Information-processing markers of vulnerability to schizophrenia: performance of patients with schizotypal and nonschizotypal personality disorders

doi:10.1016/0165-1781(95)02764-5

Psychiatry Research

Volume 60, Issue 1, 28 February 1996, Pages 49-56

https://doi.org/10.1016/0165-1781(95)02764-5 Get rights and content

Abstract

Deficits in performance on tests of information processing have been proposed to be markers of vulnerability to schizophrenia. Very few of the previous studies of these information-processing deficits, however, have examined subjects who have clinical diagnoses of schizotypal personality disorders; most studies instead have focused on schizophrenic patients and their relatives or subjects selected on the basis of psychometric evidence of schizotypal traits. In this study, patients with DSM-III schizotypal (n = 29) and non-odd cluster (n = 33) personality disorders were examined with the Continuous Performance Test (CPT) and a backward masking test and compared with a group of normal volunteers (n = 31). Patients with schizotypal personality disorder manifested a specific deficit in performance, making significantly more errors of omission in the degraded stimulus condition of the CPT compared with the nondegraded condition, whereas non-odd cluster patients and the normal volunteers performed the same in both conditions. No differences in performance between the groups were found for any of the backward-masking measures. These data suggest that specific deficits in CPT performance, possibly reflecting reduced processing capacity or load responsiveness of the vigilance system, are associated with schizotypal personality disorder and fail to replicate previous studies finding backward-masking deficits in various nonclinical schizotypal populations.

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Cited by (44)

