The assessment of neuropsychological functioning in schizophrenia

Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. The neuropsychological profile is typically characterized by prominent specific deficits in memory and learning, working memory, executive functions, attention, and processing speed, which are evident on a background of a generalized cognitive deficit. This paper provides a review of studies of neuropsychological functioning in schizophrenia. The main cognitive ability areas affected in schizophrenia are described, and the degree of impairment in each ability area as found in studies of schizophrenia patients is summarized, based on meta-analytic findings. Recent studies that have compared neuropsychological functioning across psychotic disorders are presented, and finally, neuropsychological assessment batteries specifically developed for schizophrenia are introduced.

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Cognitive impairment from early to middle adulthood in patients with affective and nonaffective psychotic disorders

Psychological Medicine ◽

10.1017/s0033291718003938 ◽

2019 ◽

Vol 50 (1) ◽

pp. 48-57 ◽

Cited By ~ 3

Author(s):

Josephine Mollon ◽

Samuel R. Mathias ◽

Emma E. M. Knowles ◽

Amanda Rodrigue ◽

Marinka M. G. Koenis ◽

...

Keyword(s):

Working Memory ◽

African American ◽

Cognitive Impairment ◽

Executive Function ◽

Cognitive Functioning ◽

Cognitive Ability ◽

Processing Speed ◽

Psychotic Disorders ◽

General Cognitive Ability ◽

Middle Adulthood

AbstractBackgroundCognitive impairment is a core feature of psychotic disorders, but the profile of impairment across adulthood, particularly in African-American populations, remains unclear.MethodsUsing cross-sectional data from a case–control study of African-American adults with affective (n = 59) and nonaffective (n = 68) psychotic disorders, we examined cognitive functioning between early and middle adulthood (ages 20–60) on measures of general cognitive ability, language, abstract reasoning, processing speed, executive function, verbal memory, and working memory.ResultsBoth affective and nonaffective psychosis patients showed substantial and widespread cognitive impairments. However, comparison of cognitive functioning between controls and psychosis groups throughout early (ages 20–40) and middle (ages 40–60) adulthood also revealed age-associated group differences. During early adulthood, the nonaffective psychosis group showed increasing impairments with age on measures of general cognitive ability and executive function, while the affective psychosis group showed increasing impairment on a measure of language ability. Impairments on other cognitive measures remained mostly stable, although decreasing impairments on measures of processing speed, memory and working memory were also observed.ConclusionsThese findings suggest similarities, but also differences in the profile of cognitive dysfunction in adults with affective and nonaffective psychotic disorders. Both affective and nonaffective patients showed substantial and relatively stable impairments across adulthood. The nonaffective group also showed increasing impairments with age in general and executive functions, and the affective group showed an increasing impairment in verbal functions, possibly suggesting different underlying etiopathogenic mechanisms.

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Genetics of Cognition: Outline of a Collaborative Twin Study

Twin Research ◽

10.1375/twin.4.1.48 ◽

2001 ◽

Vol 4 (1) ◽

pp. 48-56 ◽

Cited By ~ 77

Author(s):

Margie Wright ◽

Eco De Geus ◽

Juko Ando ◽

Michelle Luciano ◽

Danielle Posthuma ◽

...

Keyword(s):

