Enhanced facilitation of spatial attention in schizophrenia.

Objective: While attentional functions are usually found to be impaired in schizophrenia, a review of the literature on the orienting of spatial attention in schizophrenia suggested that voluntary attentional orienting in response to a valid cue might be paradoxically enhanced. We tested this hypothesis with orienting tasks involving the cued detection of a laterally presented target stimulus. Method: Subjects were chronic schizophrenia patients (SZ) and matched healthy control subjects (HC). In Experiment 1 (15 SZ, 16 HC), cues were endogenous (arrows) and could be valid (100% predictive) or neutral with respect to the subsequent target position. In Experiment 2 (16 SZ, 16 HC), subjects performed a standard orienting task with unpredictive exogenous cues (brightening of the target boxes). Results: In Experiment 1, SZ showed a larger attentional facilitation effect on reaction time than HC. In Experiment 2, no clear sign of enhanced attentional facilitation was found in SZ. Conclusions: The voluntary, facilitatory shifting of spatial attention may be relatively enhanced in individuals with schizophrenia in comparison to healthy individuals. This effect bears resemblance to other relative enhancements of information processing in schizophrenia such as saccade speed and semantic priming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional modularity of the medial prefrontal cortex: Involvement in human empathy.

To investigate medial frontal lobe mediation of human empathy, the authors analyzed the activation areas in statistical parametric maps of 80 studies reporting neural correlates of empathic processing. The meta-analysis revealed 6 spatially distinct activation clusters in the medial part of the frontal lobe dorsal to the intercommissural plane. The most dorsal cluster coincided with the left supplementary motor area (SMA). Rostrally adjacent was a cluster that overlapped with the right pre-SMA. In addition, there were 3 left-hemispheric and 1 right-hemispheric clusters located at the border between the superior frontal and anterior cingulate gyrus. A broad spectrum of cognitive functions were associated with these clusters, including attention to one's own action, which was related to activations in the SMA, and valuation of other people's behavior and ethical categories, which was related to activations in the most rostroventral cluster. These data complement the consistent observation that lesions of the medial prefrontal cortex interfere with a patient's perception of own bodily state, emotional judgments, and spontaneous behavior. The results of the current meta-analysis suggest the medial prefrontal cortex mediates human empathy by virtue of a number of distinctive processing nodes. In this way, the authors' findings suggest differentiated aspects of self-control of behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional neuroimaging of working memory in schizophrenia: Task performance as a moderating variable.

Functional neuroimaging studies in schizophrenia have demonstrated abnormal activation of dorsolateral prefrontal cortex (DLPFC) during working memory (WM) performance. However, findings of increased and decreased activity have been reported. The authors used meta-analysis to investigate whether diverging results arise as a function of differential WM task performance between patients and control participants. Results indicate that the magnitude of the group difference in WM performance is a moderator of DLPFC activation differences, and concepts such as hypo- or hyperfrontality do not universally characterize WM findings in schizophrenia. Thus, the variability in the WM activation findings between participants with schizophrenia and control participants reflects the specific conditions under which WM functions are evaluated, not just the WM construct per se. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion responsivity, social cognition, and functional outcome in schizophrenia.

Social functioning deficits have long been a defining feature in schizophrenia, but relatively little research has examined how emotion responsivity influences functional outcome in this disorder. The goal of the current study was to begin to elucidate the relationships between emotion responsivity, social cognition, and functional outcome in schizophrenia. Participants were 40 outpatients diagnosed with schizophrenia or schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) and 40 controls. Each participant completed measures of emotion responsivity, social cognition (both emotion and social perception), and functional outcome. Individuals with schizophrenia demonstrated somewhat reduced emotion responsivity for positive and negative stimuli, as well as deficits in both social cognition and functional outcome, in comparison with controls. Additionally, results indicated that both social perception and emotion responsivity were positively correlated with functional outcome. Importantly, the relationship of emotion responsivity to functional outcome was not mediated by social perception and showed a significant relationship to functional outcome independent of social cognition. This finding suggests that emotion responsivity is an important factor in understanding functional outcome in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impaired implicit learning in schizophrenia.