Working-memory impairment in schizophrenia and schizotypal personality disorder
2021, Cognitive and Behavioral Dysfunction in Schizophrenia
Working memory (WM) refers to the temporary maintenance, updating, and manipulation of information. It is a key component in cognitive neuroscience research as it improves our understanding of cognitive operations such as comprehension, problem-solving, and planning. Impairment in WM can impact day-to-day functioning and its severity can predict long-term outcome in psychosis-spectrum disorders such as schizophrenia. The goal of this chapter is to review prior studies on WM disturbances in schizophrenia and schizotypal personality disorder using N-Back Paradigm and AX-Continuous Performance Test, two commonly used WM measures for clinical trials. In addition, the commonalities and differences in WM impairment patterns between both groups are discussed. Last, we provide summary of the gaps and limitations of previous studies which will then become the focus of future research.
Does assessing the functional impact of alterations in social cognition promote commitment to care for people with psychotic disorders?
2018, Annales Medico-Psychologiques
Les troubles cognitifs, dont ceux qui touchent la cognition sociale, sont présents dès la phase précoce des troubles psychotiques. Avec les troubles de la motivation, de la métacognition et de l’insight, ces facteurs ont été identifiés comme ayant un rôle primordial dans la genèse du handicap psychique. Par ailleurs, les interventions proposées qui répondent aux besoins spécifiques des usagers, indépendamment d’une certitude diagnostique et la prise en compte des difficultés d’insight, ont été identifiées comme des facteurs permettant de réduire la durée de psychose non traitée, favorisant ainsi le pronostic d’évolution des personnes présentant une psychose émergente. Une enquête a été conduite pendant quatre mois auprès de 16 personnes présentant une schizophrénie ou un trouble schizo-affectif ayant bénéficié de l’ERF-CS et auprès des quatre infirmières ayant conduit les entretiens. Elle était destinée à interroger les effets de la conduite d’un entretien évaluant les répercussions fonctionnelles des troubles de la cognition sociale (ERF-CS) sur l’engagement dans les soins des personnes présentant une psychose en stimulant différentes composantes de la motivation pour les soins. Les résultats sont en faveur d’un impact positif de la définition d’objectifs fonctionnels sur la motivation à participer à une remédiation de la cognition sociale et sur l’alliance thérapeutique. Un impact positif sur l’insight et une meilleure compréhension des difficultés éprouvées par les participants dans leurs relations avec autrui ont été rapportés. L’étude pointe aussi les limites de l’ERF-CS : certaines questions sont trop peu claires et une formation préalable est nécessaire. L’ERF-CS peut donc être considéré comme un support favorisant l’engagement dans les soins, y compris en début de maladie. Cette dernière perspective reste toutefois à confirmer par des études menées directement auprès de cette population.
Cognitive impairments and particularly social cognitive deficits are present from the early stages of schizophrenia. With other factors such as motivation, metacognitive processes and insight, social cognition appeared as having an essential role in the genesis of psychosocial disability of patients suffering from this disease. Furthermore, it seems that interventions which meet the specific needs of users, despite both the uncertainly of the diagnosis and the lack of insight, have been identified as a determinant factor to reduce the period of untreated psychosis and thus favoring long-term prognosis. The study here aims to observe if the assessment of functional outcomes of social cognitive impairments, thanks to a semi-structured interview (Social Cognition-Functional Outcomes Scale ERF-CS), could favor involvement of people with psychosis in their health care, by encouraging motivation and therapeutic alliance. The ERF-CS is composed of 14 items that depict different social situations in which each component of social cognition is likely to have an impact. The scale provides qualitative information on difficulties lived by patients in social situations in the daily life and an overall score of functional outcomes ranging from 0 to 154. The questionnaire took around one hour to complete.
For this purpose, a survey was carried out of 16 people with schizophrenia or schizoaffective disorder and the 4 nurses who have conducted the interviews. Symptomatic activity, level of social autonomy and social cognition performances were controlled. Data have been collected thanks to questionnaires proposed to the patients and the caregivers during the 24 hours following the ERF-CS interview. Questions focused on: (1) interest, advantages and disadvantages felt during the interview, (2) the possibility of identifying concrete goals for cognitive remediation after the interview, (3) the motivation for care, and (4) the therapeutic alliance. Concerning advantages and disadvantages of the interview, a thematic analysis has been conducted on patients and nurses comments.
Results revealed globally more benefits than inconvenient of the ERF-CS. According to both patients and caregivers, it allows a greater awareness of cognitive or functional impairments. A criticism often been expressed by patients and nurses concerns the complexity of some items of the scale. Moreover, professionals pointed both the necessity of a prior training to the interview, and the importance of having strong skills concerning social cognition. The ERC-CS is perceived by the caregivers and patients has a valuable tool for favoring the identification of concrete goals for the intervention, Even if feedbacks of patient population are here not as positive as those of professionals. Results highlighted for both the patients and the nurses a positive impact of the semi-structured interview on direct and indirect motivation. They seem to be both more implicated in the care proposed after the ERF-CS interview. Moreover, the ERF-CS has been judged positively on therapeutic alliance in both populations surveyed.
