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The complex relationships between executive functions and positive symptoms in schizophrenia

Published online by Cambridge University Press:  08 February 2008

F. Guillem ,
M. Rinaldi ,
T. Pampoulova  and
E. Stip
F. Guillem*
Affiliation:
Fernand-Seguin Research Centre, L-H Lafontaine Hospital and Department of Psychiatry, University of Montreal, Montreal, Canada
M. Rinaldi
Affiliation:
Fernand-Seguin Research Centre, L-H Lafontaine Hospital and Department of Psychiatry, University of Montreal, Montreal, Canada
T. Pampoulova
Affiliation:
Fernand-Seguin Research Centre, L-H Lafontaine Hospital and Department of Psychiatry, University of Montreal, Montreal, Canada
E. Stip
Affiliation:
Fernand-Seguin Research Centre, L-H Lafontaine Hospital and Department of Psychiatry, University of Montreal, Montreal, Canada
*
*Address for correspondence: Dr F. Guillem, Centre de Recherche Fernand-Seguin, Hôpital L-H Lafontaine, 7331 Rue Hochelaga, Montréal, QC, H1N 3V2, Canada. (Email: [email protected])
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Abstract

Background

Relationships between performance on various tests of executive functions and positive symptoms, especially delusions and hallucinations, have not been found consistently. This may be related to method of rating symptoms, to possible interactions between them, as well as to the low specificity of the cognitive test measures used. In this study, we have investigated the relationships between different aspects of positive symptomatology and several executive subprocesses.

Method

Stable schizophrenia patients (n=96) were assessed for disorganization, delusion and hallucination symptoms rated from the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Interference sensitivity, inhibition and flexibility were assessed using the Wickens paradigm. The relationships between symptom dimensions as well as with cognitive and other potentially confounding variables were assessed using Pearson correlations and (simple and partial) stepwise regressions.

Results

Generally consistent with the cognitive constructs used to account for positive symptoms, the results indicated relationships between delusions, disorganization and inhibition, and between hallucinations and interference sensitivity. However, these relationships appeared more complex than expected, with some being dependent on interactions between symptoms.

Conclusions

These results suggest: (i) that the global measures usually employed may not be appropriate for demonstrating specific relationships between symptoms and executive functions and (ii) that it is necessary to take into account the interactions between positive symptoms as well as with other factors to reveal these relationships.

Keywords

FlexibilityinhibitioninterferenceWickens test
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 6 , June 2008 , pp. 853 - 860
Copyright
Copyright © Cambridge University Press 2008

