Wisconsin Card Sorting Test deficits in schizotypic individuals

Inhibition and facilitation in schizotypy

Participants scoring high and low on a schizotypy scale (n=18 in each group) switched between naming words and naming colors in a Stroop task in congruent, neutral, and incongruent conditions. The findings were that, while being slower and less accurate overall than low schizotypes, the high schizotypy group did not display disproportionately greater Stroop inhibition or facilitation, suggesting intact selective attention. However, the high schizotypy group suffered disproportionately larger switching costs. The results provide evidence for similarities between schizotypy and schizophrenia, specifically that the problem in schizotypy is to do with switching rather than selecting attention, because of a difficulty either in selecting task-relevant information or in inhibiting inappropriate response alternatives.

Schizotypal traits and cognitive function in healthy adults

Growing evidence has shown that psychometrically identified schizotypes among student populations have subtle cognitive impairments in several domains such as attention, working memory and executive function, but the possible association between psychometric schizotypy in adult populations and cognitive function has not been well documented. Here we examined the association between schizotypal traits as assessed by the Schizotypal Personality Questionnaire (SPQ) and cognitive function including memory, attention, executive function, and general intelligence in 124 healthy adults. Cognitive functioning was assessed with the Wechsler Memory Scale-Revised (WMS-R), the Wechsler Adult Intelligence Scale-Revised (WAIS-R), and the Wisconsin Card Sorting Test (WCST). SPQ scores showed a significant inverse correlation with verbal IQ and the information, comprehension and similarities subtests. No correlation was found between SPQ scores and memory, attention, performance IQ, or executive functioning. These results indicate that schizotypal traits in healthy adults are associated with verbal IQ decrements, suggesting that schizotypal traits themselves, even at a non-clinical level, may play unfavorable roles in cognitive functioning, which is in line with the viewpoint that schizotypy is on a continuum with normality, with its extreme form being clinically expressed as schizophrenia.

Decomposing perseverative errors among undergraduates scoring high on the Schizotypal Personality Questionnaire

Cognitive control (CC), the capacity to flexibly direct resources to a goal by selecting and integrating relevant contextual information, is impaired among persons with schizophrenia-spectrum disorders. CC is achieved, in part, through shifting one's cognitive set towards stimuli of task relevance. Set-shifting deficits typically result in perseverative errors, like those captured by the Wisconsin Card Sorting Test (WCST). However, a disadvantage of the WCST is that it confounds the potential sources of perseverative errors. The Dimensional Change Card Sorting Task (DCCS), in contrast, allows for the decomposition of perseverative errors by systematically varying the shape and/or color of stimuli across pre-switch, switch and post-switch trials. Using these techniques previous research has evaluated the separable contributions of negative priming, positive priming, and extra dimensional shifting to the production of perseverative errors. In the current study, college students scoring high on the Schizotypal Personality Questionnaire (High-SPQ; Raine, A., 1991. The SPQ: a scale for the assessment of schizotypal personality based on DSM-III-R criteria. Schizophr. Bull. 17 (4), 555-564.) and average scoring individuals (Ave-SPQ) were administered the DCCS to investigate schizotypal-related mechanisms underlying set-shifting abnormalities. Relative to Ave-SPQ, High-SPQ participants showed more perseverative responses that were restricted to the positive priming post-switch condition. Possible mechanisms of this impairment, including depletion of cognitive resources and differences in strategy commitment, are discussed.

Prospective memory deficits in subjects with schizophrenia spectrum disorders: a comparison study with schizophrenic subjects, psychometrically defined schizotypal subjects, and healthy controls

Memory impairment is one of the core deficits in schizophrenia. This study explored the memory profiles of schizophrenic and psychometrically defined schizotypal subjects. The study participants included 15 patients with schizophrenia, 41 schizotypal subjects, and 20 healthy controls. All of the participants completed verbal and visual memory, working memory, and prospective memory tasks. The results showed that patients with schizophrenia were impaired in all aspects of memory function, whereas the schizotypal subjects tended to show moderate to large impairment effect sizes in prospective memory. It is suggested that prospective memory be considered a potential endophenotype of schizophrenia.