This study encourages the use of the ERF-CS interview prior to starting social cognitive remediation therapy. Actually, the scale promotes motivation of patients and caregivers and helps therapists to define concrete goals, which are crucial to ensure the transfer of skills to daily life. The ERF-CS also constitutes a mediating tool promoting the therapeutic alliance between the patient and his/her therapist. However, these results should be confirmed with larger populations of patients and caregivers, working in different teams. To conclude, while this study did not concern specifically people with early psychosis, the ERF-CS interview seems useful to favor involvement of this population in health care. Further studies should consider this assumption.
Impaired automatization of a cognitive skill in first-degree relatives of patients with schizophrenia
2014, Psychiatry Research
Citation Excerpt :
Thus, evidence of reduced automatization of cognitive skills in ROS patients may have implications for daily life activities. There is agreement in the literature that individuals with schizophrenia or schizotypal personality disorder have diminished processing resources (Asarnow et al., 1995; Braff, 1981, 1985; Harvey et al., 1996, 2006; Holzman, 1987; Moriarty et al., 2003; Nuechterlein, 1991), and that the ability of individuals with schizophrenia to automate skills is more impaired than controls. Insufficient processing resources to handle higher processing loads can result in cognitive impairment in schizophrenia patients (Asarnow et al., 1991; Asarnow and Sherman, 1984; Gjerde, 1983; Sherman and Asarnow, 1985).
We studied healthy, first-degree relatives of patients with schizophrenia to test the hypothesis that deficits in cognitive skill learning are associated with genetic liability to schizophrenia. Using the Weather Prediction Task (WPT), 23 healthy controls and 10 adult first-degree Relatives Of Schizophrenia (ROS) patients were examined to determine the extent to which cognitive skill learning was automated using a dual-task paradigm to detect subtle impairments in skill learning. Automatization of a skill is the ability to execute a task without the demand for executive control and effortful behavior and is a skill in which schizophrenia patients possess a deficit. ROS patients did not differ from healthy controls in accuracy or reaction time on the WPT either during early or late training on the single-task trials. In contrast, the healthy control and ROS groups were differentially affected during the dual-task trials. Our results demonstrate that the ROS group did not automate the task as well as controls and continued to rely on controlled processing even after extensive practice. This suggests that adult ROS patients may engage in compensatory strategies to achieve normal levels of performance and support the hypothesis that impaired cognitive skill learning is associated with genetic risk for schizophrenia.
Working memory in schizotypal personality disorder: FMRI activation and deactivation differences
2013, Schizophrenia Research
Citation Excerpt :
SPD shares with schizophrenia many genetic, anatomical, functional, electrophysiological, cognitive, neuropsychological, and treatment response characteristics (Kendler et al., 1984; Gunderson and Siever, 1985; Kendler, 1985; Torgersen, 1985; Siever and Davis, 1991; Cadenhead et al., 1993; Siever, 1994; Trestman et al., 1995; Buchsbaum et al., 1997b; Keefe et al., 1997; Cadenhead et al., 1999; Dickey et al., 1999; Niznikiewicz et al., 1999; Cadenhead et al., 2000; Dickey et al., 2000; Kirrane and Siever, 2000; Niznikiewicz et al., 2000; Voglmaier et al., 2000; Byne et al., 2001; Shenton et al., 2001; Buchsbaum et al., 2002; Dickey et al., 2002a,b; Mitropoulou et al., 2002; Dickey et al., 2003a,b; Koenigsberg et al., 2003; Haznedar et al., 2004; Siever and Davis, 2004; Dickey et al., 2005; Mitropoulou et al., 2005; Nakamura et al., 2005; Voglmaier et al., 2005; Dickey et al., 2007, 2008; McClure et al., 2008; Dickey et al., 2010, 2011; Ozeki et al., 2011). Research suggests that the cognitive impairments shared between SPD and schizophrenia are more focal, mainly involving deficits in verbal learning (Kirrane and Siever, 2000; Voglmaier et al., 2000; Siever et al., 2002; Voglmaier et al., 2005), sustained attention (Condray and Steinhauer, 1992; Harvey et al., 1996; Roitman et al., 1997; Kirrane and Siever, 2000; Siever et al., 2002; Bergida and Lenzenweger, 2006) and working memory (Farmer et al., 2000; Kirrane and Siever, 2000; Roitman et al., 2000; Voglmaier et al., 2000; Siever et al., 2002; Mitropoulou et al., 2005; McClure et al., 2007; Goldstein et al., 2011). Such cognitive impairment may underlie day-to-day functioning difficulties; in schizophrenia, cognitive impairment is thought to be a better predictor of long-term daily functioning than the severity of psychotic symptoms (Green, 1996; Green and Nuechterlein, 1999; Green et al., 2000; Mitropoulou et al., 2002).
Schizotypal personality disorder (SPD) is considered a schizophrenia spectrum disorder, sharing with schizophrenia cognitive, neuropsychological, epidemiological, and biological characteristics. Working memory may be one area of shared deficit, although to date, this is only the second study to investigate working memory in SPD using fMRI.
