. doi:10.1155/2013/819587

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