Neurocognition in Schizophrenia
Neurocognition in Schizophrenia
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DOI：
10.1007/7854_2010_42
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Gur, Ruben C.
中科院分区：
文献类型：
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作者：
Kalkstein, Solomon;Hurford, Irene;Gur, Ruben C.
在过去的20年里，精神分裂症患者的神经心理缺陷一直被记录在研究中，并在本章中进行了审查。一般能力的讨论是作为背景，其次是在特定的认知领域的功能分析。总体智力缺陷由一般智力测试和综合测试组合得分的结果指示。在特定的认知领域内，包括注意力在内的许多领域都存在效应量差异，有迹象表明工作记忆比简单注意力受到的影响更严重，这可能是由于此类任务中包含执行成分。还有证据表明，精神分裂症患者的处理速度减慢，可能导致其他依赖于快速有效吸收信息的领域的缺陷。执行障碍已经被发现的测试评估集转移能力，选择性注意力和抑制不适当的反应。学习和记忆缺陷已被广泛证明，有一些证据表明，回忆的口头材料比回忆的视觉信息更受影响，而识别能力的损害相对较小，比回忆这两种方式。精神分裂症患者的语言接受和表达能力受损，视觉感知、结构和精细运动技能也受损。社会认知是一个特别重要的领域，因为它与功能结果相关。面部和韵律情感的表达和识别的缺陷已经被证明，虽然情感的主观体验似乎保存得相对较好。在这篇综述中描述的神经心理缺陷似乎在整个成年期保持稳定，支持神经发育，而不是神经退行性疾病的模型。最后，认知缺陷越来越多地被用作内表型，这可能是未来研究的一个重要方向。
Neuropsychological deficits among schizophrenia patients have been consistently documented in research over the past 20 years and are reviewed in this chapter. Discussion of general abilities is presented as a background and is followed by analysis of functioning in specific cognitive domains. Overall intellectual deficits are indicated by results from both general intelligence tests and composite test battery scores. Within specific cognitive domains, effect size differences are noted in numerous areas, including attention, with indications that working memory is affected more severely than simple attention, likely due to inclusion of an executive component in such tasks. There is also evidence of slowed processing speed among schizophrenia patients, likely contributing to deficits in other domains which rely on rapid and efficient assimilation of information. Executive impairments have been found on tests assessing set-shifting abilities, selective attention, and inhibition of inappropriate responses. Learning and memory deficits have been demonstrated extensively, with some evidence that recall of verbal material is more affected than recall of visual information, and that recognition abilities are comparatively less impaired than recall for both modalities. Receptive and expressive language abilities are compromised in schizophrenia patients, as well as visual perceptual, constructional, and fine motor skills. Social cognition is an area of particular importance due to its relevance to functional outcome. Deficits in expression and recognition of facial and prosodic affect have been demonstrated, although subjective experience of emotion appears to be relatively well preserved. Neuropsychological deficits described in this review appear to generally remain stable throughout adulthood, supporting neurodevelopmental, rather than neurodegenerative, models of the illness. Finally, cognitive deficits are increasingly used as endophenotypes, which is likely an important direction of future research.