Center for Mind and Brain, University of California, Davis, CA.
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
Schizophr Bull. 2019 Sep 11;45(5):991-1000. doi: 10.1093/schbul/sbz063.
Impairments in basic cognitive processes such as attention and working memory are commonly observed in people with schizophrenia and are predictive of long-term outcome. In this review, we describe a new theory-the hyperfocusing hypothesis-which provides a unified account of many aspects of impaired cognition in schizophrenia. This hypothesis proposes that schizophrenia involves an abnormally narrow but intense focusing of processing resources. This hyperfocusing impairs the ability of people with schizophrenia to distribute attention among multiple locations, decreases the number of representations that can simultaneously be maintained in working memory, and causes attention to be abnormally captured by irrelevant inputs that share features with active representations. Evidence supporting the hyperfocusing hypothesis comes from a variety of laboratory tasks and from both behavioral and electrophysiological measures of processing. In many of these tasks, people with schizophrenia exhibit supranormal effects of task manipulations, which cannot be explained by a generalized cognitive deficit or by nonspecific factors such as reduced motivation or poor task comprehension. In addition, the degree of hyperfocusing in these tasks is often correlated with the degree of impairment in measures of broad cognitive function, which are known to be related to long-term outcome. Thus, the mechanisms underlying hyperfocusing may be a good target for new treatments targeting cognitive deficits in schizophrenia.
注意力和工作记忆等基本认知过程的障碍在精神分裂症患者中很常见，并且可以预测长期预后。在这篇综述中，我们描述了一种新的理论——过度专注假说，它为精神分裂症认知障碍的许多方面提供了一个统一的解释。该假说提出，精神分裂症涉及到一种异常狭窄但强烈的处理资源聚焦。这种过度专注会损害精神分裂症患者在多个位置分配注意力的能力，减少工作记忆中同时可以维持的表示数量，并导致注意力被与活跃表示具有共同特征的无关输入异常捕获。支持过度专注假说的证据来自各种实验室任务，以及处理的行为和电生理测量。在这些任务中的许多任务中，精神分裂症患者表现出任务操作的超正常效应，这不能用普遍的认知缺陷或非特异性因素（如动机降低或任务理解能力差）来解释。此外，这些任务中的过度专注程度通常与广泛认知功能测量的损伤程度相关，而广泛认知功能与长期预后有关。因此，过度专注的机制可能是针对精神分裂症认知缺陷的新治疗方法的一个很好的目标。