Emotional intelligence and social functioning in persons with schizotypy

The present study is the first to examine emotional intelligence in persons with schizotypy. Over 2100 undergraduates were screened for schizotypy with the Schizotypal Personality Questionnaire-Brief Version. Forty participants identified as persons with high schizotypy and 56 participants identified as persons with low schizotypy completed assessments of emotional intelligence (Mayer-Salovey-Caruso Emotional Intelligence Test), social functioning (Social Adjustment Scale-Self Report), verbal episodic (secondary) memory (California Verbal Learning Test), and executive functioning (Wisconsin Card Sorting Test). Persons high in schizotypy were impaired in overall emotional intelligence and two aspects of emotional intelligence, the ability to perceive emotions and the ability to manage emotions. Persons high in schizotypy were also impaired in three aspects of social functioning: peer relationships, family relationships, and academic functioning. Group differences in verbal episodic (secondary) memory and executive functioning were not observed. For persons with high schizotypy, overall emotional intelligence and two aspects of emotional intelligence, the ability to perceive emotions and the ability to manage emotions, were associated with peer relationship functioning. Overall emotional intelligence was associated with verbal episodic (secondary) memory, but not executive functioning, in persons with high schizotypy. The current findings suggest that emotional intelligence is impaired in persons with schizotypy and that these impairments affect their social functioning.

Awareness of everyday executive difficulties precede overt executive dysfunction in schizotypal subjects

Much evidence indicates that schizophrenic patients exhibit deficits on tests of executive functioning. It is therefore hypothesized that individuals with high schizotypal personality traits that may have a predisposition to schizophrenia, are also likely to exhibit impairments in neuropsychological tests of executive function. The sample consisted of 65 healthy controls that were divided into high and low scorers on the Schizotypal Personality Questionnaire (SPQ-B: Raine et al., 1995). Participants completed a battery of executive tasks (category and letter fluency, the Hayling test, Zoo map); however, a MANOVA revealed no significant differences between high and low SPQ scorers. Nevertheless, high SPQ scorers scored significantly higher on the Dysexecutive Questionnaire (DEX) self-rating scale of everyday executive problems; and these self-ratings correlated significantly with the disorganisation and cognitive-perceptual features of the SPQ-B, but not with the interpersonal features. This suggests that perceived executive dysfunction is pre-morbidly present and may become evident in test performance only with the onset of schizophrenia itself.

Schizotypy and pseudoneglect: a critical update on theories of hemispheric asymmetries

INTRODUCTION

Positive schizotypy has been associated with a leftward spatial bias (pseudoneglect) in different tasks and populations. We tested whether this relationship (1) can be observed for two different hemispatial tasks in the same participants, and (2) is specific to positive schizotypy.

METHODS

Forty right-handed men performed a conventional line bisection task and a whole-body movement task. In the latter task, participants were presented with illuminated target locations on the floor, and had to visit the remembered locations (equal number in right and left hemispace) after a short time interval. We assessed side preferences in both tasks. Positive schizotypy, negative schizotypy, and cognitive disorganisation were assessed with a validated self-report questionnaire.

RESULTS

Irrespective of schizotypy, pseudoneglect was observed in both tasks. We found a rightward bisection and walking bias as a function of positive schizotypy, and also as a function of cognitive disorganisation for walking initiation.

DISCUSSION

This unexpected finding resulted in a review of hemispheric asymmetry for function in schizotypy, and in the discussion of potential variables that might account for the present discrepancy. We suggest that different schizotypy questionnaires and their presentation mode might be a potential contributor to the opposite findings in the literature.

Creative thinking in schizophrenia: the role of executive dysfunction and symptom severity

INTRODUCTION

This study examines the notion of enhanced creative thinking in schizophrenia and determines the mediating role of executive dysfunction and symptom severity in this relationship.

METHOD

Patients with chronic schizophrenia (n=28) were assessed on varied facets of creative cognition and standard tests of executive control relative to matched healthy control participants (n=18).

RESULTS

Multivariate analyses revealed poorer performance by the patient group across almost all creative and executive function measures, except in the ability to be unconstrained by the influence of restrictive examples. Symptom-based contrasts using partial correlations revealed that differences were most extensive in the presence of thought disorder. Using hierarchical regression analyses, performance on the executive function tasks was found to play a mediatory role on specific aspects of creative cognition.

CONCLUSIONS

Results are at odds with the popular notion of enhanced creative thinking in schizophrenia, but elucidate complex interactions between executive control and certain facets of creative thinking. In particular, performance of the schizophrenia group on measures that tap creativity elements of fluency and relevance were either partially or fully mediated by their performance on the executive control tasks, but this was not true of measures of originality.

