Does symptomatic schizophrenia exist?

The question if there are "symptomatic schizophrenias" has been discussed since the 20s. Schizophrenic psychoses caused be definable and well known brain diseases are presented. All schizophrenic symptoms and syndromes, the first rank symptoms (K. Schneider) too, occur in somatically founded psychoses. The group of paroxysmal transition syndromes in the sense of aura prolongata (continua) and the episodic schizophrenic psychoses in psychomotor epilepsy may be a model for the schizophrenia research. Vital threatening, so-called pernicious catatonic schizophrenias are found on the basis of infectious brain diseases, sometimes only diagnosed in autopsy. Beside acute and reversible symptomatic schizophrenic psychoses there are, even if rarely, recurrent and chronic courses of symptomatic schizophrenias. That certain conditions for the developing of symptomatic schizophrenias are rarely realised, could be an explanation for their rarity. Some findings indicate that the limbic system is significant for symptomatic (and idiopathic) schizophrenic psychoses and the pre- and postpsychotic basic stages determined by dynamic and cognitive basic symptoms, which are phenomenologically very similar to aura symptoms released by stereoelectroencephalographic depth recordings (Wieser). The characteristic features of marked fluctuation, discontinuity and insteadiness of the cognitive thought, perception, psychomotor and cenesthetic phenomena do not speak against an organic brain disorder provided that the traditional process hypothesis is abandoned in favor of a neurobiochemic disorder, fluctuating on its part depending on endogenous as well as psychic-reactive factors.     

Missing referents, psychotic symptoms, and discriminating the internal from the externalized

The communicative efficacy of the speech of schizophrenia patients is compromised by the presence of references for which there are no referents. There is evidence that this kind of error is positively associated with the genetic substrate of schizophrenia. The present study was an effort to identify a cognitive process source of these errors by looking at their association with performance on an internal source memory task assessing the ability to remember what one has said out loud versus only thought. Their relationship to psychotic symptoms also was examined. A sample of 110 schizophrenic/schizoaffective outpatients, and 23 nonpsychiatric controls provided 10-min speech samples and completed a battery of memory tests. Patients' symptoms also were rated for severity. Patients performed more poorly than controls on the memory tests, and their speech contained much more frequent references without referents. Frequency of missing referents was associated with scores on the test of internal source memory, even after scores on tests of immediate memory, working memory, and external source memory were regressed out. Missing referents were also related to severity of hallucinations and delusions, and internal source memory performance was related to hallucinations. The findings of this study support the idea that missing referents, hallucinations, and delusions have some common process underpinnings. Impairment in internal source memory appears to be one such process.     

Cognitive impairments and disordered speech in schizophrenia: thought disorder, disorganization, and communication failure perspectives

This article posits that basic cognitive impairments in schizophrenia are more highly related to speech disorder measured as communication failures than speech disorder measured as thought disorder or disorganization. The author tested 47 schizophrenia patients and 36 control participants for sustained attention, sequencing, and conceptual sequencing ability. Their speech was also rated for communication failures, thought disorder, and conceptual disorganization. Attention and sequencing impairments, examined hierarchically, explained a substantial 38% of the variance in the communication measure of speech disorder but little of the variance in formal thought disorder or conceptual disorganization. The author concludes that (a) impairments in attention and sequencing abilities contribute substantially to schizophrenic communication failures, and (b) it is important to consider lower level cognitive "3rd variables" when examining higher level cognitive associates of speech disorder.     

Suicidal tendencies in schizophrenic patients hospitalized for the first time

180 (15%) patients from 1208 first-hospitalized schizophrenic patients had suicidal tendencies. Our findings show that the suicidal tendencies of schizophrenic patients have their own features. These conclusions can be supported by the differences between the determinants of the suicidal tendencies of schizophrenic and non-schizophrenic population; such different determinants are: sex, age, family and suicidal method. Suicidal tendencies are more frequent among patients without formal thought disturbances. We explain this fact with an "incoherence of decision processes". The features of the suicidal tendencies of schizophrenic patients are based on the grounds of psychosis own dynamic.     

Impact of Card Rotation on the Frequency of Rorschach Reflection Responses

This study examines evidence for boundary disturbances in depressive, borderline, and schizophrenic hospitalized inpatients. Certain thought disorder signs on the Rorschach are reconceptualized as indices of boundary formation, which is defined as the capacity to create particular distinctions along women bipolar coordinate of experience where previously no distinction was possible, and which defines each cluster of experience through a maintenance of differential functioning. The borderline group scored significantly high on the indices of laxness and moderately severe inner-outer boundary formation. The schizophrenic group scored significantly higher on indices of self-other and somewhat higher on severe inner-outer boundary disturbance. Schizophrenics may be organized at a level of self-other boundary formation which subsumes inner-outer boundary formation, while the borderline group is organized at a level of inner-outer boundary formation.     

