Department of Psychiatry, Harvard Medical School.
Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, College of Medicine.
Neuropsychology. 2012 May;26(3):288-303. doi: 10.1037/a0027970.
The search for predictors of schizophrenia has accelerated with a growing focus on early intervention and prevention of psychotic illness. Studying nonpsychotic relatives of individuals with schizophrenia enables identification of markers of vulnerability for the illness independent of confounds associated with psychosis. The goal of these studies was to develop new auditory continuous performance tests (ACPTs) and evaluate their effects in individuals with schizophrenia and their relatives.
We carried out two studies of auditory vigilance with tasks involving working memory (WM) and interference control with increasing levels of cognitive load to discern the information-processing vulnerabilities in a sample of schizophrenia patients, and two samples of nonpsychotic relatives of individuals with schizophrenia and controls. Study 1 assessed adults (mean age = 41), and Study 2 assessed teenagers and young adults age 13-25 (M = 19).
Patients with schizophrenia were impaired on all five versions of the ACPTs, whereas relatives were impaired only on WM tasks, particularly the two interference tasks that maximize cognitive load. Across all groups, the interference tasks were more difficult to perform than the other tasks. Schizophrenia patients performed worse than relatives, who performed worse than controls. For patients, the effect sizes were large (Cohen's d = 1.5), whereas for relatives they were moderate (d = ~0.40-0.50). There was no age by group interaction in the relatives-control comparison except for participants <31 years of age.
Novel WM tasks that manipulate cognitive load and interference control index an important component of the vulnerability to schizophrenia.
随着对精神疾病早期干预和预防的日益关注，对精神分裂症预测因子的研究也在加速。研究精神分裂症患者的非精神病亲属，可以在不考虑与精神病相关的混杂因素的情况下，确定疾病易感性的标志物。这些研究的目的是开发新的听觉连续执行测试（ACPT），并评估它们在精神分裂症患者及其亲属中的效果。
我们进行了两项听觉警戒研究，任务涉及工作记忆（WM）和干扰控制，认知负荷逐渐增加，以识别精神分裂症患者样本中的信息处理缺陷，以及两个非精神病精神分裂症患者亲属和对照组的样本。研究 1 评估了成年人（平均年龄=41 岁），研究 2 评估了青少年和年轻人 13-25 岁（M=19 岁）。
精神分裂症患者在所有五种 ACPT 版本上都表现出障碍，而亲属仅在 WM 任务上表现出障碍，特别是在最大程度增加认知负荷的两项干扰任务上。在所有组中，干扰任务比其他任务更难完成。精神分裂症患者的表现比亲属差，亲属的表现比对照组差。对于患者，效应大小较大（Cohen's d=1.5），而对于亲属，效应大小为中等（d=~0.40-0.50）。除了年龄<31 岁的参与者外，亲属与对照组的比较中没有年龄与组之间的交互作用。
操纵认知负荷和干扰控制的新型 WM 任务，可作为精神分裂症易感性的一个重要指标。
