Abstracts / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279
193 – CLOSING THE GAP BETWEEN NEUROCOGNITION AND REAL-WORLD FUNCTIONING IN SCHIZOPHRENIA: METACOGNITION AS A CRUCIAL BRIDGE Dan Koren 1,2 , Anthony J. Giuliano 2 , Larry J. Seidman 2 , Polina Viksman 4 , Michael Poyurovsky 3 1 Psychology Department, University of Haifa, Haifa, Israel; 2 The Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center Department of Psychiatry, Harvard Medical School; 3 Research Unit, Tirat Ha’Carmel Mental Health Center, Tirat Ha’Carmel, Israel; 4 University of Haifa, Haifa, Israel [email protected]
Introduction: While the role of impaired neurocognition in accounting for real-world social functioning in schizophrenia is generally established by now, the overlap is far from complete. Moreover, little is known about the potential mechanisms that bridge between (both social and non-social) cognition and functional outcome. The aim of this study was to aid in closing this gap by developing and validating a novel, more ecologically valid approach for assessment of neurocognitive and social-cognitive deﬁcits in schizophrenia. The current study was motivated by the view that metacognitive processes of self-monitoring (the process by which subjects routinely assess the accuracy of their knowledge) and self-directed action (the degree to which these assessments affect their decision to actually report an answer and at what level of elaboration) are fundamental determinants of competent functioning in the real world. Based on preliminary pilot data (Koren et al., 2004; Koren et al., 2005), we hypothesized that: (1) both the concurrent and longitudinal prediction of impaired social functioning will be signiﬁcantly improved when adding to conventional measures of cognitive and social-cognitive abilities (“performance quantity”), measures of how much the products of these processes can be trusted (“performance accuracy”), which depend on metacognitive processes of self-monitoring and self-directed action; and, (2), metacognitive abilities will be more sensitive to changes in clinical (particularly, psychotic) symptoms. Methods: To assess these hypotheses, a novel metacognitive approach was adapted for use with conventional tasks in three areas: executive functioning, verbal memory, and theory of mind (ToM). The tasks were administered to a group of 45 schizophrenia patient s upon admission and six months later. Patients were examined at both baseline and follow-up assessments with symptom ratings and measures of social adjustment. Results: Our results showed that change in metacognition is a better predictor of functional outcome following symptomatic stabilization than change in cognitive functioning. Conclusions: These results suggest that: (1) metacognitive factors play an important role in real-world outcome over and beyond that of cognitive abilities per se; and, (2) remediation efforts, both pharmacological and behavioral, should be targeted at this level of cognitive functioning. Acknowledgements: This study was supported by a grant from the Israel National Institute for Psychobiology. References  Koren D, Seidman LJ, Poyurovsky M, et al. The neuropsychological basis of insight in ﬁrst-episode schizophrenia: a pilot metacognitive study. Schizophr Res. Oct 1 2004;70(2-3):195-202.  Koren D, Poyurovsky M, Seidman LJ, Goldsmith M, Wenger S, Klein EM. The neuropsychological basis of competence to consent in ﬁrst-episode schizophrenia: a pilot metacognitive study. Biol Psychiatry. Mar 15 2005;57(6):609-616.
194 – VISUAL PROCESSING OF SPATIAL FREQUENCIES IN SCHIZOPHRENIA: LIVING IN A BLURRED WORLD? Vincent Laprevote CNRS UMR 8160 Laboratoire de Neurosciences Fonctionnelles et Pathologies, Lille, France [email protected]
Introduction: Visual processing impairments have been largely observed in schizophrenia. Several studies have proposed a dysfunction of the magno- and parvocellular pathways (Butler & al., 2005), involved respectively in the processing of low- and high-spatial frequencies (LSF and HSF). In healthy controls, the selection of frequency bands for fast image recognition is a ﬂexible mechanism: it depends on viewing conditions and task (Schyns & al., 1999). We used hybrids stimuli to test the hypothesis that visual dysfunctions may impair the processing of spatial frequencies in schizophrenia. Methods: Fifteen patients with schizophrenia and 15 healthy controls performed 2 experiments. In experiment 1, they performed a recognition task with hybrids stimuli, combining an image in HSF scale and another image in LSF scale. Because the 2 images were different, the response allowed us to infer which spatial scale was preferentially perceived. In experiment 2, participants performed the same task with ﬁltered stimuli, presenting a single image ﬁltered on HSF or LSF. Results: We observed with hybrid stimuli a LSF bias for patients with schizophrenia whereas healthy controls presented a HSF bias. In experiment 2, there was no signiﬁcant difference between performances of patients with schizophrenia in LSF or HSF. Conclusions: These results indicate a preferential LSF processing in schizophrenia (experiment 1) and this preferential processing is not due to a HSF perception deﬁcit (experiment 2). These results cannot be explained by a magnocellular perceptual deﬁcit but suggest a higher-order deﬁcit involving integrated magno- and parvocellular information. References  Butler, P. and Javitt, D.C., 2005. Early-stage visual processing deﬁcits in schizophrenia. Current Opinion in Psychiatry. 18, 151-157.  Schyns, P.G. and Oliva, A., 1999. Dr Angry and Mr. Smile: when categorization ﬂexibly modiﬁes the perception of faces in rapid visual presentation. Cognition. 69, 243-265.
