Visual form perception: A comparison of individuals at high risk for psychosis, recent onset schizophrenia and chronic schizophrenia

Abstract

Schizophrenia has been associated with deficits in visual perception and processing, but there is little information about their temporal development and stability. We assessed visual form perception using the Rorschach Comprehensive System (RCS) in 23 individuals at clinical high risk for psychosis, 15 individuals with recent onset schizophrenia (< or =2 years since onset), and 34 with chronic schizophrenia (> or =3 years since onset). All three groups demonstrated reduced conventional form perception (X+%), as compared with published norms, but did not differ significantly from one another. In contrast, the high-risk group had significantly better performance on an index of clarity of conceptual thinking (WSUM6) compared to the chronic schizophrenia patients, with the recent onset group scoring intermediate to the high-risk and chronic schizophrenia groups. The results suggest that individuals at clinical high risk for psychosis display substantial deficits in visual form perception prior to the onset of psychosis and that these deficits are comparable in severity to those observed in individuals with schizophrenia. Therefore, visual form perception deficits may constitute a trait-like risk factor for psychosis in high-risk individuals and may potentially serve as an endophenotype of risk for development of psychosis. Clarity of conceptual thinking was relatively preserved among high-risk patients, consistent with a relationship to disease expression, not risk. These deficits are discussed in the context of the putative neurobiological underpinnings of visual deficits and the developmental pathophysiology of psychosis in schizophrenia.

Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective

“…van Rijn et al (2011) described deficits in face emotion processing in CHR individuals in the context of otherwise normal basic face perception (van Rijn et al 2011), suggesting relative preservation of occipital relative to temporal face regions as in schizophrenia (Butler et al 2008). Furthermore, the present study is consistent with prior work from our group demonstrating impaired form perception on the Rorschach test in CHR individuals relative to HCs (Kimhy et al 2007), as well as more recent work demonstrating impaired visual reading ability in CHR individuals (Revheim et al 2014). Over recent years, there has been an increased focus on sensory processing impairments, particularly auditory, in schizophrenia (Javitt, 2009) and CHR individuals (Bodatsch et al 2011; Kayser et al 2013, 2014; Perez et al 2014), and demonstration of predictive value for sensory measures such as auditory mismatch negativity (Bodatsch et al 2011; Kayser et al 2014; Perez et al 2014).…”

“…The present results are consistent also with other recent studies establishing early visual impairment as potential endophenotypes for psychotic disorders (Yeap et al 2006; Revheim et al 2014). The present study thus adds to the emergent literature suggesting that sensory-level deficits, including not only deficits in auditory (Bodatsch et al 2011; Kayser et al 2014; Perez et al 2014) and olfactory (Kayser et al 2013) processing, but also visual-level impairments (Kimhy et al 2007; Perez et al 2012; Revheim et al 2014), may represent critical targets for early detection and intervention.…”

Analysis of exploratory eye movements in patients with schizophrenia during visual scanning of projective tests' figures

“…There were differences in the pattern of eye movements according to the type of stimulus with schizophrenia patients making fewer fixations when compared to controls. The difference in these properties of exploratory eye movement was higher in the Rorschach test Visual-processing deficit, a well documented difficulty to perceive figure-ground pictures and objects partially obstructed or fragmented, was found in individuals at clinical high risk for psychoses, which did not differ from in-patients with schizophrenia on Rorschach inkblots perception 29 . Reduced visual exploration can be responsible for visual-processing deficit.…”

Testes projetivos na avaliação psicológica da esquizofrenia: Uma revisão da literatura

“…Estuda-se a evidência de indicadores de desordem do pensamento em parentes próximos de pacientes já diagnosticados (Gooding et al, 2012), relação entre desistência de tratamento e relacionamento interpessoal (Bouvet & Cleach, 2011) e a avaliação das habilidades de socialização dessa população (Moore, Viglione, Rosenfarb, Patterson, & Mausbach, 2013), entre outros estudos (Kimhy et al, 2007;Lukasova et al, 2010;Roisko, Wahlberg, Hakko, Wynne, & Tienari, 2011;Rosenbaum, Andersen, Knudsen, & Lorentzen, 2012;DzamonjaIgnjatovic, Smith, Jocic, & Milanovic, 2013) O objetivo desse estudo foi verificar o que se tem produzido na literatura brasileira sobre avaliação psicológica de pacientes diagnosticados com esquizofrenia por meio de instrumentos projetivos/expressivos. A maioria das pesquisas localizadas a partir dos critérios de inclusão e exclusão, utilizou a técnica das Manchas de Tinta de Rorschach como principal instrumento de investigação.…”