Can the neuropsychological case-study approach be applied to schizophrenia?

SYNOPSIS Neuropsychological studies of schizophrenia typically apply a small number of tests to a large group of patients. This approach has at least two drawbacks. First, the heterogeneity of the condition will lead to group means which may not reflect the behaviour of any individual. Secondly, it is difficult to infer the nature of the underlying cognitive impairments from a small number of tests, since good performance on a particular test depends on many different cognitive processes. In these circumstances it is more appropriate to apply the methods of cognitive neuropsychology where a large number of tests are used on a single case. This approach has proved fruitful in the study of neurological patients. We have intensively studied 5 chronic schizophrenic patients. These patients varied greatly in terms of overall ability. However, all patients, whatever their overall ability, performed badly on tests sensitive to frontal lobe lesions. This result suggests impairment of the supervisory attentional system in these patients. In addition, one patient suffered from a visual agnosia.

[1]  M. Patterson.  Understanding Brain Damage , 1992, Neurology.

[2]  A. Baddeley,et al.  Amnesic syndrome in schizophrenia , 1990, Psychological Medicine.

[3]  R. Morice.  Cognitive Inflexibility and Pre-frontal Dysfunction in Schizophrenia and Mania , 1990, British Journal of Psychiatry.

[4]  T. Crow,et al.  Schizophrenia and the brain: a prospective clinico-neuropathological study , 1990, Psychological Medicine.

[5]  A. Mayes,et al.  Spatiotemporal memory and rate of forgetting in acute schizophrenics , 1988, Psychological Medicine.

[6]  T. Shallice.  From Neuropsychology to Mental Structure: Converging Operations: Specific Syndromes and Evidence from Normal Subjects , 1988 .

[7]  J. Gruzelier,et al.  Impairments on neuropsychologic tests of temporohippocampal and frontohippocampal functions and word fluency in remitting schizophrenia and affective disorders. , 1988, Archives of general psychiatry.

[8]  D. Weinberger,et al.  Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. III. A new cohort and evidence for a monoaminergic mechanism. , 1988, Archives of general psychiatry.

[9]  Andrew J. Saykin,et al.  Neuropsychological Assessment of Neuropsychiatric Disorders , 1988 .

[10]  Elizabeth K. Warrington,et al.  Visual Apperceptive Agnosia: A Clinico-Anatomical Study of Three Cases , 1988, Cortex.

[11]  Allen Newell,et al.  SOAR: An Architecture for General Intelligence , 1987, Artif. Intell..

[12]  C. Frith,et al.  The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action , 1987, Psychological Medicine.

[13]  M. Taylor,et al.  Cognitive impairment patterns in schizophrenia and affective disorder. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[14]  P. Liddle.  Schizophrenic syndromes, cognitive performance and neurological dysfunction , 1987, Psychological Medicine.

[15]  Elizabeth K. Warrington,et al.  Arithmetic Skills in Patients with Unilateral Cerebral Lesions , 1986, Cortex.

[16]  A. Caramazza.  On drawing inferences about the structure of normal cognitive systems from the analysis of patterns of impaired performance: The case for single-patient studies , 1986, Brain and Cognition.

[17]  P. Taylor,et al.  Some cognitive correlates of schizophrenic illnesses , 1985, Psychological Medicine.

[18]  G. Vaillant,et al.  Vulnerability to schizophrenia: Prediction of adult schizophrenia using childhood information. , 1984 .

[19]  J. Brodie,et al.  Regional brain glucose metabolism in chronic schizophrenia. A positron emission transaxial tomographic study. , 1984, Archives of general psychiatry.

[20]  E. Miller,et al.  Verbal fluency as a function of a measure of verbal intelligence and in relation to different types of cerebral pathology. , 1984, The British journal of clinical psychology.

[21]  D. Weinberger.  Computed tomography (CT) findings in schizophrenia: speculation on the meaning of it all. , 1984, Journal of psychiatric research.

[22]  B. Volpe,et al.  Amnesia following the rupture and repair of an anterior communicating artery aneurysm. , 1983, Journal of neurology, neurosurgery, and psychiatry.

[23]  I. Whishaw,et al.  Performance of schizophrenic patients on tests sensitive to left or right frontal, temporal, or parietal function in neurological patients. , 1983, The Journal of nervous and mental disease.

[24]  B. Milner,et al.  Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man , 1982, Neuropsychologia.