Working Memory ◽

Individual Differences ◽

The Netherlands ◽

Cognitive Ability ◽

Processing Speed ◽

Twin Study ◽

Memory Task ◽

Inspection Time ◽

Phenotypic Correlation ◽

Spatial Span

AbstractAmultidisciplinary collaborative study examining cognition in a large sample of twins is outlined. A common experimental protocol and design is used in The Netherlands, Australia and Japan to measure cognitive ability using traditional IQ measures (i.e., psychometric IQ), processing speed (e.g., reaction time [RT] and inspection time [IT]), and working memory (e.g., spatial span, delayed response [DR] performance). The main aim is to investigate the genetic covariation among these cognitive phenotypes in order to use the correlated biological markers in future linkage and association analyses to detect quantitativetrait loci (QTLs). We outline the study and methodology, and report results from our preliminary analyses that examines the heritability of processing speed and working memory indices, and their phenotypic correlation with IQ. Heritability of Full Scale IQ was 87% in the Netherlands, 83% in Australia, and 71% in Japan. Heritability estimates for processing speed and working memory indices ranged from 33–64%. Associations of IQ with RT and IT (−0.28 to −0.36) replicated previous findings with those of higher cognitive ability showing faster speed of processing. Similarly, significant correlations were indicated between IQ and the spatial span working memory task (storage [0.31], executive processing [0.37]) and the DR working memory task (0.25), with those of higher cognitive ability showing better memory performance. These analyses establish the heritability of the processing speed and working memory measures to be used in our collaborative twin study of cognition, and support the findings that individual differences in processing speed and working memory may underlie individual differences in psychometric IQ.

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Neuropsychological Profile of Lifetime Traumatic Brain Injury in Older Veterans

Journal of the International Neuropsychological Society ◽

10.1017/s1355617716000849 ◽

2016 ◽

Vol 23 (1) ◽

pp. 56-64 ◽

Cited By ~ 13

Author(s):

Allison R. Kaup ◽

Carrie Peltz ◽

Kimbra Kenney ◽

Joel H. Kramer ◽

Ramon Diaz-Arrastia ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Working Memory ◽

Brain Injury ◽

Executive Functioning ◽

Processing Speed ◽

Executive Dysfunction ◽

Structured Interview ◽

Cognitive Domain ◽

Neuropsychological Profile ◽

Adjusted Model

AbstractObjectives:The aim of this study was to characterize the neuropsychological profile of lifetime traumatic brain injury (TBI) in older Veterans.Methods:Participants were 169 older Veterans [mean age=79.1 years (range, 51–97 years), 89% male, 92% Caucasian], 88 with lifetime TBI and 81 without TBI, living in Veterans’ retirement homes in independent residence. TBI history was ascertained with the Ohio State TBI Identification Method structured interview. Cognition was assessed with neuropsychological tests: Raw scores were converted toZ-scores compared to age-corrected normative data and combined into five domain compositeZ-scores (attention/working memory, learning/memory, language, processing speed, executive functioning). We investigated the association between TBI and performance in each cognitive domain in linear mixed effects models, with and without adjustment for demographics, medical comorbidities, and psychiatric variables.Results:Compared to those without TBI, older Veterans with TBI had greater deficits in processing speed (estimate=−.52;p=.01;f2=.08 in fully adjusted model) and executive functioning (estimate=−.41;p=.02;f2=.06 in fully adjusted model) but performed similarly in the attention/working memory, learning/memory, and language domains (allp>.05). TBI-associated deficits were most prominent among individuals with multiple mild TBIs and those with any moderate-to-severe TBI, but were not clearly present among those with single mild TBI.Conclusions:The neuropsychological profile of lifetime TBI in older Veterans is characterized by slowed processing speed and executive dysfunction, especially among those with greater injury burden. This pattern may reflect long-standing deficits or a TBI-associated cognitive decline process distinct from Alzheimer’s disease. (JINS, 2017,23, 56–64)

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Decreased working memory and processing speed mediate cognitive impairment in geriatric depression

Psychological Medicine ◽

10.1017/s0033291799001968 ◽

2000 ◽

Vol 30 (3) ◽

pp. 679-691 ◽

Cited By ~ 159

Author(s):

R. D. NEBES ◽

M. A. BUTTERS ◽

B. H. MULSANT ◽

B. G. POLLOCK ◽

M. D. ZMUDA ◽

...