Boundary disturbance in borderline and psychotic states

This study examines evidence for boundary disturbances in depressive, borderline, and schizophrenic hospitalized inpatients. Certain thought disorder signs on the Rorschach are reconceptualized as indices of boundary formation, which is defined as the capacity to create particular distinctions along wome bipolar coordinate of experience where previously no distinction was possible, and which defines each cluster of experience through a maintenance of differential functioning. The borderline group scored significantly high on the indices of laxness and moderately severe inner-outer boundary formation. The schizophrenic group scored significantly higher on indices of self-other and somewhat higher on severe inner-outer boundary disturbance. Schizophrenics may be organized at a level of self-other boundary formation which subsumes inner-outer boundary formation, while the borderline group is organized at a level of inner-outer boundary formation.     

Amphetamine on Rorschach Measures in Normal Subjects

Twenty-two normal undergraduate men were administered either d-amphetamine (0.2 mg/kg or 0.4 mg/kg) or placebo in a double-blind, counterbalanced design. The test sessions were exactly three weeks apart and included, among other measures, the Rorschach test. Rorschach anxiety and thought disorder variables were measured under drug and placebo conditions. The results suggest that amphetamine causes an increase in Rorschach anxiety indices but does not elevate Rorschach indices of thought disorder. The observed dissociation of anxiety and thought disorder on the Rorschach has implications for the role of the Rorschach in studying anxiety disorders and schizophrenic disorders.     

An event-related brain potential substrate of disturbed response monitoring in paranoid schizophrenic patients.

Response monitoring in schizophrenic patients and healthy controls was assessed by measuring performance and event-related brain potentials in the flanker priming task. Three visual-context conditions were construed: Flankers and targets pointed either into the same direction or into different directions. Stimuli without any response assignment were used as flankers in the neutral context condition. The schizophrenic patients were further subdivided into paranoid (n = 19) and nonparanoid (n = 10) patients and compared with healthy controls (n = 18). Performance scores revealed that the flankers induced a similar degree of distraction by visual context in all 3 groups. Although the schizophrenic patients showed normal error correction performance, the error negativity (NE) was significantly reduced in paranoid schizophrenic patients. The attenuation of the NE possibly reflects disturbed response monitoring in these patients.     

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.     

Limits of the processing view in accounting for dissociations among memory measures in a clinical population

In three experiments, we examined the performance of patients with schizophrenia on implicit and explicit memory tests that have been shown to involve predominantly data-driven or predominantly conceptually driven processes. In Experiment 1, we compared the implicit tests of category production (conceptually driven)and word identification (data driven) and found that schizophrenic patients’ performance on these tests did not differ from that of normal subjects. In Experiment 2, a comparison of the category-production and explicit cued-recall tests, both of which involve conceptual processes, showed that schizophrenic patients were impaired on the cued-recall test but not on the category-production test. In Experiment 3, a comparison of the word-identification and explicit graphemic cued-recall tests, both of which involve data-driven processes, showed that patients were impaired on the cued-recall test but not on the word-identification test. The results of both Experiments 2 and 3 revealed a dissociation between implicit and explicit test performance under conditions in which the two tests involve similar- types of processes. These results support theoretical views that distinguish implicit from explicit modes of retrieval.     

Normal time course of auditory recognition in schizophrenia, despite impaired precision of the auditory sensory ("echoic") memory code

Prior studies have demonstrated impaired precision of processing within the auditory sensory memory (ASM) system in schizophrenia. This study used auditory backward masking to evaluate the degree to which such deficits resulted from impaired overall precision versus premature decay of information within the short-term auditory store. ASM performance was evaluated in 14 schizophrenic participants and 16 controls. Schizophrenic participants were severely impaired in their ability to match tones following delay. However, when no-mask performance was equated across participants, schizophrenic participants were no more susceptible to the effects of backward maskers than were controls. Thus, despite impaired precision of ASM performance, schizophrenic participants showed no deficits in the time course over which short-term representations could be used within the ASM system.     

Role of structure in disordered thinking in borderline and schizophrenic disorders

Qualitative studies have noted that individuals with "borderline" psychopathology exhibit extreme thought disorder on unstructured tests, yet manifest relatively normal performance on more structured tests of cognitive performance. The present study provides empirical support for this clinical observation. Borderline syndrome patients, defined by DSM-III criteria for borderline personality disorder and/or schizotypal personality disorder, demonstrated significantly greater thought disorder on the Rorschach, as measured by Johnston and Holzman's (1979) Thought Disorder Index (TDI), than did nonpsychiatric controls and were indistinguishable from patients with schizophrenic disorder of relatively recent onset. Borderline patients did not differ from controls on a structured test of cognitive slippage. Further examination of the role of structure in the assessment and treatment of borderline syndrome disorders seems warranted.     

