Self-focused attention in schizophrenic patients with and without auditory hallucinations and normal subjects: A comparative study

Self-focused attention has been implicated in a number of psychiatric disorders, but little research has examined this in schizophrenic subjects. In this study, a sample of schizophrenic patients experiencing auditory hallucinations, schizophrenic patients not experiencing auditory hallucinations and normal controls were asked to complete the private self-consciousness subscale of the Self Consciousness Scale. It was found that patients experiencing auditory hallucinations exhibited significantly higher levels of self-focus than those not experiencing hallucinations, although they did not differ from normal subjects. It was also shown that level of self-focus predicted whether or not subjects experienced hallucinations. These results, and their implications, are discussed with reference to the literature.     

Parent and Child Effects on Cognitive Performance: An Experimental Approach to the Etiological and Responsive Theories of Schizophrenia

While many theorists have assumed that the family has an etiological part in the development of schizophrenia, most findings, since they come predominantly from observations after the illness has occurred, could plausibly be interpreted as family responses to the illness. In this experimental study, we constructed artificial families in order to measure independently of each other the effects of parents of schizophrenics on children and the effects of schizophrenic children on parents. Findings from a cognitive task requiring abilities to attend and abstract show that the presence of a schizophrenic child has only minor disruptive effects upon the performance of normal parents; parents of schizophrenics also have little effect upon normal children. Instead, the most consistent effects are those of normal parents on the schizophrenic child. Adolescent schizophrenic patients whose cognitive performance deficit is apparent prior to the experiment show significant improvement after having worked on the cognitive task with normal parents; their cognitive deficit disappears, and their performance is not different from matched normal children. Further investigation will center on the quality of the normal parents' “normalizing” effects.     

Rorschach Developmental Level in the offspring of patients with schizophrenia and manic-depressive illness

The Developmental Level (DL) score was assessed from Rorschach inkblot tests of 305 children. Children were either the offspring of one schizophrenic, one manic-depressive, one physically ill, or of two normal parents. Socioeconomic status, age, and intelligence were treated as covariates. Children of one schizophrenic parent had lower DL scores than children in the other three groups.     

The discourse of thought-disordered schizophrenic children

The conversations of two thought-disordered schizophrenic children and two age- and sex-matched normal children were studied in three different contexts. Cohesive relations and retrieval categories were analyzed. The thought-disordered schizophrenic and normal children demonstrated divergent patterns of discourse. These patterns closely paralleled those previously reported for adults by S. Rochester and J. R. Martin (1979, Crazy talk: A study of the discourse of schizophrenic speakers, New York: Plenum) for schizophrenic and normal adults, although some discrepancies were also observed. Recommendations for future research are offered.     

Is there atypical handedness in schizophrenia?

Ninety-three schizophrenic patients and 105 normal controls were tested in a single session on an 8-item repeat-administration handedness test. The schizophrenic group, in contrast to the normal controls, showed a shift in the distribution away from right-handedness, which was due to an increase in the proportion of mixed-handers. Additional analyses revealed that the increase in mixed-handedness was largely due to an increase of within-item variability in the schizophrenic group, which we refer to as ambiguous handedness. Nearly 20% of the schizophrenic patients were inconsistent on 3 or more items compared with 3.8% of the normal controls. This increased incidence of atypical handedness is discussed within the context of disorders of attention and neurodevelopment.     

Functioning of the phonological loop in auditory hallucinations

Two experiments designed to assess the functioning of the phonological store and loop were carried out with schizophrenic patients experiencing auditory hallucinations, schizophrenic patients not experiencing hallucinations and normal subjects. In the first experiment, phonological encoding was assessed. Although both groups of psychiatric patients performed more poorly overall than the normal subjects, there were no significant differences between the performances of the hallucinating and nonhallucinating patients. In the second experiment, the unattended speech effect (a phenomenon thought to reflect the functioning of the phonological store in normal subjects) was assessed in hallucinating schizophrenic patients, non-hallucinating schizophrenic patients and normal controls. The psychiatric patients performed more poorly overall than the normal subjects, but there was no evidence of abnormal functioning of the phonological store or loop in either patient group. Overall, the findings indicate that phonological store and loop abnormalities are not implicated in the experience of auditory hallucinations.     

Smooth-pursuit eye tracking in first-episode psychotic patients and their relatives.

We wished to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia and the prevalences of dysfunction among functionally psychotic and normal individuals. Therefore, we investigated pursuit tracking in a large sample of psychotic patients, normal subjects, and first-degree relatives (N = 482). Patients were recruited as part of an epidemiological study of first-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2 1/2-year period. Patients received diagnoses of schizophrenia, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The distribution of tracking performance was bimodal for the schizophrenic patients and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to schizophrenic patients and their relatives and occurred infrequently in other psychotic patients and normal subjects.     

