Nestor Paul G, Niznikiewicz Margaret, McCarley Robert W
Department of Psychology, University of Massachusetts, Boston, MA 02125-3393, USA.
J Nerv Ment Dis. 2010 Mar;198(3):206-12. doi: 10.1097/NMD.0b013e3181d14143.
Neuropsychological impairment represents a core characteristic of schizophrenia, but its underlying components have yet to be clearly established. Using a comprehensive battery of standardized measures of intelligence, declarative episodic memory, and executive function, we hypothesized that the variance in neuropsychological performance in schizophrenia may reflect at least 2 distinct sources related to failures of (a) the central executive division of working memory and (b) social comprehension. In comparison to age-matched controls, patients with schizophrenia showed not only overall reduced scores on Wechsler intelligence and memory scales and Wisconsin Card Sorting Test (WCST) of executive function, but they also demonstrated different patterns of performance for each of these tests. Hierarchical regression revealed executive attentional control, measured by Trails B performance speed, and social comprehension, measured by Wechsler IQ Comprehension and Picture Arrangement subtests, each accounted for a unique and specific proportion of variance in test scores for the patient group, even when controlling for general intelligence. Failures in social comprehension and executive attentional control may account for distinct sources of variance in the neuropsychological impairment of schizophrenia.
神经心理损害是精神分裂症的核心特征,但尚未明确其潜在组成部分。我们使用一系列全面的标准化智力、陈述性情景记忆和执行功能测量方法,推测精神分裂症患者神经心理表现的差异可能至少反映了两个不同的来源,分别与(a)工作记忆的中央执行部分功能障碍和(b)社会理解障碍有关。与年龄匹配的对照组相比,精神分裂症患者不仅在韦氏智力和记忆量表以及执行功能的威斯康星卡片分类测验(WCST)上的总分降低,而且在这些测试中的表现模式也有所不同。分层回归显示,以连线测验B的表现速度衡量的执行性注意力控制,以及以韦氏智商理解和图片排列分测验衡量的社会理解,即使在控制了一般智力后,各自在患者组的测试分数变异中都占了独特且特定的比例。社会理解和执行性注意力控制的障碍可能是精神分裂症神经心理损害差异的不同来源。
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