195 – RELATIONS BETWEEN A COMPUTERISED SHOPPING TASK AND COGNITIVE TESTS IN SCHIZOPHRENIA PATIENTS COMPARED TO HEALTHY CONTROLS Frank Laroi 1 , Jennifer Canlaire 2 , Haitham Mourad 2 , Marc-André Domken 2 , Martial Van der Linden 3 1 University of Liège; Centre Hospitalier Psychiatrique, Liege; 2 CHP, Liege; 3 University of Liège, Liege, Belgium ﬂ[email protected]
Introduction: Cognitive deﬁcits are clearly associated with poor social functioning in schizophrenia patients. However, previous studies have primarily used questionnaires to assess social functioning. Methods: In the present study, we developed a computerized real-life activity task (shopping task), where participants are required to shop for a list of 7 grocery store items. Thirty patients with schizophrenia and 30 healthy controls were administered an extensive battery of cognitive tests and the computerized shopping task. Results: Performance on the computerized shopping task signiﬁcantly differentiated patients and healthy controls for the following variables: total time to complete the task, number of correct articles chosen, aisle redundancy (number of times in the same grocery aisle), and number of times participants consulted the shopping list. Moreover, these variables correlated signiﬁcantly with speciﬁc cognitive functions: total time to complete the task with ﬂexibility and processing speed; number of correct articles chosen with verbal memory, processing
Abstracts / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279 speed, attention, and executive functions; aisle redundancy with verbal memory and attention; and number of times participants consulted the shopping list with working memory and processing speed. Conclusions: These ﬁndings suggest that the computerized task used in the present study provides a valid and precise indication of the level of cognitive and social functioning of patients with schizophrenia, and therefore may be viewed as a valuable instrument in both an evaluation and remediation context. Further research is needed relates performance on this computerized shopping task with social functioning and outcome measures. References  Rempfer et al. (2003). The relations between cognition and the independent living skill of shopping in people with schizophrenia. Psychiatry Research, 117, 103-112.  Semkovska et al. (2004). Assessment of executive dysfunction during activities of daily living in schizophrenia. Schizophrenia Research, 69, 289-300
196 – IS RECIPROCITY IMPAIRED IN SCHIZOPHRENIA: AN ANALYSIS OF NATURALISTIC SOCIAL INTERACTION Mary Lavelle, Rosemarie McCabe, Patrick G.T Healey Queen Mary University of London, London, UK [email protected]
Introduction: Impaired social functioning is documented as a hallmark of schizophrenia (Hyronemus et al. 1998). Previous analyses of naturalistic interaction in schizophrenia has explored patients’ ability to understand the mental states of others, known as Theory of Mind (ToM). Although people with schizophrenia consistently show deﬁcits on experimental ToM tasks, detailed analysis of pat ient’s ToM skills during routine clinical consultations and cognitive behaviour therapy sessions showed no such deﬁcit (McCabe et al., 2004). Hence, there is an issue of the transferability of performance on experimental tests in the laboratory to everyday social skills and interaction. The aim of the present study was to investigate patient’s social skills in interaction. We focus here on one aspect of reciprocity known as interactional synchrony as previous research indicates it may be im paired in schizophrenia (Condon and Ogston, 1966). Methods: Patients’ naturally occurring interactions were audiovisually recorded in an Augmented Human Interaction (AHI) laboratory at Queen Mary, University of London and compared with healthy controls. The laboratory is equipped with 3-D motion capture equipment, which consists of 12, high-resolution infrared cameras, which track small reﬂective markers attached to participants’ clothing. This provides a 3-D clip of interaction allowi ng in-depth analysis of all verbal and non-verbal behaviour. Results: Patients displayed deﬁcits in social interaction when compared to age and sex matched controls. This study emphasises the need for social interaction research t o be conducted within naturalistic settings and high-lights the potential of utilising 3-D motion capture to analyse micro aspects of interaction that may be pathological in the ﬁeld of mental health research. Figure 1 Audio visually recorded Figure 2 Capture reconstructed from the interaction in the AHI lab motion capture equipment References  Couture, M.S., Penn, D.L., Roberts, D.L. (2006)The functional signiﬁcance of social cognition in schizophrenia: A review. Schizophrenia Bulletin. Vol 32(1)pp.44-63.  Condon, W.S., Ogston, W.D. (1966). Sound ﬁlm analysis of normal and pathological beh aviour patterns. The Journal of Nervous and Mental Disease. Vol 143 (1)pp.338-347.  Hyronemus Ihnen, G., Penn, D.L., Corrigan, P.W., Martin, J.(1998). Social perception and social skill in schizophrenia. Psychiatry Research. Vol 80 (3)pp. 275-286.
