Metaphor interpretation and use: a window into semantics in schizophrenia.

The nature of putative semantic anomalies in schizophrenia is controversial. Metaphor interpretation and use provide a useful methodology with which to probe semantics since metaphors are critical in reasoning processes and in how conceptual knowledge is organized. The first study examined free speech for figurative language. The second study explored whether emotional versus non-emotional metaphorical language interpretation elicits differences in the tendencies to produce idiosyncratic (bizarre) or literal interpretations or use of other metaphors to describe the meaning of a metaphor. The third study examined the interpretation of time metaphors. We expected the time perspective in ambiguous sentences to be differentially influenced by previously presented unambiguous sentences of a specific perspective, either events moving relative to a stationary observer (moving-time) or an observer moving relative to a stationary event (moving-ego). First, we found that patients used a similar amount of figurative language as control participants. Second, we did not find any difference between the groups in terms of idiosyncratic interpretations, although patients did interpret more metaphors literally and controls utilized more figurative language. Third, we did not find evidence of a difference between the groups in terms of time perspectives influencing ambiguous target sentences differentially. As operationalized here, the interpretation and use of metaphors is similar in patients with schizophrenia to that of healthy control participants. To the extent that metaphors recruit semantic processes this area of cognition is generally intact in schizophrenia.

Genes, cognition and brain through a COMT lens.

Various genes are known to modulate the delicate balance of dopamine in prefrontal cortex and influence cortical information processing. Catechol-O-methyltransferase (COMT) on chromosome 22q11 is the most widely studied of these genes. Val158Met, a common, functional variant in the coding sequence that increases or decreases the enzymatic activity of the gene has been shown to impact the efficiency of prefrontally-mediated cognition, specifically executive functioning, working memory, fluid intelligence and attentional control. We review the rapidly evolving literature exploring the association between COMT genotype and cognitive performance, and illustrate how this polymorphism has served a pivotal role in characterizing various interacting dimensions of complexity in the relationship between genes and cognition. We review how Val158Met has been used to help develop and validate behavioral and neurophysiological phenotypes, as a critical tool in dissecting overlapping neural functional systems and exploring interactions within and between genes, and in exploring how gene effects on cognition are modulated by environmental, demographic and developmental factors. Despite the impressive range of findings, the COMT story is also a bracing reminder of how much work remains to translate this knowledge into practical clinical applications.

Duration judgements in patients with schizophrenia.

BACKGROUND: The ability to encode time cues underlies many cognitive processes. In the light of schizophrenic patients' compromised cognitive abilities in a variety of domains, it is noteworthy that there are numerous reports of these patients displaying impaired timing abilities. However, the timing intervals that patients have been evaluated on in prior studies vary considerably in magnitude (e.g. 1 s, 1 min, 1 h etc.). METHOD: In order to obviate differences in abilities in chronometric counting and place minimal demands on cognitive processing, we chose tasks that involve making judgements about brief durations of time (< 1 s). RESULTS: On a temporal generalization task, patients were less accurate than controls at recognizing a standard duration. The performance of patients was also significantly different from controls on a temporal bisection task, in which participants categorized durations as short or long. Although time estimation may be closely intertwined with working memory, patients' working memory as measured by the digit span task did not correlate significantly with their performance on the duration judgement tasks. Moreover, lowered intelligence scores could not completely account for the findings. CONCLUSIONS: We take these results to suggest that patients with schizophrenia are less accurate at estimating brief time periods. These deficits may reflect dysfunction of biopsychological timing processes.

Semantic clustering in verbal fluency: schizophrenic patients versus control participants.

