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Source memory biases associated with reality distortion in schizophrenia
186 latter was likely due to a ceiling effect. These findings suggest reduced perceptual learning effects and a reduced presence or influence of higher cognitive processes during contour integration task performance in schizophrenia.
NEUROPSYCHOLOGICAL FUNCTIONING AND QUALITY OF LIFE IN PEOPLE WITH SCHIZOPHRENIA ENROLLED IN THE SCHIZOPHRENIA CARE AND ASSESSMENT PROGRAM C. Williams,* J. Ponsford, R B. Fitzgerald, A. deCastella, K. Filia, J. Collins, B. M o n t g o m e r y , J. Kulkarni
Psychological Medicine, AlJ?ed Psychiatry Research Centre, Prahran, V1C, Australia In an exploratory fashion, the current study examines the relationship between neuropsychological functioning, and objective and subjective measures of quality of life in people with schizophrenia. Furthermore, this study examines the relationship between psychopathology and neuropsychological functioning in people with schizophrenia. This study is part of a bigger project namely the Schizophrenia Care and Assessment Program (SCAP). The SCAP project aims to improve the quality of mental health care for people with schizophrenia by observing patients with the disorder worldwide over a three year period. The examination of neuropsychological functioning is unique to the Australian site of the SCAP project. 95 participants from the Australian site of the SCAP study, with a diagnosis of schizophrenia are included in the current study. All participants are administered a comprehensive neuropsychological test battery, to assess memory, attention, and executive function, as well as clinical test instruments. There was a significant relationship between subjective and objective measures of quality of life and neuropsychological functioning in people with schizophrenia. Furthermore, positive and negative symptomatology significantly correlated with neuropsychological functioning. The presence of psychopathology and cognitive deficits can be devastating and debilitating. This research demonstrates the importance of interventions aimed at alleviating or reducing the impact of these symptoms, in order to increase a person's quality of life. Funding for this study has been provided by Eli Lilly.
ERRORLESS LEARNING IN PATIENTS WITH SCHIZOPHRENIA AND NON-AFFECTED CONTROLS A. E. Wood,* R. S. Kern, A. Tapp VA Puget Sound Health Care System, Tacoma, WA, USA Cognitive deficits are a core feature of schizophrenia, which has led to interest in cognitive rehabilitation strategies such as 'errorless learning'. Although errorless learning techniques have been used successfully with cognitively disabled populations, it is not clear why preventing errors is a successful strategy. In order to examine the effect of the commission of errors on learning, previous investigators have developed a stem completion list learning task. This task allows the study of the most salient feature of errorless learning, the critical role of the commission of errors on learning. The word stem completion list learning task was administered to 15 patients with schizophrenia and 11 non-affected controls under two conditions: 'error-
12. Psychology, Cognitive ful' and 'errorfree'. During the errorful condition, the subject was presented with a series of 15 stern completion cards (e.g. DA_ _ _) and was asked to guess the correct five letter word. After making several incorrect guesses, the subject was told the correct word. Afterwards, the subject was presented again with the first two letters of the word and asked to remember the correct word over three learning trials. This process was repeated during the errorfree learning trial, except that the subject was directly told the target word without guessing. The order of administration and the word lists used for the errorful and errorfree conditions were both counterbalanced across subjects. Results show that patients and controls performed similarly on the errorfree condition. However, controls performed better than patients on the errorful condition (p<.05). Patients and controls were not significantly different on the first learning trial of the errorful condition, but difference scores between the first and third administration show that the performance of controls improved significantly more than the performance of patients with schizophrenia (p=.05). This indicates that the commission of errors during learning disrupts the learning process for patients, but not for controls. Insight into the specific deficits present in the learning process of individuals with schizophrenia may lead to better rehabilitative techniques to be used with this population. This study was sponsored by a Young Investigator Grant from the NationalAlliance for Research on Schizophrenia and Depression, and the Browning Foundation.
