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Span of apprehension deficits during the postpsychotic stages of schizophrenia. A replication and extension

Archives of General Psychiatry (Impact Factor: 13.75). 10/1981; 38(9):1006-11.
Source: PubMed

ABSTRACT Thirty-five schizophrenic and 20 manic-depressive outpatients and 20 normal controls were administered a measure of visual information processing, the span of apprehension. The schizophrenic outpatients made significantly fewer correct detections of the target stimuli than did the manic-depressives and normal controls, particularly for conditions in which the target stimuli were embedded in four and nine irrelevant stimuli. A subgroup of schizophrenics produced the overall group differences. In a comparison of a subgroup of schizophrenics who showed impaired performance on the ten-letter array with the remaining schizophrenics, the ten-letter array appeared to be tapping processes that are independent of overall adjustment, the presence of particular symptoms, premorbid social adjustment, general demographic characteristics, and the presence of generalized performance deficits. The span of apprehension may be a marker for some subgroups of schizophrenia.

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    • "Sustained attention deficits measured by the Continuous Performance Test (CPT) (Rosvold et al., 1956) have been considered as potential vulnerability indicators for schizophrenia (Chen and Faraone, 2000; Cornblatt and Keilp, 1994; Keri and Janka, 2004). They were demonstrated in schizophrenic patients across illness stages (Asarnow and MacCrimmon, 1981; Nuechterlein and Dawson, 1984) and remained relatively unchanged despite fluctuations in clinical symptoms, in contrast to those manifested by affective disorders (Liu et al., 2002; Nuechterlein et al., 1994). In addition, the performance deficits were not amendable to treatment with neuroleptics when more difficult CPT versions were used (Finkelstein et al., 1997; Hong et al., 2002; Liu et al., 2000). "
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    ABSTRACT: This study examined the longitudinal patterns in the sustained attention deficits detected by the Continuous Performance Test (CPT) and the factors influencing such changes in consecutively admitted schizophrenia patients (n=224) followed up for 4-7 year. Exploratory growth mixture modeling analyses of subjects' CPT performances over successive follow-ups revealed that three major (accounting for 92.8%) plus one minor subgroups could be delineated. Subgrouping was then performed on a subsample of 104 subjects who had at least 3 times of CPT data. Based on subjects' adjusted z score of the test sensitivity index d' derived from comparing with a community sample, patients were divided into three subgroups: no impairment (-1), moderate impairment (-2.5 to -1), and severe impairment (< -2.5). The trajectory taken by individual patient was analyzed according to the initial subgroup status and subsequent changes, controlling for relevant basic and clinical characteristics. Both growth mixture modeling and subgroup status analyses found that around one third of those with severe impairment at baseline showed persistent severe impairment. Those with no impairment were stable and exhibited least tendency for further performance deterioration. Those with moderate impairment tended to fluctuate markedly, mainly towards the better rather than the worse. Previous subgrouping status and concurrent task-taking strategy predicted the performance subgroup status at follow-ups, while clinical symptoms and disease course factors did not. We concluded that there is substantial heterogeneity in schizophrenia patients' long term pattern in sustained attention deficits and those with severe impairment might represent a subgroup with stable vulnerability to schizophrenia.
    Journal of Psychiatric Research 10/2006; 40(7):613-21. DOI:10.1016/j.jpsychires.2006.06.010 · 4.09 Impact Factor
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    • "Martinez-Aran et al (2004) Jones et al (1994) Joffe et al (1988) Harmer et al (2002) Fleck et al (2005) Fleck et al (2003) Dixon et al (2004) Deckersbach et al (2004) Clark et al (2002) Asarnow et al (1981) Altshuler et al (2004) Addington & Addington (1997) 0 DL pooled effect size = 0.068009 (95% CI = -0.135686 to 0.271704) Fig. 3. Forest plot of individual and pooled random effects estimates of the standardised mean differences between bipolar patients and controls for years of education. "
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    ABSTRACT: A number of studies have reported evidence of cognitive deficits in euthymic bipolar patients. Qualitative reviews of the literature have indicated impairments in executive functions and declarative memory are most consistently reported. However, not all primary studies conducted to date have had sufficient power to detect statistically significant differences and there have been few attempts to quantify the magnitude of impairments. This review aims to combine data from available studies to identify the profile of neuropsychological deficits in euthymic bipolar patients and quantify their magnitude. Systematic literature review and meta-analysis. Large effect sizes (d>or=0.8) were noted for aspects of executive function (category fluency, mental manipulation) and verbal learning. Medium effect sizes (0.5<or=d<0.8) were found for aspects of immediate and delayed verbal memory, abstraction and set-shifting, sustained attention, response inhibition, and psychomotor speed. Small effect sizes (0.2<or=d<0.5) were reported for verbal fluency by letter, immediate memory, and sustained attention. Sufficient data were not available to investigate all domains. For example analyses did not include measures of visuospatial function. Euthymic bipolar patients demonstrate relatively marked impairment in aspects of executive function and verbal memory. It is not yet clear whether these are two discrete areas of impairment or are related to one another. Future investigations should clarify the functional significance of deficits and indicate whether patients will benefit from ameliorative interventions.
    Journal of Affective Disorders 07/2006; 93(1-3):105-15. DOI:10.1016/j.jad.2006.02.016 · 3.71 Impact Factor
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    • "Support for serial scanning being central in the SPAN task is found in studies of scanpaths that show that people in general tend to make more mistakes in the bottom than in the top quadrants (Estes & Taylor, 1964; Granholm, Asarnow & Marder, 1996; Asarnow & Sherman, 1984). It has also been shown that it is in the larger array conditions (10-and 12-letters), requiring a high processing load, that schizophrenic patients are best discriminated from nonpsychiatric individuals (Asarnow et al ., 1981; Granholm et al. , 1996). "
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    ABSTRACT: The aim of the study was to examine the effect of contingent monetary reinforcement and enhanced instructions on Span of Apprehension (SPAN) performance in a group of young people with early onset psychosis. Twenty-five participants (mean age 16.7) received a 3- and 12-letter version of the SPAN task six times: baseline, three x intervention, post-test, and 10-day follow-up. No significant effects of time were found in the 3-letter condition, indicating a ceiling effect for accuracy. In the 12-letter condition detection rates improved significantly reaching a maximum at the third intervention (p < 0.001). Performance showed a temporary decline at post-test, but performance returned to the maximum level at the 10-day follow-up. The study suggests that SPAN performance can be improved in young people with early onset psychosis using relatively simple interventions and that performance gains are relatively durable.
    Scandinavian Journal of Psychology 02/2004; 45(1):55-60. DOI:10.1111/j.1467-9450.2004.00378.x · 1.29 Impact Factor
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