In a block-design fMRI study, fifteen antipsychotic-naïve SPD and sixteen healthy control subjects performed blocks of a 2back visual working memory task and 0back continuous performance task while undergoing whole-brain fMRI at 3 T. Whole-brain analyses were performed for the 0back > rest (fixation baseline) and the 2back > 0back contrasts (isolating the working memory component from the visual perception and attention component). Parameter estimates were extracted to determine whether observed differences were due to task-induced activation and/or deactivation.
Activation differences emerged between the two groups, without differences in task performance. In the 0back task, SPD showed decreased task-induced activation of the left postcentral gyrus. In the 2back > 0back contrast, HC showed greater task-induced activation of the left posterior cingulate gyrus, superior temporal gyrus, insula, and middle frontal gyrus. These differences were due to SPD subjects' decreased task-induced activation in the left posterior cingulate gyrus, and task-induced deactivation in the remaining regions.
These findings suggest that compared to HC subjects, individuals with SPD may achieve comparable working memory performance. However, differences emerge at the level of functional neural activation, attributable to different task-induced activation and deactivation patterns. Such differential recruitment of neural resources may be beneficial, contributing to SPD subjects' ability to perform these tasks comparably to HC subjects.
A potential qualitative endophenotype for schizophrenia: Backward masking response to red light
2009, Psychiatry Research
Past research with unaffected relatives of individuals with schizophrenia has suggested a new qualitative endophenotype for schizophrenia that involves a unique change in visual processing response to red light. The current study provides the first report of this “red light effect” in individuals with schizophrenia (N = 15), compared with nonpsychiatric controls (N = 16), using a location backward masking by pattern paradigm with red and green background conditions. Analyses revealed a statistically significant group difference in the overall change in accuracy to a red background. Controls tended to show an increase in accuracy with the red (compared with green) background, although the medium effect size was not statistically significant in the small sample. In contrast, participants with schizophrenia showed a statistically significant decrease in accuracy with the red background. Results support recent reports which have suggested that a unique change in visual processing in response to red light may represent a new endophenotype for schizophrenia. This effect is unique from most existing endophenotypes in that it represents a distinct qualitative performance pattern rather than simply poorer performance relative to a comparison group.
Effect of Schizotypy on Cognitive Performance and Its Tuning by COMT val<sup>158</sup> Met Genotype Variations in a Large Population of Young Men
2007, Biological Psychiatry
Citation Excerpt :
We did not observe a relation between performance accuracy or speed and current state psychopathology. This observation offers strong support to the notion that schizotypy is a trait factor that affects cognitive performance, irrespective of current state symptomatology (Harvey et al. 1996). Current theoretical approaches postulate that the major functional deficit in schizophrenia is the hypodopaminergic function of the prefrontal cortex, resulting in what the so-called negative symptom cluster of the disease (Weinberger et al. 1988).
Mirroring schizophrenia, specific dimensions of schizotypy are related to cognitive dysfunction. The relation of schizotypy and state psychopathology to cognitive performance and its link to catechol-O-methyltransferase (COMT) val¹⁵⁸ met genotype variations was studied in a large sample of young men.
State psychopathology and schizotypy were assessed with self-rated questionnaires. Cognitive performance was assessed with tests of reasoning ability, sustained attention, and verbal and spatial working memory. Subjects were genotyped for the val¹⁵⁸ met polymorphism of the gene for COMT (low enzymatic activity met/met, intermediate met/val, and high val/val).
The val/val group had higher scores in measures of state psychopathology as well as negative and disorganized schizotypy dimensions, whereas there was no effect of COMT genotype on cognitive performance measures. Structural equation modeling showed that cognitive performance accuracy but not speed decreased with increasing negative schizotypy, increased with increasing paranoid schizotypy, and was not affected by state psychopathology. Increasing val loading resulted in a dose-dependent increase in the factor loading for the relation between negative schizotypy and cognitive performance accuracy.
Different schizotypal phenotypes had opposing relations to cognitive performance in the population. COMT genotype modulated the relation between the negative schizotypal phenotype and cognitive performance.

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ArticleInformation-processing markers of vulnerability to schizophrenia: performance of patients with schizotypal and nonschizotypal personality disorders

Abstract

Schizophr Res

Psychiatry Res

Psychiatry Res

Residual performance deficit in clinically remitted schizophrenics: a marker of schizophrenia?

J Abnorm Psychol

Impaired speed of information processing in unmedicated schizotypal patients

Schizophr Bull

Information processing and attention dysfunctions in schizophrenia

Schizophr Bull

Putatively psychosis-prone subjects 10 years later

J Abnorm Psychol

Physical anhedonia, perceptual aberration, and psychosis proneness

J Abnorm Psychol

Global attentional deviance as a marker of risk for schizophrenia: specificity and predictive validity

J Abnorm Psychol

Impaired attention, genetics, and the pathophysiology of schizophrenia

Schizophr Bull

Article
Information-processing markers of vulnerability to schizophrenia: performance of patients with schizotypal and nonschizotypal personality disorders