Visual selective attention among persons with schizophrenia: the distractor ratio effect

Impaired Fixation-Related Theta Modulation Predicts Reduced Visual Span and Guided Search Deficits in Schizophrenia

During normal visual behavior, individuals scan the environment through a series of saccades and fixations. At each fixation, the phase of ongoing rhythmic neural oscillations is reset, thereby increasing efficiency of subsequent visual processing. This phase-reset is reflected in the generation of a fixation-related potential (FRP). Here, we evaluate the integrity of theta phase-reset/FRP generation and Guided Visual Search task in schizophrenia. Subjects performed serial and parallel versions of the task. An initial study (15 healthy controls (HC)/15 schizophrenia patients (SCZ)) investigated behavioral performance parametrically across stimulus features and set-sizes. A subsequent study (25-HC/25-SCZ) evaluated integrity of search-related FRP generation relative to search performance and evaluated visual span size as an index of parafoveal processing. Search times were significantly increased for patients versus controls across all conditions. Furthermore, significantly, deficits were observed for fixation-related theta phase-reset across conditions, that fully predicted impaired reduced visual span and search performance and correlated with impaired visual components of neurocognitive processing. By contrast, overall search strategy was similar between groups. Deficits in theta phase-reset mechanisms are increasingly documented across sensory modalities in schizophrenia. Here, we demonstrate that deficits in fixation-related theta phase-reset during naturalistic visual processing underlie impaired efficiency of early visual function in schizophrenia.

Cognitive Functioning in Schizophrenia, Methamphetamine-induced Psychotic Disorder, and Healthy People: A Comparative Study

Background:

Methamphetamine-induced psychotic disorder (MIP) cannot be easily differentiated from other psychotic disorders. Some studies have reported that patients with MIP and schizophrenia have differences in their cognitive functioning. We hypothesized that their performance would be different on neuropsychological tests which assess executive functions and visual memory.

Materials and Methods:

In a cross-sectional study, 30 patients with MIP, 31 patients with schizophrenia, and 31 healthy controls were assessed by Rey–Osterrieth complex figure (ROCF) test and visual search and attention test (VSAT). One-way analysis of variance was performed to compare the mean scores of tests. Tukey's HSD test was used for post hoc analysis.

Results:

Three groups had significant differences according to ROCF test (F = 15.76, P < 0.0001), VSAT (F = 39.78, P < 0.0001), left VSAT (F = 37.96, P < 0.0001), right VSAT (F = 40.40, P < 0.0001), and the time of the test administration (F = 3.26, P = 0.04). The post hoc analysis showed that the mean score of ROCF test and VSAT (total, right, and left) was significantly higher in the control group than in the other two groups. The time of administering the test in the control group was significantly shorter than in the MIP group (P < 0.03) and nonsignificantly shorter than in the schizophrenia group (P = 0.54). The mean score of right side VSAT was significantly higher in the MIP group than in the schizophrenia group.

Conclusion:

ROCF could not differentiate MIP from schizophrenia. The better performance of patients with MIP on right side VSAT that is reported in this and in the previous study needs to be reevaluated in more controlled studies.

The influence of schizotypal traits on attention under high perceptual load

Schizophrenia Spectrum Disorders (SSD) are known to be characterised by abnormalities in attentional processes, but there are inconsistencies in the literature that remain unresolved. This article considers whether perceptual resource limitations play a role in moderating attentional abnormalities in SSD. According to perceptual load theory, perceptual resource limitations can lead to attenuated or superior performance on dual-task paradigms depending on whether participants are required to process, or attempt to ignore, secondary stimuli. If SSD is associated with perceptual resource limitations, and if it represents the extreme end of an otherwise normally distributed neuropsychological phenotype, schizotypal traits in the general population should lead to disproportionate performance costs on dual-task paradigms as a function of the perceptual task demands. To test this prediction, schizotypal traits were quantified via the Schizotypal Personality Questionnaire (SPQ) in 74 healthy volunteers, who also completed a dual-task signal detection paradigm that required participants to detect central and peripheral stimuli across conditions that varied in the overall number of stimuli presented. The results confirmed decreasing performance as the perceptual load of the task increased. More importantly, significant correlations between SPQ scores and task performance confirmed that increased schizotypal traits, particularly in the cognitive-perceptual domain, are associated with greater performance decrements under increasing perceptual load. These results confirm that attentional difficulties associated with SSD extend sub-clinically into the general population and suggest that cognitive-perceptual schizotypal traits may represent a risk factor for difficulties in the regulation of attention under increasing perceptual load.

The Associations between Visual Attention and Facial Expression Identification in Patients with Schizophrenia

OBJECTIVE

Visual search is an important attention process that precedes the information processing. Visual search also mediates the relationship between cognition function (attention) and social cognition (such as facial expression identification). However, the association between visual attention and social cognition in patients with schizophrenia remains unknown. The purposes of this study were to examine the differences in visual search performance and facial expression identification between patients with schizophrenia and normal controls, and to explore the relationship between visual search performance and facial expression identification in patients with schizophrenia.

METHODS

Fourteen patients with schizophrenia (mean age=46.36±6.74) and 15 normal controls (mean age=40.87±9.33) participated this study. The visual search task, including feature search and conjunction search, and Japanese and Caucasian Facial Expression of Emotion were administered.

RESULTS

Patients with schizophrenia had worse visual search performance both in feature search and conjunction search than normal controls, as well as had worse facial expression identification, especially in surprised and sadness. In addition, there were negative associations between visual search performance and facial expression identification in patients with schizophrenia, especially in surprised and sadness. However, this phenomenon was not showed in normal controls.