BACKGROUND: Schizophrenic patients generate fewer words than healthy controls during verbal fluency tasks. The structure of output may explain why patients generate fewer exemplars. METHODS: Twenty-four healthy controls and 24 patients with schizophrenia participated in six, 3 min semantic fluency tasks. In a subsequent session, participants were given cards, each printed with one of their own words generated from previous fluency tasks. Participants were to sort the cards into categories (e.g. subcategories of 'animals'), thus defining their own semantic subcategories of words, and thereby eliminating experimenter assumptions about word relatedness. These clusters were matched with fluency output of each participant. The time spent searching through semantic networks within clusters and switching to other clusters when locating and producing associated words were measured. RESULTS: Patients produced fewer words and spent more time switching to words within clusters and to different clusters than controls, but otherwise response profiles were similar. Although controls returned more frequently to clusters and consequently made more switches between these clusters than patients, this group difference disappeared when the total number of words produced was covaried. CONCLUSIONS: Consistent with previous literature, patients produced fewer words and made more errors than controls. The absence of a group difference in number of different clusters or mean number of items per cluster suggests that patients are similar to controls with respect to number of ideas in their semantic network. Patients' longer between-cluster switching times indicate a general slowness that may be attributed to difficulties finding new words within a semantic field.

An investigation of the integrity of semantic boundaries in schizophrenia.

Organizing information and knowledge, and hence categorization, requires specifying boundaries between items, concepts and words. Over-inclusiveness in categorization may be seen as looseness of association; over-inclusive thinking was an early description of schizophrenic thinking. Recent studies suggest semantic memory problems in schizophrenia, and that thought disorder is associated with a disorganized semantic network. One such study [Psychol. Med. 24 (1994) 193], using a word categorization task, found patients slowest to respond to items semantically related to, but outside the category, whereas controls were slower responding to items sharing less features of the category (i.e. borderline). The authors suggested that there is an outward shift of semantic category boundaries in schizophrenia. In Experiment 1, we replicated methods, but did not find this qualitative difference in patients (28 patients, 26 controls). We extended this question in Experiment 2 to a more visual domain using pictures that 'morphed' from one entity into another and asked participants to decide when they no longer considered an item to be that item (20 patients, 25 controls). We did not find a difference between patients and controls in their sensitivity to detect boundaries of representations. These two experiments do not support the notion that thought disorder with postulated looseness of association or over-inclusive thinking is related to reduced awareness of boundaries of semantic category membership or entities, and inferentially their featural network. Despite anomalies in the semantic system in schizophrenia, we found aspects to be intact. This specificity of semantic processing is promising, suggesting that research will be informative as to how semantic memory is constructed, and thus how it can selectively break down. Moreover, this study indicates that patients do not 'fail' semantic tasks (e.g. priming) because of globally disorganized decision-making: here their capability to make precise distinctions between representations was intact.

A comparison of verbal fluency tasks in schizophrenic patients and normal controls.

Previous studies have reported significant impairment on verbal fluency tasks (semantic and letter) among schizophrenic subjects. However, the possibility of specific categorical deficits has not been adequately investigated. Nor have the effects of task duration, the stability between testing sessions, and the relationship between intelligence and performance on fluency been thoroughly studied. We performed a series of 3 min fluency tasks (semantic/syntactic and letter) to determine whether duration specific or category-specific differences exist between schizophrenic subjects and normal controls. Each subject was tested at three different times as a means of estimating word pool and assessing the stability of fluency output. Subjects were asked to generate exemplars from each of four semantic/syntactic categories (animals, tools, common nouns and verbs) and three letters (G, E and T). Data from 13 schizophrenic subjects and 15 sex-, age- and pre-morbid-IQ-matched control subjects revealed that patients' overall performance on both the semantic and letter fluency tasks was impaired. While differential impairment on specific semantic categories was noted between groups, no differential effects relating to task duration or testing session were present. Further, by comparing the number of novel words produced in the three testing sessions, we found the groups to be equivalent, a finding we take to suggest that schizophrenic patients' lexicon is intact. Covarying current IQ eliminated the group difference robustly for letter fluency, while only marginally for semantic fluency. Our data revealed the presence of impairment in semantic and letter fluency tasks in schizophrenic patients consistent with previous reports, and also that patients were differentially impaired on semantic categories.

Short-term memory for serial order in schizophrenia: a detailed examination of error types.

