Lay Summary

• We explored the association between time perspective, daily time use and levels of functioning among individuals with Schizophrenia Spectrum Disorders (SSD). • We found that higher time spent “doing nothing” in individuals with SSD was predicted by higher maladaptive time orientation (i.e., Present Fatalistic) and lower levels of functional time orientations (i.e., Past-Positive and Future), Present-Hedonistic and Balanced Time Perspective. • Studying time perspectives and daily time use in individuals with SSDs is crucial because severe mental disorders may impair the continuity of normal life and are often associated to a radical change in subjective temporality, leading to a fragmentation of the experience of the self in time.

Background

Time Perspective (TP) and Balanced Time Perspective (BTP) are known to affect human emotions, cognitions, judgements and behaviours. However, few is known about TP of individuals with Schizophrenia Spectrum Disorders (SSD) and its link with daily time use. As part of the DiAPAson project, we aimed at exploring this link and the association between TP and levels of functioning as mediated by daily time use, controlling for psychiatric severity, gender and age.

Methods

620 patients with a diagnosis of SSD (313 patients living in Residential Facilities, RFs, 307 outpatients) were recruited at 37 mental health services in Italy. The Brief Psychiatric Rating Scale (BPRS) and the Specific Levels of Functioning (SLOF) were used to investigate psychiatric severity and levels of functioning. Daily time use was assessed by means of an ad hoc developed paper-and-pencil Time Use Survey (TUS) questionnaire. The Zimbardo Time Perspective Inventory (ZTPI) was used for the assessment of TP. Deviation from BTP (DBTP-r) was calculated.

Results

Among outpatients, the amount of time spent in Non-Productive Activities (NPA) was negatively predicted by Past-Positive (Exp(β): 0.92; p .005), Present-Hedonistic (Exp(β): 0.92; p .002), Future (Exp(β): 0.92; p .001) subscales and positively predicted by Present-Fatalistic subscale (Exp(β): 1.07; p .029). DBTP-r positively predicted time spent in NPA among these groups: outpatients (Exp(β): 1.10; p .001), 31-40 years old (Exp(β): 1.16; p .003), 41-55 years old (Exp(β): 1.16; p <.001), females (Exp(β): 1.13; p .012) and males (Exp(β): 1.13; p <.001). DBTP-r significantly negatively predicted SLOF ratings (p=.006), and daily time use, in particular the amount of time spent in NPA, mediated this association.

Conclusion

Fostering BTP (e.g. restructuring past memories, encouraging higher focalization on future perspectives, reducing both fatalistic and hedonistic life perspectives) may reduce inactivity levels among patients with SSD, may increase PA levels, and may promote higher engagement in rehabilitation programmes. All these changes are likely to improve patients’ levels of functioning and rehabilitation outcomes.