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Source monitoring and communication disturbance in schizophrenia
11. Psychology, Neuro-
151
verbal material, which in turn may be related to the well-known disease-related disturbance of word associations.
MEMORY PERFORMANCE AT ONSET MAY BE PREDICTIVE OF THE COURSE OF SCHIZOPHRENIA D. Nieman,* D. H. Linszen Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands The course of schizophrenia is heterogeneous, varying from one psychotic episode with remission to chronic psychosis with negative symptoms. It is still difficult to predict the course of the illness at onset. The relationship between neuropsychological test performance at first admission to the hospital and course of schizophrenia was investigated. 49 patients (mean age 22 years) with recent-onset schizophrenia were assessed with several neuropsychological tests: California Verbal Learning Test, Verbal Fluency, Finger Tapping, Stroop Test and Complex Figure of Rey. Course of the illness was investigated at 3 year follow up with a questionnaire that was filled in together with the treating psychiatrist. 7 categories were constructed indicating one psychotic episode with remission (1) to chronic psychosis with negative symptoms (6) and suicide (7). Psychosocial functioning, compared to healthy adolescents of the same age, was also evaluted at 3 year follow up, Better performance on the California Verbal Learning Test was related to better course (r = -0.43, p < 0.002) and better psychosocial functioning (r = -0.33, p < 0.02). Performance on a neuropsychological test that assesses memory functioning at the onset of schizophrenia may be predictive of the course of the illness and psychosocial functioning three years later.
A S S E S S M E N T OF NEUROCOGNITIVE DECLINE IN THE PREMORBID PERIOD OF SCHIZOPHRENIA T. N i e n d a m , * C. Bern'den, I. R o s s o , L. Sanchez, T. Hadley, K. Nuechterlein, T. D. C a n n o n
SOURCE MONITORING AND COMMUNICATION DISTURBANCE IN SCHIZOPHRENIA T. M. Nienow,* A. Armelie, A. S. Cohen, N. M. Docherty Psychology, Kent State University, Kent, OH, USA Communication disturbances have been noted in the speech of patients with schizophrenia. One method of assessing the amount of disorder in speech is by examining failures in the transmission of meaning. The Communication Disturbance Index (CDI)(Docherty, DeRosa, & Andreasen, 1996) quantifies communication disturbance by measuring the frequency of unclarity in speech due to referential failures. Previous research from our laboratory (Docherty et al., 1999; 2000) suggests that the referential failures have specific cognitive correlates. The aim of this study was to extend this work by examining whether source monitoring is a cognitive correlate of some types of referential failure in the speech of patients with schizophrenia. Rochester (1978) and Harvey, Earle-Boyer, & Levinson (1988) have suggested that schizophrenic communication failures sometimes result from an inability of the speaker to remember what he or she previously has stated versus what he or she has only thought, This hypothesis was tested in a sample of 55 stable outpatients with schizophrenia. The six types of referential failure measured by the CDI were related to indices of internal source monitoring, a test of an individual's memory for the source of previously presented information (said, thought, or new). One type of source monitoring error, reporting information that was previously only thought as informtion that was said, was found to relate to a specific type of referential failure, the missing information reference. This type of referential failure occurs when the speaker makes reference to information that has not been previously presented and that the listener does not know. Source monitoring was specifically related to this type of referential failure, and the relationship could not be explained by performance on immediate or working memory tests. The results of this study offer some support for the hypothesis put forth by Rochester and Harvey et al. This study adds to our knowledge of the cognitive correlates of referential failure in schizophrenia.
Psychology, University of California, Los Angeles, Los Angeles, CA, USA Using data from the National Collaborative Perinatal Project, this study evaluated the profile of cognitive deficits in the premorbid period of schizophrenia, before the expression of overt symptoms, on seven subtests of the Wechsler Intelligence Scale for Children (WISC). Probands' diagnoses were confirmed by chart review according to DSM-IV criteria. Because a number of these probands had siblings who were also cohort members but who did not develop schizophrenia, we were also able to evaluate the childhood WISC profile of a genetically-at-risk subgroup. Normal controls had no history of mental illness, no relationship to the probands, and were matched with the proband and sibling groups on all relevant demographic variables. An analysis of the WISC data in these individuals at age 7 showed that both probands and unaffected siblings exhibited deficits on the Picture Arrangement, Vocabulary and Coding subtests when compared with normal controls. Probands and siblings only differed from each other on the Coding subtest. These findings reveal that, during childhood, both preschizophrenic individuals and their siblings show a similar pattern of cognitive deficits in domains related to spatial reasoning, crystallized verbal knowledge and complex visual processing in childhood.
VERBAL PAIRED ASSOCIATE L E A R N I N G IN SCHIZOPHRENIA, SCHIZOPHRENIFORM PSYCHOSIS A N D 'AT RISK' MENTAL STATE C. Pantelis,* S. J. Wood, A. Tarnawski, T. Proffitt, S. Francey, W. Brewer, L. Phillips, G. Savage, D. Smith, V. A n d e r s o n , E D. M c G o r r y
Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne, Melbourne, VIC, Australia The hippocampus has been shown to be abnormal in schizophrenia by ueuropathological and neuroimaging studies. Nemopsychological studies also implicate the hippocampus, since memory function is often impaired in the disorder. However, we have recently demonstrated that visual associative learning is not impaired in patients with schizophreniform psychosis. In this study we extended this finding to verbal associative learning, and also to young people at ultra highrisk of developing a psychotic disorder. We assessed 44 patients with established schizophrenia (SZ), 47 patients with schizophreniform psychosis (SF), 69 subjects at ultra-high risk for psychosis (UHR)
International Congress on Schizophrenia Research 2003
151
verbal material, which in turn may be related to the well-known disease-related disturbance of word associations.