[25]  E. Warrington.  Neuropsychological studies of object recognition. , 1982, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[26]  C. Frith,et al.  Spontaneous involuntary disorders of movement: their prevalence, severity, and distribution in chronic schizophrenics with and without treatment with neuroleptics. , 1982, Archives of general psychiatry.

[27]  E K Warrington,et al.  Testing for nominal dysphasia. , 1980, Journal of neurology, neurosurgery, and psychiatry.

[28]  N. Kapur,et al.  Confabulation and frontal lobe dysfunction. , 1980, Journal of neurology, neurosurgery, and psychiatry.

[29]  A. Luria.  Higher Cortical Functions in Man , 1980, Springer US.

[30]  Tim Shallice,et al.  Case study approach in neuropsychological research , 1979 .

[31]  Pierre Flor-Henry,et al.  Hemisphere asymmetries of function in psychopathology , 1979 .

[32]  H. Nelson,et al.  Dementia: The Estimation of Premorbid Intelligence Levels Using the New Adult Reading Test , 1978, Cortex.

[33]  Tim Shallice,et al.  The Involvement of the Frontal Lobes in Cognitive Estimation , 1978, Cortex.

[34]  E. Warrington,et al.  Word-comprehension and word-retrieval in patients with localized cerebral lesions. , 1978, Brain : a journal of neurology.

[35]  M. Krawiecka,et al.  A standardized psychiatric assessment scale for rating chronic psychotic patients , 1977, Acta psychiatrica Scandinavica.

[36]  H. Nelson.  A Modified Card Sorting Test Sensitive to Frontal Lobe Defects , 1976, Cortex.

[37]  D. Ingvar,et al.  Abnormal distribution of cerebral activity in chronic schizophrenia. , 1975, Journal of psychiatric research.

[38]  J. Mcfie.  Assessment of organic intellectual impairment , 1975 .

[39]  E. Perret.  The left frontal lobe of man and the suppression of habitual responses in verbal categorical behaviour. , 1974, Neuropsychologia.

[40]  E. Warrington,et al.  The effect of prior learning on subsequent retention in amnesic patients. , 1974, Neuropsychologia.

[41]  F. Lhermitte,et al.  A visual-speech disconnexion syndrome. Report of a case with optic aphasia, agnosic alexia and colour agnosia. , 1973, Brain : a journal of neurology.

[42]  Gerald J. Sussman,et al.  A Computational Model of Skill Acquisition , 1973 .

[43]  A. Taylor,et al.  The contribution of the right parietal lobe to object recognition. , 1973, Cortex; a journal devoted to the study of the nervous system and behavior.

[44]  A. Taylor,et al.  Visual discrimination in patients with localized cerebral lesions. , 1973, Cortex; a journal devoted to the study of the nervous system and behavior.

[45]  J. Mcfie,et al.  Picture Arrangement: A Measure of Frontal Lobe Function? , 1972, British Journal of Psychiatry.

[46]  F. Lhermitte,et al.  [Neuropsychological analysis of the frontal syndrome]. , 1972, Revue neurologique.

[47]  N. Butters,et al.  Comparison of Parietal and Frontal Lobe Spatial Deficits in Man: Extrapersonal vs Personal (Egocentric) Space , 1972, Perceptual and motor skills.

[48]  J. Feighner,et al.  Diagnostic criteria for use in psychiatric research. , 1972, Archives of general psychiatry.

[49]  E. Warrington,et al.  Perceptual matching in patients with cerebral lesions. , 1970, Neuropsychologia.

[50]  E. Warrington,et al.  New Method of Testing Long-term Retention with Special Reference to Amnesic Patients , 1968, Nature.

[51]  E K Warrington,et al.  Tachistoscopic number estimation in patients with unilateral cerebral lesions. , 1967, Journal of neurology, neurosurgery, and psychiatry.

[52]  S. Chorover,et al.  Delayed alternation performance in patients with cerebral lesions , 1966 .

[53]  E. Renzi,et al.  The token test: A sensitive test to detect receptive disturbances in aphasics. , 1962, Brain : a journal of neurology.

[54]  E. S. Gollin,et al.  Developmental Studies of Visual Recognition of Incomplete Objects , 1960 .

[55]  R. Reitan.  Validity of the Trail Making Test as an Indicator of Organic Brain Damage , 1958 .

[56]  D. Wechsler.  A Standardized Memory Scale for Clinical Use , 1945 .

[57]  E. Weigl,et al.  On the psychology of so-called processes of abstraction. , 1941 .