Schizophrenic-like neurocognitive deficits in children and adolescents with 22q11 deletion syndrome

22q11.2 Deletion Syndrome (22q11DS) is the most common genetic microdeletion syndrome affecting humans. The syndrome is associated with general cognitive impairments and specific deficits in visual-spatial ability, non-verbal reasoning, and planning skills. 22q11DS is also associated with behavioral and psychiatric abnormalities, including a markedly elevated risk for schizophrenia. Research findings indicate that people with schizophrenia, as well as those identified as schizoptypic, show specific cognitive deficits in the areas of sustained attention, executive functioning, and verbal working memory. The present study examined such schizophrenic-like cognitive deficits in children and adolescents with 22q11DS (n = 26) and controls (n = 25) using a cross-sectional design. As hypothesized, 22q11DS participants exhibited deficits in intelligence, achievement, sustained attention, executive functioning, and verbal working memory compared to controls. Furthermore, deficits in attention and executive functioning were more pronounced in the 22q11DS sample relative to general cognitive impairment. These findings suggest that the same pattern of neuropsychological impairment seen in patients with schizophrenia is present in non-psychotic children identified as at-risk for the development of schizophrenia based on a known genetic risk marker.

Theory of mind, neurocognition, and functional status in schizotypy

The present study is the first to concurrently examine social cognition, neurocognition, and social functioning in psychometric schizotypes. Screening of 2108 undergraduates with the Schizotypal Personality Questionnaire-Brief (SPQ-B) identified 52 persons high in schizotypy and 40 persons low in schizotypy. All participants were administered a test battery designed to assess two elements of neurocognition, verbal secondary memory (California Verbal Learning Test) and executive functioning (Wisconsin Card Sorting Test), two elements of social cognition, emotion perception (The Awareness of Social Inference Test-Part 1) and theory of mind (The Awareness of Social Inference Test-Parts 2 and 3), and social functioning (Social Adjustment Scale-Self Report). Although the persons with high schizotypy were impaired in social functioning relative to the persons with low schizotypy, they were not impaired in theory of mind, emotion perception, verbal secondary memory, or executive functioning. Theory of mind and verbal secondary memory were correlated in persons with high schizotypy. The present findings suggest that psychometric schizotypes are not impaired in the domains of social cognition and neurocognition examined.

Differential effects of haloperidol, clozapine and olanzapine on learning and memory functions in mice

Many schizophrenic patients exhibit impairments in neurocognitive functions. Typical antipsychotic drugs such as haloperidol, have limited or even detrimental influence on cognitive functions. In contrast, atypical antipsychotic drugs, such as clozapine and olanzapine, may improve memory function in schizophrenics. However, only a few studies have been conducted to directly compare the effects of olanzapine, clozapine and haloperidol on memory functions in animal models. Thus, their effects on this issue were investigated in the present studies by using one-way step-through passive avoidance task and Morris water maze as models of learning and memory. The results showed that olanzapine did not affect acquisition, consolidation or retrieval process in step-through test. Moreover, it improved spatial learning function in mice in Morris water maze task. Clozapine and haloperidol appeared to impair acquisition process and consolidation process, respectively, in step-through test. Both drugs impaired spatial learning function in mice in Morris water maze task. The results suggested a positive implication for the clinical medication of olanzapine in schizophrenic treatment.

Comparison of three computer-administered cognitive tasks as putative endophenotypes of schizophrenia

It has been repeatedly demonstrated that individuals with schizotypal personality features (SPF) exhibit similar endophenotypic traits as persons with schizophrenia. Less research has compared the relative sensitivity of different endophenotypes in the same sample of individuals with SPF. Fourteen university students with SPF (mean age 20.5+/-1.6; 43% male) and 26 controls (mean age 20.3+/-1.1; 31% male) were defined by the Abbreviated Schizotypal Personality Questionnaire (SPQ-B). All participants reported no known biological relative with schizophrenia. Participants completed three computer-administered cognitive tasks: a 6-min degraded-stimuli A-X Continuous Performance Test (CPT), the Wisconsin Card Sort Test (WCST), and a Span of Apprehension (SOA) task (6- and 12-letter arrays). On the CPT, only omission errors resulted in a statistically significant group difference, U=115.5, p=.05, Cohen's d=0.54 (medium effect size), with the SPF group (mean errors: 3.43+/-3.28) making more omission errors than controls (mean errors: 1.88+/-2.66). Notably, 46% of the controls had no omission errors, compared to 14% of the SPF group. The only SPQ-B factor score to show a statistically significant linear relationship with CPT omission errors was the Cognitive-Perceptual factor (rs=.33, p=.04). Group differences on performance indices from the SOA and WCST did not approach statistical significance. Based on performance from the community-identified schizotypes, results suggest that performance on the CPT may represent a more robust endophenotype of schizophrenia, compared to the SOA and WCST.