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References

Addington, D, Addington, J, Maticka-Tyndale, E (1993). Assessing depression in schizophrenia: the Calgary Depression Scale. British Journal of Psychiatry 163 (Suppl. 22), 39–44.CrossRefGoogle Scholar
Andreasen, NC (1984 a). The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City, IA.Google Scholar
Andreasen, NC (1984 b). The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa: Iowa City, IA.Google Scholar
Baddeley, A, Della Sala, S (1998). Working memory and executive control. In The Prefrontal Cortex: Executive and Cognitive Functions (ed. Roberts, A. C., Robbins, T. W. and Weiskrantz, L.), pp. 9–21. Oxford University Press: Oxford.CrossRefGoogle Scholar
Baker, CA, Morrison, AP (1998). Cognitive processes in auditory hallucinations: attributional biases and metacognition. Psychological Medicine 28, 1199–1208.CrossRefGoogle ScholarPubMed
Baxter, RD, Liddle, PF (1998). Neuropsychological deficits associated with schizophrenic syndromes. Schizophrenia Research 30, 239–249.CrossRefGoogle ScholarPubMed
Bentall, RP (1994). Cognitive biases and abnormal beliefs: towards a model of persecutory delusions. In The Neuropsychology of Schizophrenia (ed. David, A. S. and Cutting, J.), pp. 337–360. Lawrence Erlbaum Associates: Hove, UK.Google Scholar
Birchwood, M, Meaden, A, Trower, P, Gilbert, P, Plaistow, J (2000). The power and omnipotence of voices: subordination and entrapment by voices and by significant others. Psychological Medicine 30, 337–344.CrossRefGoogle ScholarPubMed
Blackwood, NJ, Howard, RJ, Bentall, RP, Murray, RM (2001). Cognitive neuropsychiatric models of persecutory delusions. American Journal of Psychiatry 158, 527–539.CrossRefGoogle ScholarPubMed
Bleuler, E (1911). Dementia Praecox of the Group of Schizophrenias (translated by J. Zinkin, published in 1950). International Universities Press: New York.Google Scholar
Cameron, AM, Oram, J, Geffen, GM, Kavanagh, DJ, McGrath, JJ, Geffen, LB (2002). Working memory correlates of three symptom cluster in schizophrenia. Psychiatry Research 110, 49–61.CrossRefGoogle ScholarPubMed
Corrigan, PW (2006). Recovery from schizophrenia and the role of evidence-based psychosocial interventions. Expert Review of Neurotherapeutics 6, 993–1004.CrossRefGoogle ScholarPubMed
Crow, TJ (1980). The molecular pathology of schizophrenia: more than one disease process? British Medical Journal 280, 66–68.CrossRefGoogle ScholarPubMed
Cuesta, MJ, Peralta, V (1995). Cognitive disorders in the positive, negative, and disorganization syndromes of schizophrenia. Psychiatry Research: Neuroimaging 58, 227–235.CrossRefGoogle ScholarPubMed
Donohoe, G, Corvin, A, Robertson, IH (2006). Evidence that specific executive functions predict symptom variance among schizophrenia patients with a predominantly negative symptom profile. Cognitive Neuropsychiatry 11, 13–32.CrossRefGoogle ScholarPubMed
Ey, H (1996). Schizophrénie, Etudes Cliniques et Psychopathologiques (22 texts compiled by J. Garrabé). Institut Synthélabo: Les Empécheurs de penser en rond: Paris.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (1996). Structured Clinical Interview for the DSM-IV Axis I Disorders. American Psychiatric Press: Washington, DC.Google Scholar
Fossatti, P, Ergis, AM, Allilaire, JF (2001). Problem-solving abilities in unipolar depressed patients: comparison of performance on the modified version of the Wisconsin and the California sorting tests. Psychiatry Research 104, 145–156.CrossRefGoogle Scholar
Freeman, D, Garety, P, Fowler, D, Kuipers, E, Dunn, G, Bebbington, P, Hadley, C (1998). The London-East Anglia randomized controlled trial of cognitive-behaviour therapy for psychosis, IV: self-esteem and persecutory delusions. British Journal of Clinical Psychology 37, 415–430.CrossRefGoogle ScholarPubMed
Frith, CD (1979). Consciousness, information processing and schizophrenia. British Journal of Psychiatry 134, 225–235.CrossRefGoogle ScholarPubMed
Frith, CD (1992). The Neuropsychology of Schizophrenia. Lawrence Erlbaum Associates: Hove, UK.Google Scholar
Garety, PA, Fowler, D, Kuipers, E, Freeman, D, Dunn, G, Bebbington, PE, Hadley, C, Jones, S (1997). The London-East Anglia Randomised Controlled Trial of cognitive behaviour therapy for psychosis II: predictors of outcome. British Journal of Psychiatry 171, 319–327.CrossRefGoogle ScholarPubMed
Garety, PA, Freeman, D (1999). Cognitive approaches to delusions: a critical review of theories and evidence. British Journal of Clinical Psychology 38, 113–154.CrossRefGoogle ScholarPubMed
Garety, PA, Hemley, DR, Wessely, S (1991). Reasoning in deluded schizophrenic and paranoid subjects: biases on performance of a probabilistic reasoning task. Journal of Nervous and Mental Disease 179, 194–201.CrossRefGoogle Scholar