Keyword(s):

Working Memory ◽

Episodic Memory ◽

Processing Speed ◽

Neuropsychological Functioning ◽

Hierarchical Regression ◽

Geriatric Depression ◽

Information Processing Speed ◽

Neuropsychological Dysfunction ◽

Depressed Patients ◽

Processing Resources

Background. While neuropsychological dysfunction is common in geriatric depression, not all aspects of cognition are equally affected. It has been suggested that depressed patients are impaired only in tasks that make heavy demands on processing resources and that a resource decrement therefore underlies the neuropsychological decrements seen in geriatric depression. The present study examined whether processing resources in the form of working memory and information processing speed are decreased in depression and whether a decrease in these resources actually mediates neuropsychological impairment.Methods. Measures of processing resources were administered to elderly depressed patients prior to treatment and to age-matched controls. Patients whose depression remitted were retested as were the controls. Subjects also received neuropsychological tests of episodic memory and visuospatial performance.Results. Depressed patients performed significantly worse on measures of both processing speed and working memory. While performance on these measures improved in patients whose depression remitted, the amount of improvement was no greater than that seen in the controls with repeat testing. Hierarchical regression analyses showed that depression explained a significant amount of variance on the neuropsychological tasks. However, if the variance associated with processing resources was removed first, depression no longer accounted for a significant amount of neuropsychological variance.Conclusions. Processing resources are decreased in elderly depressed patients and this decrease in resources appears to mediate impairments in several areas of neuropsychological functioning including episodic memory and visuospatial performance. The resource decrement persists after remission of the depression and thus may be a trait marker of geriatric depression.

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Understanding the Cognition Related to Mathematics Difficulties: A Meta-Analysis on the Cognitive Deficit Profiles and the Bottleneck Theory

Review of Educational Research ◽

10.3102/0034654317753350 ◽

2018 ◽

Vol 88 (3) ◽

pp. 434-476 ◽

Cited By ~ 18

Author(s):

Peng Peng ◽

Cuicui Wang ◽

Jessica Namkung

Keyword(s):

Working Memory ◽

Executive Functions ◽

Cognitive Deficits ◽

Processing Speed ◽

Phonological Processing ◽

Cognitive Deficit ◽

Short Term Memory ◽

Short Term ◽

Term Memory ◽

Mathematics Difficulties

The current study investigated the cognitive deficit profiles among individuals with mathematics difficulties (MD) and potential moderators and mechanism for these profiles. Seventy-five cognitive profiling studies on MD were included, representing a total of 13,001 individuals and 126 independent samples. Results showed that compared with typically developing individuals, individuals with MD showed deficits (from most severe to less severe) in phonological processing, processing speed, working memory, attention, short-term memory, executive functions, and visuospatial skills. Moderation analyses indicated that comorbidity (with reading disabilities) and types of MD screening affected the cognitive deficits. Severity of MD was related to processing speed deficits. Deficits in phonological processing and attention were more severe in younger individuals with MD. Deficits in processing speed and working memory were most severe in the numerical domain. Deficits in low-level cognitive skills (i.e., processing speed and short-term memory) could not completely explain the deficits in high-level skills (i.e., working memory, attention, and executive functions), partially supporting the bottleneck theory. These findings, taken together, suggest that (a) deficits in processing speed and working memory are most salient and stable cognitive markers of MD, (b) numerical-processing deficit and the cognitive deficits of MD are relatively independent from each other, and (c) MD may be a discrete construct with heterogeneity reflected by MD subtypes and age. Implications for incorporating cognition in the diagnosis and the interventions for MD are discussed.

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Polygenic scores for schizophrenia and general cognitive ability: associations with six cognitive domains, premorbid intelligence, and cognitive composite score in individuals with a psychotic disorder and in healthy controls

Translational Psychiatry ◽

10.1038/s41398-020-01094-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Magnus Johan Engen ◽

Siv Hege Lyngstad ◽

Torill Ueland ◽

Carmen Elisabeth Simonsen ◽

Anja Vaskinn ◽

...