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.     

Schizophrenia and postmodern philosophy

Abstract

This essay examines the postmodern idea that the schizophrenic process can be seen as a strategy of disruption, to be directed against the stability and productive forces of modern capitalism. The modern idea that schizophrenia itself is a correctable form of mental illness is also examined, and this assumption is related to issues about power and control encountered in cultural, social and psychological studies. These issues center around the different ways that modernist and postmodernist thinkers approach schizophrenic experience. Issues pertaining to social control and its connection to the nature of personal identity are examined, as are modernist and postmodernist responses to the double bind experience. Strategies of modernist control and postmodernist disruption are compared and contrasted.     

A taxometric analysis of cognitive and neuromotor variables in children at risk for schizophrenia

A taxometric model was applied to detect a subgroup or taxon of children conjectured to be at highest risk for developing schizophrenia or related disorders in a sample of offspring of schizophrenic, depressed, and normal parents. Measures of cognitive and neuromotor performance in childhood were used as indicator tests in the analyses. A taxon consisting chiefly of children of schizophrenic parents was detected. Forty-seven percent of those children were assigned to the taxon, compared with 16% of the children of depressed parents and 4% of the children of normal parents. Assignment to the taxon is assessed in relation to the current functional status of the subjects in young adulthood.     

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.     

The categorization of thought disorder

We describe the development of a new system for categorizing thought disorder. In the development phase (Study 1), we examined the degree to which speech samples and definitions of thought disorder subtypes taken from: (1) the Scale for the Assessment of Thought, Language, and Communication (TLC); (2) the Though Disorder Index (TDI); and (3) the Assessment of Bizarre-Idiosyncratic Thinking (BIT), reflected disturbances in form versus disturbances in content. Ratings were provided by naive judges, experienced clinicians, and linguistic experts. The results contributed to the development of a new system dividing thought disorder into disturbances in (1) fluency, (2) discourse coherence, (3) content, and (4) social convention. In the validation phase (Study 2), 21 schizophrenic and 19 manic subjects were interviewed, interpreted proverbs, and responded to Rorschach cards. Subjects' speech was rated using the TLC, TDI, and BIT. We also measured hallucinations, delusions, and digit span performance. The results of Study 2 provided evidence supporting the validity of our new categorization system.     

A comparison between the Grid Test of Schizophrenic Thought Disorder and diagnostic psychologicaI testing

Abstract.— Bannister and Fransella's Grid Test of Schizophrenic Thought Disorder based on Personal Construct Theory and the concept of "loosened construing", as measurable in the scores of Intensity and Consistency between intercorrelations, has been applied to a Scandinavian sample of psychiatric patients. The validity of the test was illustrated, and a significant difference was found between a group of schizophrenics and schizophrenic borderline states and a group without schizophrenic thought disorders. The Grid Test scores were found to agree with thought disorder manifestations as evaluated in qualitative terms on the basis of cognitive and projective tests, but they did not differentiate between developmental levels of thinking corresponding to con-creteness in organic impairment versus diffuseness in schizophrenia. Thus, the concept of "loosened construing" as applied in this thought disorder test seems too unspecific.     

Social attitudes of schizophrenics

The Wilson-Patterson Conservatism Scale was given to 34 schizophrenic and 34 non-schizophrenic patients in a Dutch mental hospital. The absence of liberal-scoring schizophrenics was interpreted as consistent with the theory that the social withdrawal seen in chronic schizophrenia represents a strategy for coping with stimulus overload. Internal consistency analysis of C scale performance indicated that this test might be used to assess thought disorder in much the same way as the Bannister and Fransella Grid Test, but a great deal more economically. Furthermore, the questionnaire permits a more detailed examination of the source of inconsistency than does the repertory grid method.     

Executive Function: The Search for an Integrated Account

ABSTRACT— In general, executive function can be thought of as the set of abilities required to effortfully guide behavior toward a goal, especially in nonroutine situations. Psychologists are interested in expanding the understanding of executive function because it is thought to be a key process in intelligent behavior, it is compromised in a variety of psychiatric and neurological disorders, it varies across the life span, and it affects performance in complicated environments, such as the cockpits of advanced aircraft. This article provides a brief introduction to the concept of executive function and discusses how it is assessed and the conditions under which it is compromised. A short overview of the diverse theoretical viewpoints regarding its psychological and biological underpinnings is also provided. The article concludes with a consideration of how a multilevel approach may provide a more integrated account of executive function than has been previously available.