Schizophrenia patients consistently show deficits on tasks of explicit learning and memory. In contrast, their performance on implicit processing tasks often appears to be relatively intact, although most studies have focused on implicit learning of motor skills. This study evaluated implicit learning in 59 medicated schizophrenia outpatients and 43 controls using 2 different cognitive skill tasks. Participants completed a probabilistic classification task to assess procedural habit learning and an artificial grammar task to assess incidental learning of complex rule-based knowledge, as well as an explicit verbal learning and memory task. In addition to performing worse than controls on the explicit learning task, patients showed worse overall performance on the probabilistic classification task, which involves gradual learning through trial-by-trial performance feedback. However, patients and controls showed similar levels of learning on the artificial grammar task, suggesting a preserved ability to acquire complex rule-based knowledge in the absence of performance feedback. Discussion focuses on possible explanations for schizophrenia patients' poor probabilistic classification task performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder.

Objective: To investigate sex differences in neurocognition and social functioning in schizophrenia and bipolar disorder and the possible role of sex as a moderator of this relationship. Method: Participants with schizophrenia (60 women/94 men), bipolar I disorder (55 women/51 men), and healthy controls (158 women/182 men) were assessed with an extensive neuropsychological test battery and a social functioning questionnaire. Results: We found significant main effects of sex for neuropsychological tests (p     

The influence of affective factors on conceptualization in schizophrenia.

2 groups of schizophrenics, distinguished as to their capacity for abstract thinking (see 15: 3039), and normals were presented with stimuli composed of groupings of words constructed so that affect-laden words could be placed in the figure or ground of a gestalt. Schizophrenics characterized as demonstrating "concrete" thinking avoided affect-laden words whether they appeared in the figure or ground of the tachistoscopically presented gestalten. The finding tends to validate the assumption that generalized withdrawal in some schizophrenics is a product of withdrawal from affect-laden stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurocognition in first-episode schizophrenia: A meta-analytic review.

Compromised neurocognition is a core feature of schizophrenia. Following Heinrichs and Zakzanis’s (1998) seminal meta-analysis of middle-aged and predominantly chronic schizophrenia samples, the aim of this study is to provide a meta-analysis of neurocognitive findings from 47 studies of first-episode (FE) schizophrenia published through October 2007. The meta-analysis uses 43 separate samples of 2,204 FE patients with a mean age of 25.5 and 2,775 largely age- and gender-matched control participants. FE samples demonstrated medium-to-large impairments across 10 neurocognitive domains (mean effect sizes from ?0.64 to ?1.20). Findings indicate that impairments are reliably and broadly present by the FE, approach or match the degree of deficit shown in well-established illness, and are maximal in immediate verbal memory and processing speed. Larger IQ impairments in the FE compared to the premorbid period, but comparable to later phases of illness suggests deterioration between premorbid and FE phases followed by deficit stability at the group level. Considerable heterogeneity of effect sizes across studies, however, underscores variability in manifestations of the illness and a need for improved reporting of sample characteristics to support moderator variable analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Event-Related fMRI Study of Context Processing in Dorsolateral Prefrontal Cortex of Patients With Schizophrenia.

Context processing is conceptualized as an executive function involved in voluntary, complex actions such as overcoming automatic responses. The present study tested the hypothesis that context-processing deficits in patients with schizophrenia are associated with a dysfunction of left dorsolateral prefrontal cortex (DLPFC). Using event-related functional magnetic resonance imaging (fMRI), 17 controls and 17 medicated patients performed a version of the AX task in which a learned, automatic response had to be inhibited. In controls, left DLPFC activity increased when preparing to overcome an automatic response, whereas patients with schizophrenia showed no differential activation. In controls, context processing appeared to be associated with the differential representation of cues associated with the need to provide top-down support for overcoming automatic responses. This mechanism appeared to be impaired in patients with schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Automatic hypermnesia and impaired recollection in schizophrenia.

Evidence from studies of nonmnemonic automatic cognitive processes provides reason to expect that schizophrenia is associated with exaggerated automatic memory (implicit memory), or automatic hypermnesia. Participants with schizophrenia (n?=?22) and control participants (n?=?26) were compared on word stem completion (WSC) and list discrimination (LD) tasks administered using the process dissociation procedure. Unadjusted, extended measurement model and dual-process signal-detection methods were used to estimate recollection and automatic memory indices. Schizophrenia was associated with automatic hypermnesia on the WSC task and impaired recollection on both tasks. Thought disorder was associated with even greater automatic hypermnesia. The absence of automatic hypermnesia on the LD task was interpreted with reference to the neuropsychological bases of context and content memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion deficits in schizophrenia: Timing matters.