Impaired working speed and executive functions as frontal lobe dysfunctions in young first-degree relatives of schizophrenic patients

The aim of the investigation was to detect neuropsychological markers, such as sustained and selective attention and executive functions, which contribute to the vulnerability to schizophrenia especially in young persons. Performance was assessed in 32 siblings and children of schizophrenic patients and 32 matched controls using Wisconsin Card Sorting Test, Colour-Word-Interference-Test, Trail Making Test, and d2-Concentration-Test. The first-degree relatives showed certain impairments on all four tests, in particular, slower times on all time-limited tests. These results suggest the need for more time when completing neuropsychological tasks involving selected and focused attention, as well as cognitive flexibility, as a possible indicator of genetic vulnerability to schizophrenia.

Anhedonia in schizophrenia: a review of assessment strategies

Anhedonia, the diminished capacity to experience pleasant emotions, is a common, treatment-resistant feature of schizophrenia that is often included among the negative symptoms of this disorder. This selective review describes the 3 most commonly used approaches to assess anhedonia in schizophrenia: interview-based measures, self-report trait questionnaires, and laboratory-based assessments of emotional experience. For each assessment approach, psychometric properties, relationships to other symptoms and features of schizophrenia, and relationships with the other assessment approaches are evaluated. It is concluded that anhedonia can be reliably assessed and constitutes a distinctive, clinically important aspect of schizophrenia that should be included in a comprehensive evaluation of negative symptoms. Current efforts to define more precisely the nature of the hedonic deficit in schizophrenia are discussed, and recommendations for optimal assessment of anhedonia in clinical trials of novel treatments for negative symptoms are provided.

Sustained attention deficits in relation to psychometrically identified schizotypy: evaluating a potential endophenotypic marker

Sustained attention deficits have been posited as a potential endophenotypic marker of vulnerability to schizophrenia. Prior studies have indicated that schizophrenia patients, their first-degree relatives, and psychosis-prone individuals, identified on the basis of measures of positive schizotypy, have demonstrated sustained attention deficits. To date, there have been no published reports of sustained attention deficits in individuals with negative schizotypy, as measured by the revised Social Anhedonia Scale. In this study, we examined sustained attention, measured with the CPT-Identical Pairs version, in 160 individuals with elevated scores on the Chapman Perceptual Aberration and/or Magical Ideation Scales, 96 individuals with elevated scales on the Social Anhedonia Scale, and 137 controls. Both psychosis-prone groups performed more poorly than the controls in terms of discrimination ability, as measured by d', though the groups did not differ in terms of either their reaction time or overall response criterion (lnbeta). These results provide evidence that both positive and negative aspects of schizotypy are associated with sustained attention deficits, as measured by the Continuous Performance Test. The findings add to the converging evidence indicating that sustained attention deficits are a potential endophenotypic indicator of a schizophrenia diathesis.

Dimensional approaches to experimental psychopathology of schizophrenia: shift learning and report of psychotic-like experiences in college students

Adopting a dimensional approach to experimental psychopathology, and taking into account inconsistencies in the previous literature, we examined whether reports of psychotic-like experiences in undergraduate students were associated with shift-learning deficits, akin to those seen in schizophrenia. The participants (N=72) were tested on a new compound stimulus discrimination task before and after a target shift, and were administered a multi-dimensional schizotypy inventory (O-LIFE). Performance impairment following a target shift was associated with the negative (introvertive anhedonia) and the impulsive (impulsive non-conformity) dimension of schizotypy, but not with the positive (unusual experiences), nor the disorganised (cognitive disorganisation) dimension. None of the schizotypy measures were associated with performance on discrimination learning before the target shift. The obtained results are in line with past evidence that shift learning is associated with the severity of the negative symptomatology of schizophrenia. The possibility that psychotic-like features may contribute differentially to performance deficits across successive stages of learning is considered.

Behavioral signs of schizoidia and schizotypy in social anhedonics

Social anhedonia appears to be a promising indicator of Meehl's construct of schizotypy. While findings from diagnostic, cognitive, and psychophysiological studies have supported the validity of social anhedonia as an indicator of schizotypy, the behavioral characteristics of these putative schizotypes are not yet fully understood. This study utilized a rating system for behavioral signs of schizoidia and schizotypy to determine whether atypical interpersonal behaviors were observable in social anhedonics and to examine if these behavioral signs provide unique information, beyond traditional symptom ratings, in the identification of putative schizotypes. A community sample of 170 18-19-year-olds (85 social anhedonics, 85 controls) received diagnostic evaluations which were videotaped and subsequently rated for behavioral signs of schizoidia and schizotypy. Compared to controls, the social anhedonia group displayed significantly more behavioral signs characteristic of schizoid and schizotypal personality disorders. Behavioral signs of schizoidia accounted for a significant amount of group variance even after controlling for clinical symptom ratings. These results indicate that social anhedonics display interpersonal behaviors consistent with risk for schizophrenia-spectrum disorders and that these behavioral signs convey information about group status that is not accounted for by traditional clinical interview ratings of symptomatology.