MEMORY PERFORMANCE AT ONSET MAY BE PREDICTIVE OF THE COURSE OF SCHIZOPHRENIA D. Nieman,* D. H. Linszen Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands The course of schizophrenia is heterogeneous, varying from one psychotic episode with remission to chronic psychosis with negative symptoms. It is still difficult to predict the course of the illness at onset. The relationship between neuropsychological test performance at first admission to the hospital and course of schizophrenia was investigated. 49 patients (mean age 22 years) with recent-onset schizophrenia were assessed with several neuropsychological tests: California Verbal Learning Test, Verbal Fluency, Finger Tapping, Stroop Test and Complex Figure of Rey. Course of the illness was investigated at 3 year follow up with a questionnaire that was filled in together with the treating psychiatrist. 7 categories were constructed indicating one psychotic episode with remission (1) to chronic psychosis with negative symptoms (6) and suicide (7). Psychosocial functioning, compared to healthy adolescents of the same age, was also evaluted at 3 year follow up, Better performance on the California Verbal Learning Test was related to better course (r = -0.43, p < 0.002) and better psychosocial functioning (r = -0.33, p < 0.02). Performance on a neuropsychological test that assesses memory functioning at the onset of schizophrenia may be predictive of the course of the illness and psychosocial functioning three years later.
A S S E S S M E N T OF NEUROCOGNITIVE DECLINE IN THE PREMORBID PERIOD OF SCHIZOPHRENIA T. N i e n d a m , * C. Bern'den, I. R o s s o , L. Sanchez, T. Hadley, K. Nuechterlein, T. D. C a n n o n
SOURCE MONITORING AND COMMUNICATION DISTURBANCE IN SCHIZOPHRENIA T. M. Nienow,* A. Armelie, A. S. Cohen, N. M. Docherty Psychology, Kent State University, Kent, OH, USA Communication disturbances have been noted in the speech of patients with schizophrenia. One method of assessing the amount of disorder in speech is by examining failures in the transmission of meaning. The Communication Disturbance Index (CDI)(Docherty, DeRosa, & Andreasen, 1996) quantifies communication disturbance by measuring the frequency of unclarity in speech due to referential failures. Previous research from our laboratory (Docherty et al., 1999; 2000) suggests that the referential failures have specific cognitive correlates. The aim of this study was to extend this work by examining whether source monitoring is a cognitive correlate of some types of referential failure in the speech of patients with schizophrenia. Rochester (1978) and Harvey, Earle-Boyer, & Levinson (1988) have suggested that schizophrenic communication failures sometimes result from an inability of the speaker to remember what he or she previously has stated versus what he or she has only thought, This hypothesis was tested in a sample of 55 stable outpatients with schizophrenia. The six types of referential failure measured by the CDI were related to indices of internal source monitoring, a test of an individual's memory for the source of previously presented information (said, thought, or new). One type of source monitoring error, reporting information that was previously only thought as informtion that was said, was found to relate to a specific type of referential failure, the missing information reference. This type of referential failure occurs when the speaker makes reference to information that has not been previously presented and that the listener does not know. Source monitoring was specifically related to this type of referential failure, and the relationship could not be explained by performance on immediate or working memory tests. The results of this study offer some support for the hypothesis put forth by Rochester and Harvey et al. This study adds to our knowledge of the cognitive correlates of referential failure in schizophrenia.
Psychology, University of California, Los Angeles, Los Angeles, CA, USA Using data from the National Collaborative Perinatal Project, this study evaluated the profile of cognitive deficits in the premorbid period of schizophrenia, before the expression of overt symptoms, on seven subtests of the Wechsler Intelligence Scale for Children (WISC). Probands' diagnoses were confirmed by chart review according to DSM-IV criteria. Because a number of these probands had siblings who were also cohort members but who did not develop schizophrenia, we were also able to evaluate the childhood WISC profile of a genetically-at-risk subgroup. Normal controls had no history of mental illness, no relationship to the probands, and were matched with the proband and sibling groups on all relevant demographic variables. An analysis of the WISC data in these individuals at age 7 showed that both probands and unaffected siblings exhibited deficits on the Picture Arrangement, Vocabulary and Coding subtests when compared with normal controls. Probands and siblings only differed from each other on the Coding subtest. These findings reveal that, during childhood, both preschizophrenic individuals and their siblings show a similar pattern of cognitive deficits in domains related to spatial reasoning, crystallized verbal knowledge and complex visual processing in childhood.
VERBAL PAIRED ASSOCIATE L E A R N I N G IN SCHIZOPHRENIA, SCHIZOPHRENIFORM PSYCHOSIS A N D 'AT RISK' MENTAL STATE C. Pantelis,* S. J. Wood, A. Tarnawski, T. Proffitt, S. Francey, W. Brewer, L. Phillips, G. Savage, D. Smith, V. A n d e r s o n , E D. M c G o r r y
Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne, Melbourne, VIC, Australia The hippocampus has been shown to be abnormal in schizophrenia by ueuropathological and neuroimaging studies. Nemopsychological studies also implicate the hippocampus, since memory function is often impaired in the disorder. However, we have recently demonstrated that visual associative learning is not impaired in patients with schizophreniform psychosis. In this study we extended this finding to verbal associative learning, and also to young people at ultra highrisk of developing a psychotic disorder. We assessed 44 patients with established schizophrenia (SZ), 47 patients with schizophreniform psychosis (SF), 69 subjects at ultra-high risk for psychosis (UHR)
International Congress on Schizophrenia Research 2003