The past two decades of research on emotional response in schizophrenia has demonstrated that people with schizophrenia do not have a marked deficit in reported emotional experience in the presence of emotionally evocative stimuli. However, the extent to which people with schizophrenia maintain their emotional state to guide future behavior remains a largely unexplored area of investigation. In the present study, we tested hypotheses about whether people with schizophrenia maintained their emotional state in the absence of emotionally evocative stimuli. In addition to reported emotional experience, we measured startle response magnitude both during the viewing and after the offset of emotional pictures to assess whether people with schizophrenia (n = 31) and without schizophrenia (n = 28) differ in their patterns of immediate response to emotional pictures and in their patterns of maintenance of these responses. Our findings indicated that people with and without schizophrenia did not differ in their self-report or startle response magnitude during presentation of emotional pictures. However, healthy controls maintained these responses after the stimuli were removed from view, but people with schizophrenia did not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working and long-term memory deficits in schizophrenia: Is there a common prefrontal mechanism?

This study tested the hypothesis that dorsolateral prefrontal cortex deficits contribute to both working memory and long-term memory disturbances in schizophrenia. It also examined whether such deficits were more severe for verbal than nonverbal stimuli. Functional magnetic resonance imaging was used to assess cortical activation during performance of verbal and nonverbal versions of a working memory task and both encoding and recognition tasks in 38 individuals with schizophrenia and 48 healthy controls. Performance of both working memory and long-term memory tasks revealed disturbed dorolateral prefrontal cortex activation in schizophrenia, although medial temporal deficits were also present. Some evidence was found for more severe cognitive and functional deficits with verbal than nonverbal stimuli, although these results were mixed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurocognitive abnormalities during comprehension of real-world goal-directed behaviors in schizophrenia.

Origins of impaired adaptive functioning in schizophrenia remain poorly understood. Behavioral disorganization may arise from an abnormal reliance on common combinations between concepts stored in semantic memory. Avolition–apathy may be related to deficits in using goal-related requirements to flexibly plan behavior. The authors recorded event-related potentials (ERPs) in 16 patients with medicated schizophrenia and 16 healthy controls in a novel video paradigm presenting congruous or incongruous objects in real-world activities. All incongruous objects were contextually inappropriate, but the incongruous scenes varied in comprehensibility. Psychopathology was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS/SANS) and the Brief Psychiatric Rating Scale. In patients, an N400 ERP, thought to index activity in semantic memory, was abnormally enhanced to less comprehensible incongruous scenes, and larger N400 priming was associated with disorganization severity. A P600 ERP, which may index flexible object–action integration based on goal-related requirements, was abnormally attenuated in patients, and its smaller magnitude was associated with the SANS rating of impersistence at work or school (goal-directed behavior). Thus, distinct neurocognitive abnormalities may underlie disorganization and goal-directed behavior deficits in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Context processing in schizotypal personality disorder: Evidence of specificity of impairment to the schizophrenia spectrum.

Working memory abnormalities, which are particularly pronounced on context processing tasks, appear relatively specific to schizophrenia spectrum illnesses compared with other psychotic disorders. However, the specificity of context processing deficits to schizotypal personality disorder (SPD), a prototype of schizophrenia, has not been studied. The authors administered 3 versions of the modified AX Continuous Performance Test and an N-back working memory test to 63 individuals with SPD and 25 with other personality disorders, as well as 42 healthy controls. For the AX Continuous Performance Test standard and degraded versions, there was a significant Trial Type × Delay × Group interaction, as SPDs made significantly more errors reflecting poor maintenance of context and fewer errors reflecting good maintenance of context. SPDs also demonstrated poor performance on the N-back, especially at the 2-back condition. Context processing errors and N-back accuracy scores were related to disorganization symptoms. These findings, which are quite similar to those previously reported in patients with schizophrenia, suggest that context processing deficits are specific to the schizophrenia spectrum and are not a reflection of overall psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unpacking the informational bases of empathic accuracy.