SOURCE MEMORY BIASES ASSOCIATED WITH REALITY DISTORTION IN SCHIZOPHRENIA T. W o o d w a r d , * J. C. W h i t m a n , C. C. Cuttler, S. Moritz
Department of Psychology, University of British Columbia, Vancouver, BC, Canada Fundamental to an understanding of the cognitive underpinnings of reality distortion (delusions and hallucinations) is how the brain distinguishes between external/observed and internal/imagined events; that is to say, the study of source monitoring. Source monitoring studies of schizophrenia have consistently demonstrated correlations of "target symptoms" (e.g., hallucinations and thought insertion) with deficits in recalling internally generated items, and/or a bias towards attributing internally generated information to an external source. In pilot work with a word association task, we partially replicated this externalization bias, but also observed a clearer internalization bias when patients were grouped according to presence/absence of paranoid delusions. In the present work, we report results from two follow-up source monitoring studies collected on two samples (N = 33 for each) of patients with schizophrenia, In both studies, patients were required to solve anagram puzzles: internally generated items were produced by requiring patients to verbalize solutions to computer-presented anagrams with clues (e.g., "A scaly reptile SANEK"). For externally generated items, the computer played a digitized sound file, or the experimenter read the solution aloud, simultaneously with the presentation of the puzzle. Subsequently, a list of previously encountered and new words were presented, and the patients were asked to indicate whether or not the word was a previously encountered solution, and if it was, whether or not it was generated by themselves or by an external source. Both effects observed in previous work were replicated in both studies: on the recognition test, (1) patients reporting hallucinations attributed internally generated items to the external source more frequently than did other patients, and (2) patients reporting paranoid delusions/delusions of
International Congress on Schizophrenia Research 2003
187
12. Psychology, Cognitive
reference attributed externally generated items to themselves more frequently than did other patients. This lends further support to the notion that the impaired neural system underling reality distortion codes and/or retrieves source information inaccurately. Our novel
finding of an association between an internalization bias and paranoid delusions implicates source monitoring as one of the dysfunctional cognitive operations involved in the integration of external, otherwise neutral perceptions into internal, reality distorted schemata.
International Congress on Schizophrenia Research 2003
NEUROPSYCHOLOGICAL FUNCTIONING AND QUALITY OF LIFE IN PEOPLE WITH SCHIZOPHRENIA ENROLLED IN THE SCHIZOPHRENIA CARE AND ASSESSMENT PROGRAM C. Williams,* J. Ponsford, R B. Fitzgerald, A. deCastella, K. Filia, J. Collins, B. M o n t g o m e r y , J. Kulkarni
Psychological Medicine, AlJ?ed Psychiatry Research Centre, Prahran, V1C, Australia In an exploratory fashion, the current study examines the relationship between neuropsychological functioning, and objective and subjective measures of quality of life in people with schizophrenia. Furthermore, this study examines the relationship between psychopathology and neuropsychological functioning in people with schizophrenia. This study is part of a bigger project namely the Schizophrenia Care and Assessment Program (SCAP). The SCAP project aims to improve the quality of mental health care for people with schizophrenia by observing patients with the disorder worldwide over a three year period. The examination of neuropsychological functioning is unique to the Australian site of the SCAP project. 95 participants from the Australian site of the SCAP study, with a diagnosis of schizophrenia are included in the current study. All participants are administered a comprehensive neuropsychological test battery, to assess memory, attention, and executive function, as well as clinical test instruments. There was a significant relationship between subjective and objective measures of quality of life and neuropsychological functioning in people with schizophrenia. Furthermore, positive and negative symptomatology significantly correlated with neuropsychological functioning. The presence of psychopathology and cognitive deficits can be devastating and debilitating. This research demonstrates the importance of interventions aimed at alleviating or reducing the impact of these symptoms, in order to increase a person's quality of life. Funding for this study has been provided by Eli Lilly.