Cognitive deficits in schizophrenia have been associated with working memory problems. Schizophrenic patients (n = 24) and controls (n = 29) participated in simple short-term memory tasks, recalling a list of letters from the first to last item in the order of presentation. The authors hypothesized that deficient sequential representations would increase movement errors (e.g., ABCD being recalled as ABDC) or intrusion errors (e.g., ABCD being recalled as ABCX), whereas simple trace decay would lead to omission errors (e.g., ABCD being recalled as ABC_). Patients made disproportionately more omissions toward the end of 6-item lists. There were no group differences in movements or intrusions as a function of serial position. Schizophrenic patients' limited short-term memory span may be due to greater forgetting during recall and not to a selective deficit in the mechanisms responsible for maintaining serial order information.

Memory for temporal order in patients with schizophrenia.

There is some evidence that memory for temporal order is a process that may be impaired independently of other forms of memory. For example, patients with Korsakoff's syndrome have been shown to have poorer temporal-order memory than other amnesic patients, despite item memory being equivalent. Patients with schizophrenia have been reported to have a variety of memory problems, although memory for the order of events has not been examined very frequently. In this study, we tested memory for temporal order in patients with schizophrenia and in control subjects. Subjects were presented with two lists of 15 words (at two different times) and were later asked to reproduce the order of each list from a random array of the words. In both versions of the test, patients with schizophrenia were impaired in placing the items in the correct temporal order. Recall and recognition of the actual words used to comprise the lists were also impaired in the schizophrenic patients. However, when recall measures were covaried, and when patients were matched with controls for recall, post-hoc group differences in temporal memory were eliminated. In contrast, covarying recognition (indexed by d' or matching for recognition) did not eliminate group differences. Therefore, although memory for temporal order is compromised in patients with schizophrenia, this deficit is highly correlated with generally poorer item-specific memory retrieval (i.e., recall). It is possible that both impairments are due to some third process that underlies and aids in the reconstruction of episodes.

Paired-associate learning and memory interference in schizophrenia.

Patients with frontal lobe damage have been shown to exhibit disproportionate impairments of second list learning as a result of interference effects. Based upon the assumption that schizophrenia is associated with frontal dysfunction, we attempted to explore how various manipulations of paired-associate learning tasks would interfere with schizophrenic patients' memory performance. Patients with schizophrenia were administered four tests of paired-associate learning, in which cue and response words were manipulated to increase interference across two study lists. In two tests of paired-associate learning (AB-AC test), cue words used in one list were repeated in a second list but were associated with different response words (e.g. lion-hunter, lion-circus). One version of this test employed moderately related word pairs and the other version employed unrelated word pairs. In the other two tests (AB-ABr test), all words used in one list were repeated in a second list but were rearranged to form new pairs. Again, one version of this test used moderately related word pairs and the other version used unrelated word pairs. We hypothesized that patients with schizophrenia would exhibit disproportionate impairment of second-list learning as a result of interference effects and that they would do especially poorly in the AB-ABr task, where the word pairs were unrelated. However, these predictions were not supported. Furthermore, it was difficult to tease apart a specific problem in list discrimination from the generally poor memory of the schizophrenic patients. We suggest that the susceptibility to these interference effects in patients with schizophrenia is not a specific problem in cognition, but rather one that is confounded by general memory problems.

The use of cognitive context in schizophrenia: an investigation.

BACKGROUND: Cognitive deficits in schizophrenia have recently been ascribed to impaired representation and use of cognitive context. Context is defined as relevant information held temporarily in mind to mediate appropriate but often non-habitual responses. METHODS: Parallel studies in a variety of cognitive domains were designed in order to explore the generality of any schizophrenic deficit in context use. In all of the tasks (a Stroop task, a Continuous Performance Task and a cued spatial location task), we examined how performance was affected by the time for which contextual information must be held in mind, and by whether context or task demands were consistent or varying between trials. It was predicted that manipulation of these variables would produce tests especially sensitive to schizophrenic attentional problems. RESULTS: Predictions were partially confirmed. Although increasing contextual demands failed in most cases to produce disproportionate slowing of performance in patients, error data were largely in line with predictions. At the same time, the data did not suggest a simple unitary context deficit. Instead, different aspects of context--the time over which contextual information must be held in mind and the consistency of context--were differentially important in different tasks. CONCLUSIONS: The cognitive impairments of schizophrenic patients cannot be simply characterized as a generalized context deficit. A more differentiated, if not task specific, picture of schizophrenic deficits is suggested.

