Walter Heinrichs

Walter Heinrichs
York University · Department of Psychology

PhD

About

97
Publications
23,332
Reads
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5,151
Citations
Additional affiliations
July 1988 - July 2018
York University
Position
  • Professor (Full)
Description
  • undergraduate and graduate teaching and supervision in clinical psychology; research on neuropsychological aspects of schizophrenia; clinical neuropsychologist, York University Psychology Clinic
September 1987 - April 1988
University of Toronto
Position
  • Lecturer

Publications

Publications (97)
Article
Background Cortical thinning is a well-known feature in schizophrenia. The considerable variation in the spatial distribution of thickness changes has been used to parse heterogeneity. A ‘cortical impoverishment’ subgroup with a generalized reduction in thickness has been reported. However, it is unclear if this subgroup is recoverable irrespective...
Preprint
Full-text available
Background This study applied an algorithm developed to identify schizophrenia spectrum disorder patients with probable decrements between estimated premorbid and current cognitive ability (Keefe et al., 2005). Cognitive trajectories and associated functional status were examined in patients and control participants. Methods Patients with schizoph...
Article
Previous work has found that the Breakfast Task (BT), a computerized, ecologically informed executive ability measure, is sensitive to group differences in aging, acquired brain injury, and Parkinson's disease. We investigated whether this measure improves the prediction of functional status over and above standard measures of general intellectual...
Article
What people think about, the intentional aspect of cognition, is distinguished from its operational aspect, or how proficiently they think. Many psychiatric disorders as well as social problems like racism, are defined largely by specified thought contents, whereas neurological disorders including dementia are defined by low proficiency. Intentiona...
Article
Schizophrenia is characterized by psychosis and, in most cases, cognitive impairment. It is unclear, however, whether these elements of the disorder represent distinct or related disease processes. Accordingly, this study investigated 3-way interactions between group, cognition and cortical thickness in cognitively-matched patients with schizophren...
Poster
Full-text available
Background Multiple clustering algorithms have been proposed to organize and thereby reduce the clinical, cognitive, neurobiological and functional heterogeneity in the schizophrenia spectrum. Cortical thickness (CT) is a key gene-mediated aspect of brain morphology that may reflect reduced synaptic structure and excessive pruning. It is also an as...
Article
Background Variability and replication failures in research and treatment findings are common in literatures on complex and heterogeneous psychiatric syndromes. Clinical settings and programs where patients are recruited for studies represent a possible, but seldom considered or controlled, source of this variability. For example, Ismail and collea...
Article
Full-text available
Background Cognitive dysfunction is a core feature of schizophrenia, yet a subset of patients, perhaps 25%, performs within normal population limits on many cognitive tasks. Our interpretation of cognitive normality findings is complicated by the possibility that normal-range patients have nevertheless declined relative to higher performance expect...
Article
Full-text available
Although schizophrenia and schizoaffective disorder remain separable in diagnostic systems, the validity of the distinction is uncertain. This study asked whether schizophrenia and schizoaffective disorder are distinguishable on selected cognitive, social cognitive and structural social brain measures. Outpatients with a diagnosis of schizophrenia...
Article
Full-text available
Background Resolving the definition, heterogeneity and validity of schizophrenia-spectrum disorders remains a challenge, including the distinctiveness of schizophrenia and schizoaffective disorder. Here we report clinical, cognitive and structural brain imaging data with special reference to social processing in corresponding patient groups and non...
Article
Full-text available
Background Cognitive dysfunction is considered a core feature of schizophrenia. Nonetheless, patients with the illness overlap with healthy controls on many tasks, giving rise to the identification of subpopulations with relatively normal cognitive performance. However, the prevalence and implications of these subgroups for understanding schizophre...
Article
Full-text available
Objective: Cognitive impairment is prevalent and related to functional outcome in schizophrenia, but a significant minority of the patient population overlaps with healthy controls on many performance measures, including declarative-verbal-memory tasks. In this study, we assessed the validity, clinical, and functional implications of normal-range...
Article
Background: Thinning of the cerebral cortex has been reported in schizophrenia, with reductions in frontotemporal regions a common finding. However, considerable heterogeneity across studies has also been reported with little consensus on a typical profile or signature of thinning in the disorder. In addition, reporting conventions tend to highligh...