What is perseverated in schizophrenia? Evidence of abnormal response plasticity in the saccadic system

Although perseveration is sometimes attributed to defective set switching, the authors have recently shown that set-switching is normal in schizophrenia. In this article, the authors tested for persistent states of the saccadic response system, rather than set perseveration. Schizophrenic and healthy subjects performed antisaccades and prosaccades. The authors analyzed for 3 carry-over effects. First, whereas the latency of the current saccade correlated with that of the prior saccade in both groups, the correlations under mixed-task conditions declined in healthy but not in schizophrenic subjects. Second, antisaccades in penultimate trials delayed upcoming saccades in schizophrenic but not in healthy subjects. Third, schizophrenic subjects were more likely to erroneously perseverate the direction of a prior antisaccade but not a prior prosaccade. The authors concluded that, in schizophrenia, the effects of correct antisaccades are persistent not weak. Saccades in schizophrenia are characterized by perseveration of antisaccade-induced changes in the saccadic response system rather than failures to switch task set.     

The role of metacognitive beliefs in auditory hallucinations

The mechanisms contributing to the occurrence of auditory hallucinations have not been fully described, although many researchers agree that they may result from some type of misattributed cognitive event. A number of authors have shown that this misattribution may be influenced by ‘top down' processes such as beliefs and expectations. This type of cognitive bias has also been implicated in other psychological disorders. One area of focus, particularly within the anxiety disorders, has been on metacognitive beliefs and their role in the occurrence and maintenance of symptoms. Metacognitive beliefs have not been widely investigated in psychosis and tools to investigate them have not been developed. In this study, a metacognitions questionnaire [MCQ; Cartwright-Hatton, S., & Wells, A. (1997). Journal of Anxiety Disorders, 11(3),279–296.] (previously used with anxiety disorders) was modified and used to assess metacognitive beliefs with schizophrenic patients. Metacognitive beliefs were compared between schizophrenic patients who were currently experiencing auditory hallucinations and schizophrenic patients who had never had hallucinations. A group of patients with anxiety disorders and a group of non-patients were used as controls. Hallucinating and non-hallucinating schizophrenics scored significantly higher than both the non-patient group and the anxiety patient group on the amount to which they believed their thoughts should be consistent with each other. Hallucinators and anxiety controls had significantly lower confidence in their cognitive processes than non-hallucinating schizophrenics and normal controls. The significance of these findings are discussed in relation to the literature on cognitive processes in hallucinations.     

Effect of normal aging on the manipulation of information in working memory

The goal of this study is to examine the central executive of working memory in normal aging, specifically focusing on its capacities to manipulate or modify the format of the to-be-recalled material. The central executive was measured with the alphabetical span procedure, during which subjects were asked to recall a random series of words in their alphabetical order. The storage demand was equalized across subjects by adjusting the list lengths according to individual span. Experiments 1, 2, and 3 showed that elderly subjects were not impaired in manipulating information, relative to young controls, even when the difficulty of the task was increased. In Experiment 4, validity was tested by asking young subjects to perform the task under the conditions of full or divided attention. Alphabetical recall was more impaired than direct recall during the divided attention condition, which suggests a larger involvement of the central executive component in the former. These results are discussed in relation to the hypothesis of a central executive impairment being associated with normal aging.     

Effects of relaxation response training on attentional deficits in schizophrenics

Four groups of six male patients each (12 = schizophrenic; 12 = antisocial personality) volunteered. One group from each diagnostic category were instructed in the Relaxation Response while the other two groups were instructed with a placebo exercise. After training, subjects were exposed to an attentional task involving manual responding to visual stimuli. Analyses of several dependent measures including mean correct responses yielded no significant group differences.     

Monaural and binaural story recall by schizophrenic subjects.

P. Green and other investigators have reported that schizophrenic Ss have poorer recall of stories presented to both ears than to the single best ear (binaural deficit) and poorer recall of stories presented to the left ear than to the right ear (monaural asymmetry) than do normal control Ss. These studies are plagued by potential methodological problems, including differences in overall accuracy, which artifactually affect the difference scores, and scoring methods that are vulnerable to systematic bias. In this study, scores of schizophrenic, bipolar, and normal control Ss on the Auditory Comprehension Test were compared. Scoring bias was avoided by the use of blind scoring and a revised scoring manual, and artifactual effects of accuracy were considered in interpreting the results. Contrary to previous findings, the groups did not differ on either monaural asymmetry or binaural deficit.     

Characteristics of Schizogenic Families During a Joint Story-Telling Task

For a joint family story-telling task, families with a schizophrenic offspring were compared to normal families on the completeness and clarity of the final composite stories and on their interactional behavior. The composite stories from schizogenic families were more “vague and confused”, fragmented, and less complete as to the five components required to satisfy the task instructions. Schizogenic families displayed more conflict, failure, and confusion during the interactional task than control families, and, fathers and mothers of schizophrenic offspring displayed more “anxiety and tension”, “depressive mood”, “evasiveness” and “lack of interest” than fathers and mothers of normal families. Mothers of schizophrenic offspring were also described as more “hostile” than control mothers. Comparing schizogenic families from which the patient was absent during the task with schizogenic families with the patient present, and with control families, indicated that the central findings were not attributable to the immediate presence and participation of the schizophrenic member.     