Blinking and schizotypal thinking

Spontaneous eye blink rate (SBR) is thought to be a biological marker for cerebral dopamine (DA) activity. Accordingly, positive psychotic symptoms have been found to be associated with an increased SBR and negative psychotic symptoms with a decreased SBR. However, modulations of the DA system in patient populations also result from prior neuroleptic treatment. Here, we tested the possible relationship between SBR and positive and negative schizotypal thought. To test the direct influence of DA on SBR in general and as a function of schizotypy, half of a sample of 40 healthy men received levodopa and the other half placebo in a double-blind procedure. SBR did not differ between substance groups suggesting that a pharmacologically induced DA increase in healthy individuals does not generally increase SBR. However, in the levodopa group, increasing SBR correlated with increasing negative schizotypy scores, while no relationship was found between SBR and (1) negative schizotypy in the placebo group, or (2) positive schizotypy in either substance group. We conjecture that a pre-existing hypodopaminergic state in high negative schizotypy scorers, made these individuals susceptible to an increased DA concentration, as it has been observed in Parkinson's disease. Furthermore, the absence of any relationship in the placebo group might suggest that variations in DA concentration as a function of schizotypy are too subtle to influence SBR. Finally, the lack of any association of SBR with positive schizotypy might indicate that SBR and positive schizotypy are mediated by functionally distinct neural circuits.

Psychometric schizotypy modulates levodopa effects on lateralized lexical decision performance

Emergence of psychotic thought has been related to a breakdown in left-hemisphere language dominance. Dopamine (DA) is implicated in both psychotic pathology and modulation of the semantic system. The present study explored whether controlled DA administration modulates basic language functions: (1) in general and/or (2) as a function of schizophrenia-associated thought. Forty healthy men performed a tachistoscopic lexical decision task. Participants' performance was also analyzed as a function of their positive (magical ideation, MI) and negative (physical anhedonia, PHYSAN) schizotypal features. Half of the subjects received 200 mg levodopa, the other half a placebo. Our findings showed that pharmacological treatment per se did not influence task performance, but influenced laterality patterns as a function of participants' schizotypal features. In the placebo, but not in the levodopa group, right hemisphere language contribution increased as a function of increasing MI scores. In the levodopa, but not in the placebo group, superior left hemisphere lexical decision performance was related to increasing PHYSAN scores. The findings from both substance groups suggest that in the healthy brain, a DA agonist restores left-hemispheric dominance for language by reducing right-hemispheric contribution with respect to a positive schizotypal trait and by increasing left-hemispheric specialization with respect to a negative schizotypal trait. We conjecture that the healthy brain compensates through intact neurochemical mechanisms an increased DA concentration, in particular for persons with elevated positive psychotic-like features.

Levodopa reverses gait asymmetries related to anhedonia and magical ideation

Animals and men turn preferentially away from the hemisphere with the more active dopamine (DA) system. Consistent with the idea of a right-hemispheric hyperdopaminergia in schizophrenia, a leftsided turning bias was described for unmedicated psychotic patients. We investigated the modulating role of DA and schizophrenia-like thought on whole-body turns in a controlled double-blind study. The number of veers to either side when walking blindfolded straight ahead (20 meter) was assessed in 40 healthy righthanded men (20 men received levodopa, the remaining participants placebo). Side preferences were analyzed in terms of individuals' positive (Magical Ideation, MI) and negative (Physical Anhedonia, PhysAn) schizotypal features. In the placebo group, increasing MI scores were related to increasing left-sided veering and increasing PhysAn scores were related to increasing right-sided veering. In the levodopa group, this relationship between preferred veering side and type of schizotypy was reversed. The finding in the placebo group suggests an association between MI and a relative right-hemispheric hyperdopaminergia. Unexpectedly, levodopa did not enhance this veering bias, but reversed it, suggesting that psychosis-protective mechanisms exist in the healthy positive "schizotypic" brain. Also unexpectedly, levodopa made "anhedonics" veer like "magics" after placebo, suggesting that DA agonists suppress negative schizotypal symptoms.

The psychometric detection of schizotypy: do putative schizotypy indicators identify the same latent class?

The authors examined whether three indicators of Schizotypy, the Revised Social Anhedonia Scale (RSAS), Magical Ideation Scale (MIS), and Perceptual Aberration Scale (PAS), identify a common latent class or taxon as conceptualized by P. E. Meehl (1962, 1990). The separate and joint latent structures of these scales were evaluated using taxometric methods in two large, independent samples. Replicating prior findings, the RSAS and PAS each identified latent taxa with base rates approximating.10. Results for the taxonicity of the MIS were less consistent. Analyses of joint latent structure indicated that the RSAS-identified taxon was essentially independent of constructs measured by the PAS or MIS. Measures commonly thought to tap the same latent class, conjectured to be schizotypy, do not share this property.

