Cognitive Symptoms of Schizophrenia

Cognitive Symptoms of Schizophrenia

• Cognitive impairments play a crucial role in determining the quality of life and everyday functioning in individuals with schizophrenia
• Positive symptoms of schizophrenia can be treated with antipsychotics, but negative and cognitive symptoms are more challenging to treat and can lead to long-term difficulties

Cognitive Impairments and Underlying Mechanisms

• Cognitive impairments in schizophrenia involve a broad range of cognitive processes, making it difficult to understand the underlying mechanisms and develop effective interventions

The Hypothesis: A Common Mechanism Across Cognitive Domains

• Researchers Barch and Ceaser (2012) propose a hypothesis that a common mechanism, involving 'context processing', 'working memory (WM)', and 'episodic memory', underlies cognitive impairments in schizophrenia
• Impairment in representing goal information in working memory (WM) impairs proactive control, leading to difficulties in guiding behavior

Proactive Control and Goal Representation

• Proactive control involves representing goals before tasks or decisions are made, enabling focus and preparation of the motor system
• Goals refer to intended outcomes of actions or mental operations, such as communicating main points in a conversation or organizing a shopping trip
• Proactive control is associated with the representation of information in the dorsolateral prefrontal cortex (DLPFC)

Schizophrenia and Proactive Control

• A meta-analysis of fMRI studies (Minzenberg et al., 2009) showed reduced DLPFC activity in schizophrenia patients during tasks requiring proactive control
• This reduction in DLPFC activity may lead to more actions going wrong, requiring schizophrenia patients to rely more heavily on reactive control
• Impaired proactive control can affect both motor and internal processes, potentially explaining language deficits in schizophrenia patients