197 – FACIAL AFFECT RECOGNITION DEFICITS AND SOCIAL DYSFUNCTION IN SCHIZOPHRENIC PATIENTS Shi-Kai Liu Depatment of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan [email protected]
Introduction: Despite that affect recognition has been related to social functioning in schizophrenia, whether the relationship is independent of neurocognitive deﬁcits and clinical symptoms remains undetermined. This study aimed to explore the their hierachical interrelationships in schizophrenic patients at different disease stages Methods: Subjects included 40 acute remitting inpatients, 33 stabilized community-dwelling outpatients, and 40 healthy comparison subjects matched for age, sex, and education. Social functioning was assessed using the Personal and Social Performance Scale (P SP), affect recognition using the Taiwanese version of Diagnostic Analysis of Non-Verbal Accuracy-II (DANVA2-TW), and neurocognitive performances including visual-spatial working memory, sustained attention, selective attention, mental ﬂexibility and intellectual ability. Correlational analyses and general linear models were used to explore the interrelationships between affect recognition, social function, neurocognition and clinical symptoms. Results: For acute patients, affect recognition correlated with basic neurocognitive abilities but not with social dysfunction. In contrast, for stabilized patients, affect recognition contributed to impaired social role performances, self-care, and global social functioning independent of basic neurocognitive abilities and negative symptoms. Among basic neurocognitive abilities, visual-spatial working memory was the most important determinant of social functioning. Conclusions: We concluded that affect recognition deﬁcits were speciﬁc deﬁcits rather than part of a generalized neurocognitive dysfunction in stabilized schizophrenia and hence affect recognition deﬁcits should be speciﬁcally assessed in the remission phas e of schizophrenia for further treatment planning.
198 – FAMILIARITY AND RECOLLECTION IN SCHIZOPHRENIA Clara Martin 1 , Nicolas Franck 1 , Caroline Huron 2 , Guy Tiberghien 1 Lyon; 2 INSERM, Strasbourg, France [email protected]
Introduction: Recognition memory may be based either on feelings of familiarity or on conscious recollection of information. Two procedures are commonly used to experimentally investigate recollection and familiarity: In the remember-know (RK) procedure, participants are asked to decide if they remember (recollection) or know (familiarity) a recognized item. In the receiving operating characteristic (ROC) procedure, participants have to rate their conﬁdence for each recognized and non recognized item. Recollection and familiarity are mathematically estimated from this rating. Although recollection is consistently impaired in schizophrenia, the results from RK and ROC studies of familiarity are less congruent. To clarify the contribution of familiarity in schizophrenia, we compared word and face recognition estimated with the RK or ROC procedure in the same subjects. Methods: Twenty ﬁve schizophrenic patients and 25 healthy subjects were recruited. In the study phase, subjects were asked to make a gender decision on 64 unfamiliar faces. In the recognition task, the 64 faces from the study list were intermixed with 64 new faces. Subjects were asked to respond ‘yes’ to old faces and ‘no’ to new faces and to give a remember-know response (RK) or to rate their conﬁdence (ROC). The same procedure was used in a word recognition task. Results: RK and ROC procedure comparison revealed that these two methods are not equivalent and are not affected by experimental factors in the same way. Conclusions: This study revealed that the impairment of familiarity in schizophrenia might depend on the procedure and material used to measure the recognition process.