Story Sequence Analysis of Family TATs

One hundred twenty-six three-member families were asked to produce conjointly three TAT stories based on nine cards, which were scored by the Arnold system of Story Sequence Analysis. There were 50 families with normal children, 44 with emotionally maladjusted, 16 with schizophrenic, and 16 with delinquent children. Analysis of the results revealed that the Arnold score successfully differentiated normal from abnormal families, but that the three abnormal groups did not differ from each other. The last set of TAT cards given was the most effective.     

A comparison of cognitive/neuropsychological impairments of nonretarded autistic and schizophrenic children

The performance of children meeting DSM-III criteria for schizophrenic disorder and infantile autism and of normal children (ages 7 years 10 months to 14 years 4 months) was compared on the Wisconsin Card Sorting Test, Rey's Tangled Line Test, Benton Judgment of Line Orientation, Digit Symbol Substitution Test, and Peabody Picture Vocabulary Test. The mean performance IQ of the schizophrenic and autistic children was equal and in the normal range. The normal children were of average intelligence as estimated by the PPVT. As compared to normal children, both autistic and schizophrenic children were impaired on the DSST and RTLT. The autistic children had significantly lower scores on the PPVT than schizophrenic and normal children. The schizophrenic children made significantly more perseverative responses on the WCST than did normal children. They significantly increased their nonperseverative errors on the second half of the WCST, after having been taught the correct sorting principles. It is argued that in schizophrenia a core deficit in momentary processing capacity underlies the above performance pattern. In contrast, in autism the core cognitive deficit involves an inability to use language to regulate and control ongoing behavior.Preparation of this article was supported in part by a John D. and Catherine T. MacArthur Foundation Grant to Robert Asarnow, and NIMH Grant MH 30897 to the UCLA Clinical Research Center for the Study of Childhood Psychoses. We gratefully acknowledge the assistance of Michael J. Goldstein, Ph.D., who acted as reseach advisor to the first author over the course of this study; Delores Adams, who assisted us in data analysis; and Sara Lerner, who enthusiastically helped us in data collection. We also acknowledge the assistance of the staff of the Clinical Research Center for the Study of Childhood Psychosis at UCLA, as well as the many children who participated in this study, and their parents.     

Cloze analysis in schizophrenic speech: scoring method and raters' education

This report examines two methodologic concerns pertaining to use of the cloze procedure in studying the predictability of schizophrenic speech, scoring criteria and raters' education (at or below college level). We find that two strategies for scoring the predictions of raters, one requiring the exact word, the other permitting a reasonable synonym, do not appear to differ in distinguishing groups of patients. The accuracy of raters' guessing is, however, correlated with raters' education: the more educated the rater, the more accurate the guessing. Thought-disordered schizophrenic speech is significantly less predictable than that of nonthought-disordered schizophrenics and normal controls when scored by less educated raters. These differences diminish when more highly educated raters are used. We conclude that raters' education can influence the sensitivity of cloze analysis.     

Religiosity, schizotypal thinking, and schizophrenia

The relationship between religiosity and the incidence of schizotypal thinking was investigated in a normal sample and in acute and chronic schizophrenic samples. The Rust Inventory of Schizotypal Cognitions was administered to measure schizotypal thinking, and two religiosity measures were developed. Religiosity had a significantly negative relationship with schizotypal thinking in normal subjects, while in schizophrenic patients the relationship was positive and significantly different. It is suggested that the process of existential growth of awareness in the normal development of religious belief, which is thought to be associated with schizotypal thinking, may have proceeded differently in persons suffering from schizophrenia.     

Decisional processing in paranoid and non-paranoid schizophrenics

40 schizophrenic subjects, divided into paranoid/non-paranoid categories and 14 normal controls were presented a task which involved making "same-different" judgments during random presentations of a series of visual comparison stimuli with a standard which represented the midpoint of the stimulus continuum. Using Sternberg's Choice RT paradigm for studying the locus of cognitive deficit, difficulty at the response-selection stage was manipulated while holding other stages constant. It was predicted that paranoids would have shorter RTs at easy decision points and longer RTs at difficult decision points relative to non-paranoids. The directions of the differences were as predicted but did not attain statistical significance. Both schizophrenic groups, compared to normals, made significantly fewer "same" responses on those trials where the comparison and standard were most similar.     

Span of apprehension in schizophrenic patients as a function of distractor masking and laterality.

Twenty schizophrenic patients, 10 depressed control patients, and 20 normal control subjects were compared in a forced-choice, target-detection method for assessing the span of apprehension. The detection task required the subject to report which of 2 target letters was presented among 7 other (distractor) letters. Performance accuracy was examined as a function of target location and whether the distractor letters were masked after their presentation. The backward masking of the distractors improved target-detection accuracy of both control groups but reduced accuracy of the schizophrenic group. In addition, schizophrenics performed particularly poorly on targets located in the left half or lower half of the display. These results suggest that response to the masking of distractors may be a new index of attentional shortcoming in schizophrenia. Various theoretical explanations for the target location findings are also discussed.