Continuous performance test and schizophrenia: a test of stimulus-response compatibility, working memory, response readiness, or none of the above?

OBJECTIVE: Abnormalities of attention are considered the fundamental deficits in cognitive function manifested by patients with schizophrenia. The authors administered variations of two types of cognitive tasks to patients with schizophrenia (N=20) and normal comparison subjects (N=30) to test four possible cognitive mechanisms that might account for such abnormalities. METHOD: Variations of the Continuous Performance Test were used to test the four mechanisms. Stimulus-response mapping was explored by comparing results on a task in which subjects were to make a response if the word "nine" was preceded by the word "one" with results on a task in which the required response was made explicit by the stimulus (the word "ready" followed by the word "press"). The building up of a prepotent response tendency was tested by manipulating the probability with which the cue and imperative stimulus appeared (17% or 50%). The amount of working memory required to maintain contextual information was tested by using different delay intervals (1000 msec and 3000 msec). The extent to which problems in vigilance might be attributable to problems in the "motoric" component of response readiness was operationalized by having subjects perform a secondary motor task concurrent with the attentional task. RESULTS: Patients with schizophrenia performed significantly worse than the normal comparison subjects on all tasks. However, none of the four manipulations of the Continuous Performance Test tasks had a differential impact on the patients' performance speed or accuracy. In contrast, there was a significant interaction of group, delay interval, and target probability in which patients made disproportionately more omission errors at short delay intervals and at low target probabilities. CONCLUSIONS: The findings may call into question the explanatory power of certain well-known contemporary mechanistic accounts of performance on the Continuous Performance Test in patients with schizophrenia. The findings suggest that a difficulty in rapidly encoding information (i.e., constructing a representation) in certain "unengaging" situations may be at the core of deficits on tasks associated with this attentional test.

Cognitive impairment in schizophrenia is the core of the disorder.

Patients with schizophrenia exhibit an exceedingly wide range of symptoms from a variety of domains. The cardinal features are abnormal ideas (such as delusions); abnormal perceptions (such as hallucinations); formal thought disorder (as evidenced by disorganized speech); motor, volitional, and behavioral disorders; and emotional disorders (such as affective flattening or inappropriateness). In addition to these diverse, and sometimes bizarre symptoms, it has become increasingly apparent that the disorder is, to variable degrees, accompanied by a broad spectrum of cognitive impairments. This review addresses the question of whether the cognitive deficits seen in schizophrenic patients are the core features of the disorder. In other words, we explore whether schizophrenia is best characterized by symptoms or cognitive deficits (we suggest the latter) and moreover, whether there is a specific cognitive deficit profile that may assist in diagnosis. First, we discuss what the cognitive deficits are. Then we address in turn the reality, frequency, predictive validity, specificity, course and susceptibility to neuroleptic effects of these cognitive impairments. In brief, we argue that various cognitive deficits are enduring features of the schizophrenia illness, that they are not state-related and are not specific to subtypes of the illness, and, more specifically, that working memory and attention are characteristically impaired in patients with schizophrenia, irrespective of their level of intelligence. Last, we conclude that problems in these cognitive domains are at the very core of the dysfunction in this disease.

Semantic category word search impairment in schizophrenia.

Mechanisms of lexical retrieval within natural semantic categories are investigated in patients with schizophrenia. We predicted and found that schizophrenics show lexical retrieval impairments on word search tasks. Experiments are described in which subjects either scan through word lists for single target items (simple search), or search for members of a semantic category (semantic search). Two groups of subjects are employed: medicated schizophrenics, and a comparison group with similar age and premorbid intelligence. A significant between-group difference is reported (for both speed and accuracy) in semantic category search but not in simple search. It is known that many schizophrenic patients have word finding difficulties (Frith, 1992; Frith et al., 1991). Our results support the claim that in some schizophrenics at least, selective lexical-semantic parallel processing deficits may underlie word finding aberrations. It is possible that such dysfunctions reflect weakened connection strengths between units making up a lexical-semantic field (as characterised by proximity to a prototype).