CONCLUSION

Patients with schizophrenia who had visual search deficits had the impairment on facial expression identification. Increasing ability of visual search and facial expression identification may improve their social function and interpersonal relationship.

Use of visual cueing for blood glucose documentation in a person with schizophrenia and diabetes

Persons diagnosed with schizophrenia are also at-risk for medical comorbidities. We present the case of one such patient with the comorbidity of diabetes. By applying the research on visual cueing for this population, we developed a glucose monitoring form that increased documentation. We encourage other healthcare practitioners to develop visually appealing or interesting documentation forms for their patients to help empower them for self-care.

Attentional guidance during visual search among patients with schizophrenia

The current study investigated visual guidance and saccadic selectivity during visual search among patients with schizophrenia (SCZ). Data from a previous study (Elahipanah, A., Christensen, B.K., & Reingold, E.M., 2008. Visual selective attention among persons with schizophrenia: The distractor ratio effect. Schizophr. Res. 105, 61-67.) suggested that visual guidance for the less frequent distractors in a conjunction search display (i.e., the distractor ratio effect) is intact among SCZ patients. The current study investigated the distractor ratio effect among SCZ patients when: 1) search is more demanding, and 2) search involves motion perception. In addition, eye tracking was employed to directly study saccadic selectivity for the different types of distractors. Twenty-eight SCZ patients receiving a single antipsychotic medication and 26 healthy control participants performed two conjunction search tasks: a within-dimension (i.e., colour × colour) search task; and a cross-dimension (i.e., motion × colour) search task. In each task the relative frequency of distractors was manipulated across 5 levels. Despite slower search times, patients' eye movement data indicated unimpaired visual guidance in both tasks. However, in the motion × colour conjunction search task, patients displayed disproportionate difficulty detecting the moving target when the majority of distractors were also moving. Results demonstrate that bottom-up attentional guidance is unimpaired among patients with SCZ; however, patients' impairment in motion discrimination impedes their ability to detect a moving target against noisy backgrounds.

Does hallucination affect vigilance performance in schizophrenia? An exploratory study

The present study investigates the role of "auditory verbal hallucination" (AVH) in the attentional processes of individuals diagnosed with schizophrenia compared with healthy participants. The sample consisted of 26 participants diagnosed with schizophrenia divided into - "schizophrenia with hallucination" (N=12) and "schizophrenia without hallucination" (N=14). 13 matched healthy participants were taken. A general health questionnaire was used to screen out psychiatric morbidity in healthy participants. The presence and/or absence of AVH were substantiated through the administration of the Positive and Negative Syndrome Scale (PANSS). Only individuals having higher composite scores in the positive scale were included. Edinburgh Handedness Inventory was administered to all participants. Software designed to measure vigilance was used to assess attentional deficits in the three groups included in the study. The complexity of the "vigilance task" was varied across three parameters: (1) spatial position of the target stimulus and buffer, (2) frequency of the target stimulus and buffer and (3) colour of target stimulus and buffer. The performances of the 3 groups were compared statistically in terms of Hit, Miss and False Alarm scores. Results revealed that schizophrenia patients are deficient as compared to their healthy counterparts in the ability to focus on a specific target while inhibiting non-relevant information across all conditions. Also, schizophrenia patients who have AVH are relatively more deficient as compared to the schizophrenia patients without AVH. It can be concluded that perceptual abnormality in schizophrenia patients with hallucination has an additional negative impact on attentional processes.

Perceptual organization impairment in schizophrenia and associated brain mechanisms: review of research from 2005 to 2010

Perceptual organization (PO) refers to the processes by which visual information is structured into coherent patterns such as groups, contours, perceptual wholes, and object representations. Impairments in PO have been demonstrated in schizophrenia since the 1960s and have been linked to several illness-related factors including poor premorbid functioning, poor prognosis, and disorganized symptoms. This literature was last reviewed in 2005. Since then, electrophysiological (electroencephalographic, event-related potential, and magnetoencephalographic) and fMRI studies in both patient and nonpatient samples have clarified brain mechanisms involved in the impairment, and additional behavioral studies in patients and nonpatients have clarified the computational mechanisms. In addition, data now exist on the functional consequences of PO impairments, in terms of secondary difficulties in face processing, selective attention, working memory, and social cognition. Preliminary data on drug effects on PO and on changes in response to treatment suggest that anomalies in PO may furnish a biomarker for the integrity of its associated biological mechanisms. All of this recent evidence allows for a clearer picture of the nature of the impairment and how it relates to broader aspects of brain and behavioral functioning in schizophrenia.

Turning it upside down: areas of preserved cognitive function in schizophrenia

Patients with schizophrenia demonstrate marked impairments on most clinical neuropsychological tests. These findings suggest that patients suffer from a generalized form of cognitive impairment, with little evidence of spared performance documented in several large meta-analytic reviews of the clinical literature. In contrast, we review evidence for relative sparing of aspects of attention, procedural memory, and emotional processing observed in studies that have employed experimental approaches adapted from the cognitive and affective neuroscience literature. These islands of preserved performance suggest that the cognitive deficits in schizophrenia are not as general as they appear to be when assayed with clinical neuropsychological methods. The apparent contradiction in findings across methods may offer important clues about the nature of cognitive impairment in schizophrenia. The documentation of preserved cognitive function in schizophrenia may serve to sharpen hypotheses about the biological mechanisms that are implicated in the illness.