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.CrossRefGoogle ScholarPubMed
Guillem, F, Bicu, M, Bloom, D, Wolf, MA, Desautels, R, Lalinec, M, Kraus, D, Debruille, JB (2001). Neuropsychological impairments in the syndromes of schizophrenia: a comparison between different dimensional models. Brain and Cognition 46, 153–159.CrossRefGoogle ScholarPubMed
Guillem, F, Ganeva, E, Pampoulova, T, Stip, E (2005 a). Changes in the neuropsychological correlates of clinical dimensions between the acute and stable phase of schizophrenia. Brain and Cognition 57, 93–101.CrossRefGoogle ScholarPubMed
Guillem, F, Pampoulova, T, Stip, E, Lalonde, P, Todorov, C (2005 b). Symptom dimensions and dysphoria in schizophrenia: their relationships and cognitive interpretations. Schizophrenia Research 75, 83–96.CrossRefGoogle Scholar
Hemsley, DR (1993). A simple (or simplistic?) cognitive model for schizophrenia. Behavioral Research and Therapy 31, 633–645.CrossRefGoogle ScholarPubMed
Leeson, VC, Simpson, A, McKenna, PJ, Laws, KR (2005). Executive inhibition and semantic association in schizophrenia. Schizophrenia Research 74, 61–67.CrossRefGoogle ScholarPubMed
Liddle, PF, Morris, DL (1991). Schizophrenic symptoms and frontal lobe performance. British Journal of Psychiatry 158, 340–345.CrossRefGoogle ScholarPubMed
Lucas, S, Fitzgerald, D, Redoblado-Hodge, MA, Anderson, J, Sanbrook, M, Harris, A, Brennan, J (2004). Neuropsychological correlates of symptom profiles in first episode schizophrenia. Schizophrenia Research 71, 323–330.CrossRefGoogle ScholarPubMed
Lysaker, PH, Bell, DB (1995). Prominent negative symptoms and work impairment in schizophrenia. Acta Psychiatrica Scandinavica 91, 205–208.CrossRefGoogle ScholarPubMed
Lysaker, PH, Bell, DB, Kaplan, E, Bryson, G (1998). Personality and psychosocial dysfunction in schizophrenia: the association of extraversion and neuroticism to deficits in work performance. Psychiatry Research 80, 61–68.CrossRefGoogle ScholarPubMed
Lysaker, PH, Hemmersley, J (2006). Association of delusions and lack of cognitive flexibility with social anxiety in schizophrenia spectrum disorders. Schizophrenia Research 86, 147–153.CrossRefGoogle ScholarPubMed
Magaro, PA (1980). Cognition in Schizophrenia and Paranoia: the Integration of Cognitive Processes. Erlbaum: Hillsdale, NJ.Google Scholar
Malla, AK, Norman, RMG, Morrison-Stewart, S, Williamson, PC, Helmes, E, Cortese, L (2001). Does sex influence the relation between symptoms and neurocognitive functions in schizophrenia? Journal of Psychiatry and Neuroscience 26, 49–54.Google ScholarPubMed
Morrison, AP, Haddock, G, Tarrier, N (1995). Intrusive thoughts and auditory hallucinations: a cognitive approach. Behavioural and Cognitive Psychotherapy 23, 265–280.CrossRefGoogle Scholar
Norman, RMG, Malla, AK (1994). Correlations over time between dysphoric mood and symptomatology in schizophrenia. Comprehensive Psychiatry 35, 34–38.CrossRefGoogle ScholarPubMed
Norman, RMG, Malla, AK, Cortese, L, Diaz, F (1998). Aspects of dysphoria and symptoms of schizophrenia. Psychological Medicine 28, 1433–1441.CrossRefGoogle ScholarPubMed
Norman, RMG, Malla, AK, Morisson-Stewart, SL, Helmes, E, Williamson, PC, Thomas, J, Cortese, L (1997). Neuropsychological correlates of syndromes in schizophrenia. British Journal of Psychiatry 170, 134–139.CrossRefGoogle ScholarPubMed
Pantelis, C, Harvey, CA, Plant, G, Fossey, E, Maruff, P, Stuart, GW, Brewer, WJ, Nelson, HE, Robbins, TW, Barnes, TR (2004). Relationship of behavioural and symptomatic syndromes in schizophrenia to spatial working memory and attentional set-shifting ability. Psychological Medicine 34, 693–703.CrossRefGoogle ScholarPubMed
Rocca, P, Castagna, F, Marchiaro, L, Rasetti, R, Rivoira, E, Bogetto, F (2006). Neuropsychological correlates of reality distortion in schizophrenic patients. Psychiatry Research 145, 49–60.CrossRefGoogle ScholarPubMed
Takahashi, H, Iwase, M, Nakahachi, T, Sekiyama, R, Tabushi, K, Kajimoto, O, Shimizu, A, Takeda, M (2005). Spatial working memory deficit correlates with disorganization symptoms and social functioning in schizophrenia. Psychiatry and Clinical Neuroscience 59, 453–460.CrossRefGoogle ScholarPubMed
Toomey, R, Kremen, WS, Simpson, JC, Samson, JA, Seidman, LJ, Lyons, MJ, Faraone, SV, Tsuang, MT (1997). Revisiting the factor structure for positive and negative symptoms: evidence from a large heterogeneous group of psychiatric patients. American Journal of Psychiatry 154, 371–377.Google ScholarPubMed
Wickens, DD (1970). Encoding categories of words: an empirical approach to meaning. Psychological Review 77, 1–15.CrossRefGoogle Scholar
Wickens, DD, Born, DG, Allen, CK (1963). Proactive inhibition and item similarity in short-term memory. Journal of Verbal Learning and Verbal Behavior 2, 440–445.CrossRefGoogle Scholar