Self-Disorders, Neurocognition and Rationality in Schizophrenia: A Preliminary Study

Abstract

Background/Aims: Although the very idea that the generative disorder in schizophrenia is a disturbance of the self is as old as the schizophrenia concept itself, empirical studies have only recently emerged, documenting that anomalous self-experiences (i.e. self-disorders, SDs) aggregate in schizophrenia spectrum disorders but not in other mental disorders. The aim of this study is to explore potential associations between SDs, neurocognitive performance, rationality and IQ in patients with schizophrenia. Methods: The sample comprises 31 patients diagnosed with schizophrenia (DSM-IV). All patients underwent comprehensive evaluation. SDs were assessed with the Examination of Anomalous Self-Experience scale. Neurocognitive performance was measured with 4 PC-implemented subtests from the Cambridge Neuropsychological Test Automated Battery. Rationality was measured using syllogism tests. The IQ was indexed by a summary score of 4 IST-2000-R computerized subtests. Results: No correlation was found between SDs and neurocognitive performance or between SDs and IQ. SDs were found to correlate with rationality. Neurocognitive performance correlated with rationality, and both correlated with IQ, respectively. Conclusions: The lack of correlation between SDs and neurocognitive performance is consistent with the results from the only previous study exploring this issue, suggesting that SDs depict something essential to schizophrenia, whereas neurocognitive impairment does not. The correlation between SDs and rationality indicates that the syllogism tests reflect something central for schizophrenia, but the result needs further corroboration from larger, empirical studies.

Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia

“…These findings are all consistent with the notion of a failure to make accurate "topdown" predictions based on contextual information (drawing on memory-based processes) and an overreliance on lower level perceptual processing. It is interesting, then, that schizophrenia patients show a pattern of superior performance on several kinds of tasks in which standard expectations/predictions normally cause a decline in performance: 1, recognition of unlikely scenes shown tachistoscopically [92]; 2, a tendency to be more "logical" when logic requires the ignoring of practical context [110], although contrasting results have been reported by Nordgaard and colleagues [44]; 3, greater accuracy in discerning a concave mask, as described above, or in which attention to larger Gestalt factors might be misleading [111][112][113]; and 4, more accurate perception of speech when paired with video footage of incongruous facial movements (the McGurk effect) [114] .…”

Basic self‐disturbance, neurocognition and metacognition: A pilot study among help‐seeking adolescents with and without attenuated psychosis syndrome

“…Similarly, 2 recent studies with prodromal (Schultze-Lutter et al, 2007) and chronic schizophrenia patients (Zanello & Huguelet, 2001) failed to replicate the findings of a previous study (Cuesta, Peralta, & Juan, 1996) that found correlations between "basic symptoms," which have a significant overall correlation with SD, and neurocognition. This lack of evidence for an association between SD and neurocognition might suggest that the 2 phenomena represent different qualities of schizophrenia (Nordgaard et al, 2015). Nevertheless, in a recent series of theoretical papers, Nelson and colleagues (Nelson, Whitford, Lavoie, & Sass, 2014a;Nelson, Whitford, Lavoie, & Sass, 2014b) theorized that the lack of association was a result of a poor selection of neurocognitive tests.…”

“…However, to date, only a few studies addressed the relationship between these two phenomena. Interestingly, the only two studies that examined this association among first‐episode (Haug et al, ) and chronic schizophrenia patients (Nordgaard, Revsbech, & Henriksen, ) found few and rather weak correlations between SD and neurocognitive measures. Similarly, 2 recent studies with prodromal (Schultze‐Lutter et al, ) and chronic schizophrenia patients (Zanello & Huguelet, ) failed to replicate the findings of a previous study (Cuesta, Peralta, & Juan, ) that found correlations between “basic symptoms,” which have a significant overall correlation with SD, and neurocognition.…”

Clinical Manifestations of Self-disorders in Schizophrenia Spectrum Conditions

“… Self-disorders hyper-aggregate in schizophrenia spectrum disorders but not in other mental disorders [39][40][41][42][43]  There is no statistical difference in the level of selfdisorders among patients with schizophrenia and patients with the schizotypal disorder [41,43]  Self-disorders differentiate between first-admitted cases with bipolar psychosis and schizophrenia [42] and self-disorders occur more frequently in residual schizophrenia than in remitted bipolar psychosis [44]  Self-disorders occur in genetically high-risk individuals [45]  Self-disorders are detectable in community samples of adolescent diagnosed as suffering from "at-risk mental state" [46] and in clinical samples of young adults at Clinical High Risk for psychosis [47]  Prospective studies indicate that self-disorders predict transition to psychosis in an Ultra-High Risk for psychosis sample [48] and that high baseline scores of self-disorders predict later transition to a schizophrenia spectrum diagnosis [49,50]  Positive correlations have been found between self-disorders and positive symptoms, negative symptoms, formal thought disorders, and perceptual disturbances, respectively [43]  Correlations have been found between selfdisorders and social dysfunction [51] and suicidality [52,53], respectively  No correlations have been found between selfdisorders and IQ or neurocognitive measures [43,54,55], except for impaired verbal memory [54]  Self-disorders have been found to be temporarily stable over a 5-year period [56] …”