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Startup M. Insight and cognitive deficits in schizophrenia: evidence for a curvilinear relationship. Psychol Med 1996; 26:1277-1281. In contrast to authors considering lack of insight from either cognitive or motivational viewpoints, this author states that both approaches might be partially correct. Quadratic rather than linear relationships between insight and cognitive deficits are hypothesized, and found. The author suggests that this curvilinear relationship might be mediated by specific brain structures associated with the frontal lobes.
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McGuire PK, Frith CD. Disordered functional connectivity in schizophrenia. Psychol Med 1996; 26:663-667. The authors argue that recent neuroimaging studies point to disordered functional connectivity between frontal and temporal areas. This disconnectivity is not necessarily understood as a disruption of anatomical interconnections, it is viewed as a specific (abnormal) pattern of physiological activity in different brain areas. The implications of the disconnectivity concept for the understanding of psychotic phenomena are proposed.
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Andreasen NC, O'Leary D, Cizadlo T, Arndt S, Rezai K, Boles Ponto LL, Watkins GL, Hichwa RD. Schizophrenia and cognitive dysmetria: a positron-emission tomography study of dysfunctional prefrontal-thalamic-cerebellar circuitry. Proc Natl Acad Sci U S A 1996; 93:9985-9990. The authors offer a unifying approach to the different manifestations of schizophrenia: cognitive deficits, abnormalities in posture, gait, emotional response and expression. All these signs of schizophrenia could be considered as a manifestation of 'dysmetria', that is, considered more generally rather than a solely motor process. The concept of 'cognitive dysmetria' is proposed as the dysfunction of neural circuitry that coordinates the interactions between perception, retention, retrieval and response. The results of a PET study of 14 schizophrenic patients confirm the prediction of dysfunction in prefrontal thalamic cerebellar circuitry revealed by recall of narrative material.
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McKay AP, McKenna PJ, Bentham P, Mortimer AM, Holbery A, Hodges JR. Semantic memory is impaired in schizophrenia. Biol Psychiatry 1996; 39:929-937.
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Servan-Schreiber D, Cohen JD, Steingard S. Schizophrenic deficits in the processing of context. A test of a theoretical model. Arch Gen Psychiatry 1996; 53:1105-1112. In this study, different groups of schizophrenic patients were investigated: first episode unmedicated, multiepisode unmedicated, medicated. Patients with mood dosorders served as a control group. The impairment revealed in unmedicated schizophrenic patients performing CPT was interpreted as the deficit in the processing of contextual information, which could account for other cognitive impairments observed in schizophrenia (i.e. deficits in working memory and in inhibition).
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Frith CD, Corcoran R. Exploring 'theory of mind' in people with schizophrenia. Psychol Med 1996; 26:521-530. The authors studied the ability to mentalize in 46 symptomatic schizophrenic patients and 44 normal control individuals. Patients with paranoid delusions demonstrated the poorest performance on theory of mind tasks. The same deficits in the patients with negative features or incoherence were caused by memory impairments. Patients with delusions of control and patients in remission did not differ from normal control individuals. The authors concluded that the mentalizing deficit was distant from other cognitive impairments.
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