DISCRIMINATION LEARNING AND SET-SHIFTING IN SCHIZOPHRENIA: ASSOCIATIONS WITH NEGATIVE SYMPTOMS
Abstract:
Background: Working Memory deficits are considered a cardinal cognitive feature of schizophrenia. The intradimensional/extradimensional (IDED) task assesses different forms of learning from feedback. Attentional set-shifting deteriorates over time in schizophrenia. Aims: In this study, we compared the performance of patients with schizophrenia with that of healthy controls on tests of executive functioning and verbal memory in order to identify specific impairments in executive functioning and the relationship between executive function and memory performance. We then compared the performance of patients with or without negative symptoms. Method: 138 outpatients with a diagnosis of schizophrenia and 43 healthy controls were tested with tests of verbal memory and executive function (RAVLT and IED) Results: Significant group differences were observed in cognitive performance. Schizophrenic patients showed impairment in executive function and verbal memory in comparison with healthy control subjects. Patients showed impaired set-shifting that correlated with verbal memory. Conclusions: Impaired performance can be attributed to negative symptoms. Our findings suggest that patients with schizophrenia can learn and generalize rules but are inflexible when rules change, reflecting both reduced responsiveness to negative feedback and difficulty in switching attention. This profile seems to represent a stable trait of the illness.
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