Article
Background: Schizophrenia is characterized by both psychotic illness and cognitive impairment, but it is unclear whether they represent related yet distinct disease processes. There is evidence to suggest dissociation. For example, cognitive impairment occurs in schizophrenia patients during both active psychosis and symptom remission. However, the...
Article
Background: Patients with schizophrenia experience deficits in multiple domains of functioning. Cognition is often considered a primary predictor of functioning in this population. Standard cognitive test batteries, however, do not always capture substantial variance in functional outcome. This may reflect inadequate sampling of functionality relev...
Article
Full-text available
This study assessed whether cortical thickness across the brain and regionally in terms of the default mode, salience, and central executive networks differentiates schizophrenia patients and healthy controls with normal range or below-normal range cognitive performance. Cognitive normality was defined using the MATRICS Consensus Cognitive Battery...
Article
Full-text available
The validity and significance of normal range neurocognition in schizophrenia remain unclear and controversial. We assessed whether normal range patients and controls demonstrate evidence of decline relative to premorbid ability and differ in performance profiles across measures, including those external to the normality criterion. In addition, we...
Article
Full-text available
Recent reports suggest that cognition is relatively preserved in some schizophrenia patients. However, little is known about the functional advantage these patients may demonstrate. The purpose of this study was to identify cognitively normal patients with a recently developed test battery and to determine the functional benefit of this normality r...
Article
Full-text available
Objective: The main purpose of this investigation was to identify patterns of intellectual performance in schizophrenia patients suggesting preserved, deteriorated, and premorbidly impaired ability, and to determine clinical, cognitive, and functional correlates of these patterns. Method: We assessed 101 patients with schizophrenia or schizoaffe...
Article
It has been well established that neurocognitive deficits are a core feature in schizophrenia and predict difficulties in functional independence. However, few studies have assessed the longitudinal stability of cognition and key aspects of functional outcome concurrently. Even less attention has been directed at the contingency of cognitive change...
Article
Full-text available
The Wechsler Adult Intelligence Scale (WAIS) has been used extensively to study impairment across a range of cognitive domains in schizophrenia. However, cognitive performance among those with the illness has yet to be examined using the newest edition of this measure. Hence, the current study aims first, to provide WAIS-IV normative data for Canad...
Article
This study examined the reliability and validity of a new performance-based measure of functional competence for individuals with serious mental illness, the Canadian Objective Assessment of Life Skills (COALS). The COALS assesses both routinized procedural knowledge routines (PKR) and executive operations (EXO) in order to capture functional outco...
Article
The schizophrenia-crime relationship was studied in 151 research participants meeting DSM-IV criteria for schizophrenia or schizoaffective disorder and with histories positive or negative for criminal charges, convictions and offences involving violence. These crime-related variables were regressed on a block of nine predictors reflecting non-speci...
Article
As treatment efforts to enhance cognitive abilities in schizophrenia increase, so too does the need for a critical appraisal of instruments that measure functionality and adjustment to community living. The Multidimensional Scale of Independent Functioning (MSIF; Jaeger et al., 2003) is a promising instrument that assesses functionality in relation...
Article
To assess deductive reasoning in schizophrenia patients with special reference to whether accuracy varies across type of stimulus problem. Previous research suggests that patients, unlike healthy controls, are insensitive to emotionally provocative (salient) problem content. A syllogistic reasoning task consisting of five argument types varying in...
Article
The purpose of this investigation was to identify patients with cognitively impaired, cognitively normal and verbal memory-impaired subtypes of schizophrenia and to examine their clinical and functional validity as distinct forms of the disorder. These subtypes occurred in 73 of 154 patients meeting DSM-IV criteria for schizophrenia or schizoaffect...
Article
Neurological soft signs (NSS) have been associated with the neuropsychopathology of schizophrenia, and have been proposed as candidate endophenotypes for this clinical group. However, the prevalence rate of NSS in non-psychotic first-degree relatives is not fully known. The authors systematically and quantitatively reviewed the literature to determ...
Article
Full-text available
Neurological soft signs (NSS) are hypothesized as candidate endophenotypes for schizophrenia, but their prevalence and relations with clinical and demographic data are unknown. The authors undertook a quantification (meta-analysis) of the published literature on NSS in patients with schizophrenia and healthy controls. A systematic search was conduc...