Nonstereotyped responding in positive schizotypy after a single dose of levodopa

Stereotyped behavior and left-sided orientation biases, associated with the dopamine (DA) system, were observed in populations of the schizophrenia spectrum disorders. We investigated whether heightened DA concentrations influence both side biases and stereotyped responding in a visuo-motor computer task, in which 90, 180, and 270 degrees rotated objects had to be brought into a target position. To account for the role of the schizophrenia spectrum, task performance was also analyzed as a function of healthy participants' high or low magical ideation (MI), a positive schizotypal feature. The first 36 participants (20 women) remained substance free. In a second sample, 20 men received levodopa and 20 men a placebo in a double-blind procedure. Results showed that high MI scorers responded more stereotyped than low MI scorers, without being specifically biased towards the left side. Rotation preferences toward one or the other side made high MI scorers less flexible for objects efficiently to be rotated into the opposite direction. This inflexibility may reflect impaired left hemisphere functioning. Unexpectedly, in the levodopa group, high MI scorers performed superior to low MI scorers. Since DA actions appear to follow an inverted U-shape function, the 'low' performing high MI scorers profited from the enhanced DA availability. Our observation in the levodopa group points to a dissociation between schizotypy and schizophrenia: while cognitive improvement in schizophrenia can occur after treatment with atypical neuroleptic agents, in our positive schizotypal participants a DA agonist resulted in improved task performance. This dissociation may point to protective neurochemical mechanisms preventing healthy schizotypes from developing full-blown psychotic symptoms.

Context-Processing Deficits in Schizotypal Personality Disorder

Research suggests that schizotypal personality disorder (SPD) is a part of the spectrum of schizophrenia-related illnesses. This article hypothesizes that a deficit in the representation and maintenance of context is a core cognitive disturbance in schizophrenia and that SPD individuals should demonstrate context-processing deficits. To test this hypothesis, the authors administered 3 versions of their AX-CPT task, designed to assess context processing, to 35 healthy controls and 26 individuals with DSM-IV SPD. They also administered working memory and selective attention tasks. SPD individuals displayed context representation deficits similar to those found in schizophrenia but did not show the same additional deficits in context maintenance. Context processing was strongly associated with working memory and selective attention performance in the SPD individuals.

Executive function assessed by memory updating and random generation in schizotypal individuals

Individuals scoring high (N=32) and low (N=27) on the unusual experiences (UnEx) scale of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) were selected from a large sample (N=265) of normal volunteer undergraduates. The high- and low-UnEx groups were compared on two tasks, random generation and memory updating, which target executive functions that inhibit prepotent responses and update current information. The groups differed only on the R measure of random generation that assesses inequality in the relative frequencies of response alternatives, a result attributed to superstitious behaviour rather than to executive deficit. The results suggest that the executive impairments previously observed in high schizotypal individuals using the Wisconsin Card Sorting Test and other measures are selective rather than global.

Peeling the onion: NMDA dysfunction as a unifying model in schizophrenia

N-methyl-d-aspartate receptor (NMDAR) dysfunction plays a crucial role in schizophrenia, leading to impairments in cognitive coordination. NMDAR agonists (e.g., glycine) ameliorate negative and cognitive symptoms, consistent with NMDAR models. However, not all types of cognitive coordination use NMDAR. Further, not all aspects of cognitive coordination are impaired in schizophrenia, suggesting the need for specificity in applying the cognitive coordination construct.

High-frequency synchronisation in schizophrenia: Too much or too little?

Phillips & Silverstein's focus on schizophrenia as a failure of “cognitive coordination” is welcome. They note that a simple hypothesis of reduced Gamma synchronisation subserving impaired coordination does not fully account for recent observations. We suggest that schizophrenia reflects a dynamic compensation to a core deficit of coordination, expressed either as hyper- or hyposynchronisation, with neurotransmitter systems and arousal as modulatory mechanisms.

No blind schizophrenics: Are NMDA-receptor dynamics involved?

Numerous searches have failed to identify a single co-occurrence of total blindness and schizophrenia. Evidence that blindness causes loss of certain NMDA-receptor functions is balanced by reports of compensatory gains. Connections between visual and anterior cingulate NMDA-receptor systems may help to explain how blindness could protect against schizophrenia.

Setting domain boundaries for convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

The claim that the disorganized subtype of schizophrenia results from glutamate hypofunction is enhanced by consideration of current subtypology of schizophrenia, symptom definition, interdependence of neurotransmitters, and the nature of the data needed to support the hypothesis. Careful specification clarifies the clinical reality of disorganization as a feature of schizophrenia and increases the utility of the subtype.