ERRORLESS LEARNING IN PATIENTS WITH SCHIZOPHRENIA AND NON-AFFECTED CONTROLS A. E. Wood,* R. S. Kern, A. Tapp VA Puget Sound Health Care System, Tacoma, WA, USA Cognitive deficits are a core feature of schizophrenia, which has led to interest in cognitive rehabilitation strategies such as 'errorless learning'. Although errorless learning techniques have been used successfully with cognitively disabled populations, it is not clear why preventing errors is a successful strategy. In order to examine the effect of the commission of errors on learning, previous investigators have developed a stem completion list learning task. This task allows the study of the most salient feature of errorless learning, the critical role of the commission of errors on learning. The word stem completion list learning task was administered to 15 patients with schizophrenia and 11 non-affected controls under two conditions: 'error-
12. Psychology, Cognitive ful' and 'errorfree'. During the errorful condition, the subject was presented with a series of 15 stern completion cards (e.g. DA_ _ _) and was asked to guess the correct five letter word. After making several incorrect guesses, the subject was told the correct word. Afterwards, the subject was presented again with the first two letters of the word and asked to remember the correct word over three learning trials. This process was repeated during the errorfree learning trial, except that the subject was directly told the target word without guessing. The order of administration and the word lists used for the errorful and errorfree conditions were both counterbalanced across subjects. Results show that patients and controls performed similarly on the errorfree condition. However, controls performed better than patients on the errorful condition (p<.05). Patients and controls were not significantly different on the first learning trial of the errorful condition, but difference scores between the first and third administration show that the performance of controls improved significantly more than the performance of patients with schizophrenia (p=.05). This indicates that the commission of errors during learning disrupts the learning process for patients, but not for controls. Insight into the specific deficits present in the learning process of individuals with schizophrenia may lead to better rehabilitative techniques to be used with this population. This study was sponsored by a Young Investigator Grant from the NationalAlliance for Research on Schizophrenia and Depression, and the Browning Foundation.
SOURCE MEMORY BIASES ASSOCIATED WITH REALITY DISTORTION IN SCHIZOPHRENIA T. W o o d w a r d , * J. C. W h i t m a n , C. C. Cuttler, S. Moritz
Department of Psychology, University of British Columbia, Vancouver, BC, Canada Fundamental to an understanding of the cognitive underpinnings of reality distortion (delusions and hallucinations) is how the brain distinguishes between external/observed and internal/imagined events; that is to say, the study of source monitoring. Source monitoring studies of schizophrenia have consistently demonstrated correlations of "target symptoms" (e.g., hallucinations and thought insertion) with deficits in recalling internally generated items, and/or a bias towards attributing internally generated information to an external source. In pilot work with a word association task, we partially replicated this externalization bias, but also observed a clearer internalization bias when patients were grouped according to presence/absence of paranoid delusions. In the present work, we report results from two follow-up source monitoring studies collected on two samples (N = 33 for each) of patients with schizophrenia, In both studies, patients were required to solve anagram puzzles: internally generated items were produced by requiring patients to verbalize solutions to computer-presented anagrams with clues (e.g., "A scaly reptile SANEK"). For externally generated items, the computer played a digitized sound file, or the experimenter read the solution aloud, simultaneously with the presentation of the puzzle. Subsequently, a list of previously encountered and new words were presented, and the patients were asked to indicate whether or not the word was a previously encountered solution, and if it was, whether or not it was generated by themselves or by an external source. Both effects observed in previous work were replicated in both studies: on the recognition test, (1) patients reporting hallucinations attributed internally generated items to the external source more frequently than did other patients, and (2) patients reporting paranoid delusions/delusions of
International Congress on Schizophrenia Research 2003
187
12. Psychology, Cognitive
reference attributed externally generated items to themselves more frequently than did other patients. This lends further support to the notion that the impaired neural system underling reality distortion codes and/or retrieves source information inaccurately. Our novel
finding of an association between an internalization bias and paranoid delusions implicates source monitoring as one of the dysfunctional cognitive operations involved in the integration of external, otherwise neutral perceptions into internal, reality distorted schemata.
International Congress on Schizophrenia Research 2003