Keyword(s):

Working Memory ◽

Cognitive Ability ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Cognitive Impairments ◽

Genetic Correlations ◽

Healthy Controls ◽

General Cognitive Ability ◽

Cognitive Domains ◽

Polygenic Scores

AbstractCognitive impairments are considered core features in schizophrenia and other psychotic disorders. Cognitive impairments are, to a lesser degree, also documented in healthy first-degree relatives. Although recent studies have shown (negative) genetic correlations between schizophrenia and general cognitive ability, the association between polygenic risk for schizophrenia and individual cognitive phenotypes remains unclear. We here investigated the association between a polygenic score for schizophrenia (SCZPGS) and six well-defined cognitive domains, in addition to a composite measure of cognitive ability and a measure of premorbid intellectual ability in 731 participants with a psychotic disorder and 851 healthy controls. We also investigated the association between a PGS for general cognitive ability (COGPGS) and the same cognitive domains in the same sample. We found no significant associations between the SCZPGS and any cognitive phenotypes, in either patients with a psychotic disorder or healthy controls. For COGPGS we observed stronger associations with cognitive phenotypes in healthy controls than in participants with psychotic disorders. In healthy controls, the association between COGPGS (at the p value threshold of ≥0.01) and working memory remained significant after Bonferroni correction (β = 0.12, p = 8.6 × 10−5). Altogether, the lack of associations between SCZPGS and COGPGS with cognitive performance in participants with psychotic disorders suggests that either environmental factors or unassessed genetic factors play a role in the development of cognitive impairments in psychotic disorders. Working memory should be further studied as an important cognitive phenotype.

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Comparison of the touch-screen and traditional versions of the Corsi block-tapping test in patients with psychosis and healthy controls.

10.21203/rs.2.17557/v1 ◽

2019 ◽

Author(s):

Sara Siddi ◽

Antonio Preti ◽

Elvira Lara ◽

Gildas Brébion ◽

Regina Vila ◽

...

Keyword(s):

Working Memory ◽

Cognitive Deficit ◽

Psychotic Disorders ◽

Standard Procedure ◽

Verbal Working Memory ◽

Healthy Controls ◽

Visuospatial Working Memory ◽

Digital Version ◽

Significant Effort ◽

Corsi Test

Abstract Working memory (WM) refers to the capacity system for temporary storage and processing of information, which is known to depend on the integrity of the prefrontal cortex. Impairment in working memory is a core cognitive deficit among individuals with psychotic disorders. The Corsi block-tapping test is a widely used instrument to assess visuospatial working memory. The traditional version is composed of 9 square blocks positioned on a physical board. In recent years, the number of digital instruments has increased significantly; several advantages might derive from the use of a digital version of the Corsi test. This study aimed to compare the digital and traditional versions of the Corsi test in 45 patients with psychotic disorders and 45 healthy controls. Both groups completed a neuropsychological assessment involving attention and working memory divided into two conditions. Results were consistent between the traditional and digital versions of the Corsi test. Overall, patients performed worse relative to the healthy comparison group. The traditional Corsi test was positively related to intelligence and verbal working memory, probably due to a more significant effort to execute the test. The digital version is able to discriminate between patients with psychosis and healthy controls. It would be of use in determining who is at risk of developing a psychotic disorder, and in those already with psychosis, it might provide a prognostic marker for future functional outcome. Further, it is easy to administer while ensuring a standard procedure.

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The neuropsychological profile of children at high risk of developing an eating disorder

Psychological Medicine ◽

10.1017/s0033291712002188 ◽

2012 ◽

Vol 43 (7) ◽

pp. 1543-1554 ◽

Cited By ~ 27

Author(s):

R. Kothari ◽

F. Solmi ◽

J. Treasure ◽

N. Micali

Keyword(s):