Schizophrenia: Putting context in context

Although context-processing deficits may be core features of schizophrenia, context remains a poorly defined concept. To test Phillips & Silverstein's model, we need to operationalize context more precisely. We offer several useful ways of framing context and discuss enhancing or facilitating schizophrenic patients' performance under different contextual situations. Furthermore, creativity may be a byproduct of cognitive uncoordination.

Phenomenology, context, and self-experience in schizophrenia

Impairments in cognitive coordination in schizophrenia are supported by phenomenological data that suggest deficits in the processing of visual context. Although the target article is sympathetic to such a phenomenological perspective, we argue that the relevance of phenomenological data for a wider understanding of consciousness in schizophrenia is not sufficiently addressed by the authors.

Guarding against over-inclusive notions of “context”: Psycholinguistic and electrophysiological studies of specific context functions in schizophrenia

Phillips & Silverstein offer an exciting synthesis of ongoing efforts to link the clinical and cognitive manifestations of schizophrenia with cellular accounts of its pathophysiology. We applaud their efforts but wonder whether the highly inclusive notion of “context” adequately captures some important details regarding schizophrenia and NMDA/glutamate function that are suggested by work on language processing and cognitive electrophysiology.

Mechanisms of disrupted language comprehension in schizophrenia

Mechanisms that contribute to perceptual processing dysfunction in schizophrenia were examined by Phillips & Silverstein, and formulated as involving disruptions in both local and higher-level coordination of signals. We agree that dysfunction in the coordination of cognitive functions (disconnection) is also indicated for many of the linguistic processing deficits documented for schizophrenia. We suggest, however, that it may be necessary to add a timing mechanism to the theoretical account.

Theory of mind in schizophrenia: Damaged module or deficit in cognitive coordination?

Schizophrenics exhibit a deficit in theory of mind (ToM), but an intact theory of biology (ToB). One explanation is that ToM relies on an independent module that is selectively damaged. Phillips & Silverstein's analyses suggest an alternative: ToM requires the type of coordination that is impaired in schizophrenia, whereas ToB is spared because this type of coordination is not involved.

Cognitive coordination and its neurobiological bases: A new continent to explore

The additional arguments and evidence supplied by the commentaries strengthen the hypothesis that underactivity of NMDA receptors produces impaired cognitive coordination in schizophrenia. This encourages the hope that though the distance from molecules to mind is great, it can nevertheless be traversed. We therefore predict that in this decade or the next molecular psychology will be seen to be as fundamental to our understanding of mind as molecular biology is to our understanding of life.

Context rules

It is proposed that cortical activity is normally coordinated across synaptically connected areas and that this coordination supports cognitive coherence relations. This view is consistent with the NMDA- hypoactivity hypothesis of the target article in regarding disorganization symptoms in schizophrenia as arising from disruption of normal interareal coordination. This disruption may produce abnormal contextual effects in the cortex that lead to anomalous cognitive coherence relations.

The ketamine model for schizophrenia

This commentary compares clinical aspects of ketamine with the amphetamine model of schizophrenia. Hallucinations and loss of insight, associated with amphetamine, seem more schizophrenia-like. Flat affect encountered with ketamine is closer to the clinical presentation in schizophrenia. We argue that flat affect is not a sign of schizophrenia, but rather, arisk factorfor chronic schizophrenia.

Cortical connectivity in high-frequency beta-rhythm in schizophrenics with positive and negative symptoms

In chronic schizophrenic patients with both positive and negative symptoms (see Table 1), interhemispheric connections at the high frequency beta2-rhythm are absent during cognitive tasks, in contrast to normal controls, who have many interhemispheric connections at this frequency in the same situation. Connectivity is a fundamental brain feature, evidently greatly promoted by the NMDA system. It is a more reliable measure of brain function than the spectral power of this rhythm.

Neurocognitive, behavioural and neurodevelopmental correlates of schizotypy clusters in adolescents from the general population

INTRODUCTION

Studies on the neurocognitive correlates of schizotypy dimensions have found inconsistent results. This might stem from the fact that correlational methods, in contrast to cluster analysis, do not account for the possibility that a subject presents high scores on more than one dimension simultaneously. We aimed to establish clusters of normal adolescents based on schizotypy dimensions and compare them on neurocognitive, behavioural, and neurodevelopmental markers.

METHODS

Two hundred seventy normal adolescents from the general population (mean age 13.4, SD=0.72) attending obligatory education were evaluated.