Article
Cognitive performance rather than symptoms, especially positive symptoms, is regarded as the primary predictor of functional outcome in schizophrenia. However, contradictory evidence exists and many studies fail to sample from the extremes of outcome measures. This study tested whether the differential importance assigned to symptoms and cognitive...
Article
Full-text available
Measures of functional competence have been introduced to supplement standard cognitive and neuropsychological evaluations in schizophrenia research and practice. Functional competence comprises skills and abilities that are more relevant to daily life and community adjustment. However, it is unclear whether relevance translates into significantly...
Article
Full-text available
The existence of small numbers of schizophrenia patients with superior ability in specific cognitive domains is implied by meta-analytic evidence as well as by occasional empirical reports. The authors identified 25 patients with superior (i.e., > or =90th percentile) ability on the Vocabulary subtest of the Wechsler Adult Intelligence Scale 3rd ed...
Article
This study sought to objectify the distinction between schizophrenia and schizoaffective disorder in terms of standard tasks measuring verbal and non-verbal cognitive ability, auditory working memory, verbal declarative memory and visual processing speed. Research participants included 103 outpatients with a diagnosis of schizophrenia, 48 with schi...
Article
Competence in self-administration of a drug regimen is related to both treatment adherence and functional outcome. Previous research with middle-aged and older schizophrenia patients suggests a central role for cognitive performance in predicting this competence. We examined the relative and joint contributions of demographic, clinical and cognitiv...
Article
Schizophrenia is an illness that expresses itself in severe disturbances of thought and behavior. These disturbances include strikingly implausible and bizarre beliefs, suspicions, and interpretations of experience. However, it is not just the contents of thought or what the person with schizophrenia thinks about that is abnormal. The illness also...
Article
This study evaluated the University of California Performance-based Skills Assessment (UPSA) in a Canadian outpatient schizophrenia setting. The UPSA was administered to 64 patients with schizophrenia and schizoaffective disorder and to 42 nonpsychiatric controls. Patient and control samples did not differ in age, gender composition, first language...
Article
This study assessed whether verbal memory performance indexed by the California Verbal Learning Test (CVLT) can organize and reduce the heterogeneity of schizophrenia. The temporal stability, cognitive and clinical validity of: (a) a putatively cortical-subcortical-normative typology derived from dementia patients' scores on the CVLT and (b) a memo...
Article
Full-text available
A study was conducted to determine the value of personality and background variables (e g, emotional responsivity, anxiety, parental memories, art training) as predictors of painting preferences One set of 24 paintings was selected, holding theme (sexual or aggressive) constant while contrasting Idealized (12) with Expressionist (12) styles Another...
Article
In this article, I respond to comments made by K. Salzinger (see record 2006-00920-010) and A. Aleman and A. S. David (see record 2006-00920-011) on my original article (see record 2005-03019-003). The constructive, reconstructive, and interpretive nature of human cognition is well illustrated by these two responses to my recent article on schizoph...
Article
Full-text available
Cognitive tasks and concepts are used increasingly in schizophrenia science and treatment. Recent meta-analyses show that across a spectrum of research domains only cognitive measures distinguish a majority of schizophrenia patients from healthy people. Average effect sizes derived from common clinical tests of attention, memory, language, and reas...
Article
The published literature on depression in multiple sclerosis (MS) is reviewed quantitatively. The authors report mean effect sizes for 20 studies comparing depression scores of MS patients with those of healthy participants (d=1.07) and 21 studies comparing depression scores of MS patients with those of patients who have other chronic conditions (d...
Article
We sought to evaluate demographic, clinical, and neurocognitive predictors of self-rated life quality and hospitalization in schizophrenia patients without the potentially cognition-enhancing influence of newer generation neuroleptic medication. A sample of 55 atypical neuroleptic-naive schizophrenia patients was assessed at index and 3 years later...
Article
Quantification (meta-analysis) of the neuroscience evidence on schizophrenia shows very modest average differences between patient and control distributions across a great variety of measures and literatures. The strongest findings involve cognitive and psychophysiological measures. Several possible explanations for this situation are reviewed incl...
Article
To extend and test hypotheses linking positive and negative symptoms to selective aspects of verbal memory in schizophrenia. Verbal memory includes the ability to discriminate and prevent the intrusion of irrelevant information into recall and recognition. This ability has been proposed as a cognitive process that differentially mediates positive a...