Perceivers’ ability to correctly identify the internal states of social targets—known as empathic accuracy (EA)—is critical to social interactions, but little work has examined the specific types of information that support EA. In the current study, social targets varying in trait emotional expressivity were videotaped while discussing emotional autobiographical events. Perceivers watched these videos and inferred targets’ affect while having access to only visual or auditory information, or both. EA was assessed as the correlation of perceivers’ inference and targets’ self-ratings. Results suggest that auditory, and especially verbal information, is critical to EA. Furthermore, targets’ expressivity predicted both target behavior and EA, an effect influenced by the valence of the events they discussed. Specifically, expressive targets produced more nonverbal negative cues, and higher levels of EA when perceivers could only see them discussing negative events; expressive targets also produced more positive verbal cues, and higher levels of EA when perceivers could only hear them discussing positive events. These results are discussed in relation to social display rules and clinical disorders involving social deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention to gaze and emotion in schizophrenia.

Objective: Individuals with schizophrenia have difficulty interpreting social and emotional cues such as facial expression, gaze direction, body position, and voice intonation. Nonverbal cues are powerful social signals but are often processed implicitly, outside the focus of attention. The aim of this research was to assess implicit processing of social cues in individuals with schizophrenia. Method: Patients with schizophrenia or schizoaffective disorder and matched controls performed a primary task of word classification with social cues in the background. Participants were asked to classify target words (LEFT/RIGHT) by pressing a key that corresponded to the word, in the context of facial expressions with eye gaze averted to the left or right. Results: Although facial expression and gaze direction were irrelevant to the task, these facial cues influenced word classification performance. Participants were slower to classify target words (e.g., LEFT) that were incongruent to gaze direction (e.g., eyes averted to the right) compared to target words (e.g., LEFT) that were congruent to gaze direction (e.g., eyes averted to the left), but this only occurred for expressions of fear. This pattern did not differ for patients and controls. Conclusion: The results showed that threat-related signals capture the attention of individuals with schizophrenia. These data suggest that implicit processing of eye gaze and fearful expressions is intact in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Second-order facial information processing in schizophrenia.

This study investigated the processing of second-order relational face information in schizophrenia. Twenty-eight schizophrenic patients and 28 controls were asked to say whether the space between the eyes was the same in 2 side-by-side faces. The 2 faces were derived from the same original face, but the spacing between the eyes was either the same or differed by various distances. The results showed that schizophrenic patients needed a space that was twice as great as controls to see a difference. The authors conclude that schizophrenic patients have a deficit in processing second-order relational face information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How to fill a half-full glass: Emotion and schizophrenia.

The authors comment on the article "The primacy of cognition in schizophrenia," by R. W. Heinrichs (see record 2005-03019-003). They state that Heinrichs persuasively argued as to the primacy of cognition in schizophrenia by citing an impressive body of evidence in favor of the view that schizophrenia is a complex biobehavioral disorder that manifests itself primarily in cognition. His conclusion is something of an anticlimax. At the same time, however, he acknowledged that "the glass of evidence is half empty as well as half full" (Heinrichs, 2005, p. 238). That is to say, the symptoms that mark out schizophrenia--the hallucinations, delusions, and so forth--do not appear to map onto cognitive deficits, or at least they do not map onto those that are measured with traditional neuropsychological tests. To fill the other half of the glass, the authors propose that a focus on emotion (largely neglected in the target article) will be of crucial importance. Furthermore, they commend the methods of cognitive neuropsychiatry as being eminently suitable to guide this research. The authors briefly illustrate the value of this approach with reference to affective characteristics of hallucinations and cognitive-emotional interactions in source monitoring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pursuing the kernel of truth in the psychotherapy of schizophrenia.

This article concerns the utility of pursuing the kernels of truth in the delusions of schizophrenic patients as a means of empathizing with their unique personal experience of events. Pursuing the kernel of truth implies listening for the real interpersonal experiences past and present that are represented within delusions, as opposed to focusing on derivatives of infantile fantasy. This orientation restores the rights of the schizophrenic person as a perceptive observer of events with a valid, although not commonly understood, point of view. A clinical case example is presented in which the delusion of being raped while others stand idly by both literally and metaphorically described a wide variety of interpersonal experiences which had shaped the patient's life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alone but feeling no pain: Effects of social exclusion on physical pain tolerance and pain threshold, affective forecasting, and interpersonal empathy.

Prior findings of emotional numbness (rather than distress) among socially excluded persons led the authors to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1-4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional insensitivity, as indicated by reductions in affective forecasting of joy or woe over a future football outcome (Experiment 3), as well as lesser empathizing with another person's suffering from either romantic breakup (Experiment 4) or a broken leg (Experiment 5). The insensitivities to pain and emotion were highly intercorrelated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)