RESULTS

A K-means iterative cluster analysis was performed with the Perceptual Aberration, Revised Social Anhedonia and Physical Anhedonia Scales. A forced four-cluster model yielded the following clusters: 'negative schizotypy', 'high or mixed schizotypy', 'positive schizotypy', and 'normal scorers'. Comparisons with ANOVAs showed that 'high schizotypes' performed poorly on neurocognition (Wechsler Intelligence Scales for Children-Revised (WISC-R) and Verbal Fluency (FAS)) and obtained the highest teacher ratings (TRF) of behavioural problems. 'Negative schizotypes' had the worst WCST results and more dermatoglyphic abnormalities. Both clusters had more neurological soft signs than 'normal scorers' and 'positive schizotypes'.

CONCLUSIONS

Our results with community adolescents found the same cluster structure than the previous cluster analytic studies conducted in adult college subjects. Furthermore, we showed differences among them on neurocognitive and malneurodevelopment markers consistent with the adult literature on schizotypy.

Where the rubber meets the road: The importance of implementation

Phillips & Silverstein argue that a range of cognitive disturbances in schizophrenia result from a deficit in cognitive coordination attributable to NMDA receptor dysfunction. We suggest that the viability of this hypothesis would be further supported by explicit implementation in a computational framework that can produce quantitative estimates of the behavior of both healthy individuals and individuals with schizophrenia.

Context, connection, and coordination: The need to switch

Context, connection, and coordination (CCC) describe well where the problems that apply to thought-disordered patients with schizophrenia lie. But they may be part of the experience of those with other symptom constellations. Switching is an important mechanism to allow context to be applied appropriately to changing circumstances. In some cases, NMDA-voltage modulations may be central, but gain and shift are also functions that monoaminergic systems express in CCC.

Synchronous dynamics for cognitive coordination: But how?

Although interesting, the hypotheses proposed by Phillips & Silverstein lack unifying structure both in specific mechanisms and in cited evidence. They provide little to support the notion that low-level sensory processing and high-level cognitive coordination share dynamic grouping by synchrony as a common processing mechanism. We suggest that more realistic large-scale modeling at multiple levels is needed to address these issues.

A wide-spectrum coordination model of schizophrenia

The target article presents a model for schizophrenia extending four levels of abstraction: molecules, cells, cognition, and syndrome. An important notion in the model is that of coordination, applicable to both the level of cells and of cognition. The molecular level provides an “implementation” of the coordination at the cellular level, which in turn underlies the coordination at the cognitive level, giving rise to the clinical symptoms.

Linking brain to mind in normal behavior and schizophrenia

To understand schizophrenia, a linking hypothesis is needed that shows how brain mechanisms lead to behavioral functions in normals, and also how breakdowns in these mechanisms lead to behavioral symptoms of schizophrenia. Such a linking hypothesis is now available that complements the discussion offered by Phillips & Silverstein (P&S).

Spatial integration in perception and cognition: An empirical approach to the pathophysiology of schizophrenia

Evidence for a dysfunction in cognitive coordination in schizophrenia is emerging, but it is not specific enough to prove (or disprove) this long-standing hypothesis. Many aspects of the external world are spatially mapped in the brain. A comprehensive internal representation relies on integration of information across space. Focus on spatial integration in the perceptual and cognitive processes will generate empirical data that shed light on the pathophysiology of schizophrenia.

Inferring contextual field interactions from scalp EEG

This commentary highlights methods for using scalp EEG to make inferences about contextual field interactions, which, in view of the target article, may be specially relevant to the study of schizophrenia. Although scalp EEG has limited spatial resolution, prior knowledge combined with experimental manipulations may be used to strengthen inferences about underlying brain processes. Both spatial and temporal context are discussed within the framework of nonlinear interactions. Finally, results from a visual contour integration EEG pilot study are summarized in view of a hypothesis that relates receptive field and contextual field processing to evoked and induced activity, respectively.

Reconciling schizophrenic deficits in top-down and bottom-up processes: Not yet

This commentary challenges the authors to use their computational modeling techniques to support one of their central claims: that schizophrenic deficits in bottom-up (Gestalt-type tasks) and top-down (cognitive control tasks) context processing tasks arise from the same dysfunction. Further clarification about the limits of cognitive coordination would also strengthen the hypothesis.

Cognitive coordination deficits: A necessary but not sufficient factor in the development of schizophrenia

The Phillips & Silverstein model of NMDA-mediated coordination deficits provides a useful heuristic for the study of schizophrenic cognition. However, the model does not specifically account for the development of schizophrenia-spectrum disorders. The P&S model is compared to Meehl's seminal model of schizotaxia, schizotypy, and schizophrenia, as well as the model of schizophrenic cognitive dysfunction posited by McCarley and colleagues.