Working Memory ◽

Anorexia Nervosa ◽

High Risk ◽

Attentional Control ◽

Neuropsychological Functioning ◽

Large Body ◽

Neuropsychological Profile ◽

Intermediate Phenotypes ◽

High Intelligence ◽

And Performance

BackgroundThere is a large body of evidence indicating that eating disorders (EDs) are characterized by particular neuropsychological profiles. We aimed to further explore whether impairments in neuropsychological functioning previously found in ED groups are present prior to onset, or are secondary to the disorder.MethodThis is the first study to explore neuropsychological functioning in children born to a mother with a lifetime ED, who are therefore at high risk of developing an ED, in a large cohort sample. We investigated intelligence and attention at age 8 years (n = 6201) and working memory (WM) and inhibition at age 10 years (6192) in children who are at high risk of developing an ED, compared to children who are not.ResultsThe children of women with lifetime anorexia nervosa (AN) showed high full-scale and performance IQ, increased WM capacity, better visuo-spatial functioning, and decreased attentional control. The children of women with lifetime bulimia nervosa (BN) showed comparatively poor visuo-spatial functioning.ConclusionsOur findings suggest that high intelligence, increased WM capacity and impaired attentional control might be intermediate phenotypes on the pathway between genetic vulnerability and the development of an ED.

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Working Memory, Processing Speed, and Memory Functioning Are Minimally Predictive of Victoria Symptom Validity Test Performance

Assessment ◽

10.1177/1073191120911102 ◽

2020 ◽

pp. 107319112091110

Author(s):

Zachary J. Resch ◽

Jason R. Soble ◽

Gabriel P. Ovsiew ◽

Liliam R. Castillo ◽

Kevin F. Saladino ◽

...

Keyword(s):

Working Memory ◽

Cognitive Ability ◽

Processing Speed ◽

Verbal Memory ◽

Test Performance ◽

Symptom Validity ◽

Memory Processing ◽

Validity Test ◽

Victoria Symptom Validity Test ◽

Symptom Validity Test

A sound performance validity test is accurate for detecting invalid neuropsychological test performance and relatively insensitive to actual cognitive ability or impairment. This study explored the relationship of several cognitive abilities to several performance indices on the Victoria Symptom Validity Test (VSVT), including accuracy and response latency. This cross-sectional study examined data from a mixed clinical sample of 88 adults identified as having valid neurocognitive test profiles via independent validity measures, and who completed the VSVT along with objective measures of working memory, processing speed, and verbal memory during their clinical neuropsychological evaluation. Results of linear regression analyses indicated that cognitive test performance accounted for 5% to 14% of total variance for VSVT performance across indices. Working memory was the only cognitive ability to predict significant, albeit minimal, variance on the VSVT response accuracy indices. Results show that VSVT performance is minimally predicted by working memory, processing speed, or delayed verbal memory recall.

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Neuropsychological functioning in adolescents with first episode psychosis: A two-year follow-up study

European Psychiatry ◽

10.1016/j.eurpsy.2008.01.1420 ◽

2008 ◽

Vol 23 (5) ◽

pp. 375-383 ◽

Cited By ~ 34

Author(s):

M. Mayoral ◽

A. Zabala ◽

O. Robles ◽

I. Bombín ◽

P. Andrés ◽

...

Keyword(s):

Working Memory ◽

Executive Function ◽

Cognitive Functioning ◽

Learning And Memory ◽

Psychotic Disorders ◽

Neuropsychological Functioning ◽

Pathological Process ◽

First Episode ◽

Cognitive Domains

AbstractCognitive deficits are a core feature of psychotic disorders. Both in adult and adolescent populations, studies have shown that patients with psychosis have poorer cognitive functioning than controls. The cognitive domains that seem to be affected are mainly attention, working memory, learning and memory, and executive function. However, with regard to the trajectory of cognitive function throughout the illness, there is still a dearth of prospective data in patients who develop psychosis during adolescence. In this article, neuropsychological functioning was assessed in a sample of 24 first episodes of early onset psychosis (EOP) and 29 healthy adolescents at baseline and after a two-year follow-up. Patients with EOP showed lower scores than controls in overall cognitive functioning and in all specific domains assessed (attention, working memory, executive function, and learning and memory) both at baseline and the two-year follow-up. When changes in cognitive functioning over two years were assessed, patients and controls showed significant improvement in almost all cognitive domains. However, this improvement disappeared in the patient group after controlling for improvement in symptomatology. Our findings support a neurodevelopmental pathological process in this sample of adolescents with psychosis.

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