Article
The relationship between sex and verbal learning and memory was investigated in 70 males and 36 females with a diagnosis of schizophrenia. Ninety-seven percent of the sample was receiving typical neuroleptic medication as treatment and had never received atypical medications. Selected scores from the California Verbal Learning Test (CVLT) [Delis, D...
Article
The relationship between depression and performance on selected neurocognitive tests was examined in two mild head injury samples (n1 = 72, n2 = 50). A series of hierarchical regression analyses showed that scores on depression-related scales of both the MCMI-II (Millon Clinical Multi-Axial Inventory; Millon, 1987) and MMPI-2 (Minnesota Multiphasic...
Article
Magnetic resonance imaging (MRI) and positron emission tomography (PET) studies of the frontal and temporal lobes in schizophrenia patients and healthy controls have proliferated over the past 2 decades, but there have been relatively few attempts to quantify the evidence. In this meta-analytic review, 155 studies on frontal and temporal lobe neuro...
Article
Schizophrenia is a serious mental illness with a remarkably short recorded history. Unlike depression and mania, which are recognizable in ancient texts, schizophrenia-like disorder appeared rather suddenly in the psychiatric literature of the early nineteenth century. This could mean that the illness is a recent disease that was largely unknown in...
Article
Evidence is presented that verbal memory impairment distinguishes a subgroup of patients with schizophrenia who also differ in symptom profile and illness adjustment. On the basis of the California Verbal Learning Test (CVLT), a sample of patients was partitioned into memory-impaired (n=16) and memory-unimpaired groups (n=16). Groups were matched f...
Article
Clustering and switching components of phonemic fluency performance were compared in patients with schizophrenia and healthy normal controls to provide evidence for a specific anatomical locus for the breakdown of language processes or for a multiple-disease model of schizophrenia. The patients showed small but significant impairments in clustering...
Book
This book evaluates the progress of schizophrenia science by summarizing what is known about how patients with the illness differ from healthy people. The tools of meta-analysis are first explained and then employed to make the strength and consistency of these differences explicit. Beginning with the study of symptoms, then moving through the sear...
Article
Full-text available
Clustering and-switching components of phonemic fluency performance were compared in patients with schizophrenia and healthy normal controls. These components were selected to provide evidence for a specific anatomic locus for the breakdown of language processes or for a multiple-disease model of schizophrenia. As part of a larger battery of neurop...
Article
Structural and physiological frontal brain system deficits in patients with schizophrenia are reviewed quantitatively. We report effect sizes from studies since 1980 that used structural (CT, MRI), and functional (PET) neuroimaging methods. We found both literatures to be distinguished by heterogeneity whereby most patients show normative frontal f...
Article
Full-text available
The neurocognitive literature on test performance in schizophrenia is reviewed quantitatively. The authors report 22 mean effect sizes from 204 studies to index schizophrenia versus control differences in global and selective verbal memory, nonverbal memory, bilateral and unilateral motor performance, visual and auditory attention, general intellig...
Article
The stability and validity of a neurocognitive typology for schizophrenia were studied in 55 chronic patients who met DSMIII-R criteria for the illness. Subtypes were based on an earlier cluster analytic study by Heinrichs and Awad (1993) that utilized the following variables: IQ (WAIS-R), categories (Wisconsin Card Sorting Test), free recall intru...
Article
Performance on selected scores from the California Verbal Learning Test (CVLT) was compared in schizophrenia, Korsakoff's syndrome, and personality disorder patients. Five CVLT scores sensitive to dysfunction in the diencephalic-hippocampal memory system and one attention-sensitive variable were examined. The patient groups were matched on age, edu...
Article
In this article I describe 3 conditions for understanding schizophrenia as a kind of brain disease. First, the disorder must cohere as a clinical entity that is distinct from other disorders. Second, schizophrenia must be linked with an identifiable neuropathology. Third, implicated brain systems must have behavioral functions that fit the psycholo...
Article
Performance on four key neurocognitive tasks was used to search for subtypes in 104 DSM-IIIR schizophrenic patients. The tasks were the Wisconsin Card Sorting Test to index executive prefrontal cerebral function, intrusion errors from the California Verbal Learning Test to tap hippocampal-diencephalic mnestic function, bilateral hand performance on...
Article
The relationship between work attendance-absence and selected measures of executive (Wisconsin Card Sorting Test, Trail Making B) and motor (Purdue Pegboard) function was explored in a sample of 42 chronic psychiatric patients at a sheltered workshop setting. Work attendance was unrelated to intelligence but correlated with several executive and mo...
Article
This study examined the ability of a memory-impaired patient with alcoholic Korsakoff's syndrome to learn and retain a schedule of daily activities. A letter-fragment cueing method was used as a teaching technique. Despite evidence of severe frontal lobe deficits and high levels of anxiety the patient showed a strong learning effect relative to bas...
Article
We assessed three copying strategies on the Rey-Osterrieth Complex Figure Test among 50 psychiatric patients. The strategies were featural (detail-focused), contextual (framework-focused), and mixed. Reliable classification of each patient's copying strategy showed 7 patients used a featural and 7 patients used a contextual strategy. The remaining...
Article
The ability of learning measures to predict a behavioral treatment response was of interest in this study. A severely impaired and behaviorally disturbed female neuropsychiatric patient was unable to demonstrate any learning on "direct" tests involving multiple free recall trials or cued paired associate recall. However, she performed normally on a...
Article
The author argues that the knowledge base in support of applying neuropsychological data to the assessment of functional competence and rehabilitation potential is not extensive. Clinical neuropsychology will have to develop new assessment concepts and methods. Reasons for the shift from a neurodiagnostic to a functional emphasis are reviewed. The...
Article
A summary index of neuropsychological impairment (mean Luria-Nebraska T score), along with age, education, and presence/absence of confirmed brain disease, was used to predict employment status (working/not working). Subjects were 50 patients referred for neuropsychological assessment of confirmed or suspected brain damage. The Luria-Nebraska index...
Article
This study examined the Wisconsin Card Sorting Test (WCST) performance of 56 neuropsychiatric patients referred for neuropsychological assessment. Descriptive statistics showed a high degree of impairment on the WCST in the sample as a whole. The point biserial correlations between WCST variables and frontal cerebral involvement were significant bu...
Article
A summary index of neuropsychological impairment (mean Luria-Nebraska T score), along with age, education, and presence/absence of confirmed brain disease, was used to predict employment status (working/not working). Subjects were 50 patients referred for neuropsychological assessment of confirmed or suspected brain damage. The Luria-Nebraska index...
Article
A case study is reported which attempted to teach personal orienting information (i.e., recent history) to an amnesic male patient. The structured cuing methods reported by Kovner, Mattis, and Pass (1985, Journal of Clinical and Experimental Neuropsychology, 7, 395-411) were adopted. This involves structured presentation and cuing of target words e...
Article
The contribution of selected neurological, psychiatric, and demographic variables to the frequency of violent incidents was studied in an institutional context. A multiple regression procedure was used to predict the number of documented incidents for each of 45 neuropsychiatric patients. This procedure yielded a 5-variable equation that accounted...
Article
This study investigated Fuld's (1983) contention that a WAIS dementia profile occurs infrequently in conditions other than Alzheimer's Disease. A sample of 50 male head trauma patients was examined for incidence of the profile. The WAIS profile occurred in five cases (10%) of the patients. This compares favourably with the figures reported for pati...
Article
Both the Luria-Nebraska Neuropsychological Battery (LNNB) and the Beck Depression Inventory (BDI) were administered to 48 consecutively referred patients. These consecutively seen patients comprised 25 cases of confirmed brain damage and 23 cases of "suspected" or questionable damage. Product-moment correlations were calculated between the BDI and...
Article
20 male undergraduates rated 60 human figure paintings on verbal scales to index collative variability (e.g., simple-complex), perceived sexuality, and perceived aggression in the stimuli. Regression equations were used to predict epistemic (interest) and diversive (pleasingness) responses to the paintings. Collative variability predicted diversive...
Article
22 undergraduates rated 36 human-figure paintings on verbal scales to index uncertainty (e.g., simple–complex) and 2 types of aesthetic reaction: epistemic (e.g., uninteresting–interesting) and diversive (e.g., displeasing–pleasing). Linear and quadratic regression equations were used to examine relations between uncertainty and evaluative reaction...
Chapter
Full-text available
Consider the following scenario: A spectator is standing in front of a painting in an art gallery, he moves up close to the canvas, and then retreats several paces, finally, shaking his head as if to indicate displeasure, he moves on to the next painting. This episode appears simple to us, and its explanation seems obvious. Yet, on further examinat...

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