Negative Symptoms and Cognitive Deficits: What Is the Nature of Their Relationship?

Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY, USA.
Schizophrenia Bulletin (Impact Factor: 8.45). 05/2006; 32(2):250-8. DOI: 10.1093/schbul/sbj011
Source: PubMed


Negative symptoms and cognitive deficits in schizophrenia share many features and are correlated in their severity on a cross-sectional
basis. The question arises as to the nature of this relationship: are these symptoms the same, caused by the same factor (or
factors); or is the nature of their relationship determined by other factors, such as definitional issues and common correlates?
In this article we provide a conceptual overview for addressing this question and provide a selective review of the literature
on the cross-sectional and longitudinal relationships between these two features of the illness. We describe 4 different models
of the “true” relationship between these variables. Some data suggest that the relationship between these variables is determined
by the definition of negative symptoms employed and that, in general, the correlation is moderate at the most. Further, path
modeling suggests the possibility, to be addressed with later research, that correlations between negative and cognitive symptoms
and everyday functional outcomes may influence the observed correlations between these variables. Thus, we conclude that negative
and cognitive symptoms may be separable, if not conceptually independent, domains of the illness and that it might be possible
to develop treatments that target negative symptoms and cognitive deficits independently.

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Available from: Christopher Bowie, Dec 24, 2014
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    • "Our two subgroups of patients were relatively similar on all other demographic and clinical measures, with the exception of negative symptom severity. Negative symptoms in schizophrenia are related to VM deficits (Harvey et al., 2006;Hovington et al., 2013) and as such, this difference is not surprising. There are several studies that have not found significant cortical thickness associations with negative symptom severity in schizophrenia (Sigmundsson et al., 2001;Kuperberg et al., 2003;Rimol et al., 2012;Xiao et al., 2015). "
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    ABSTRACT: Verbal memory (VM) represents one of the most affected cognitive domains in schizophrenia. Multiple studies have shown that schizophrenia is associated with cortical abnormalities, but it remains unclear whether these are related to VM impairments. Considering the vast literature demonstrating the role of the frontal cortex, the parahippocampal cortex, and the hippocampus in VM, we examined the cortical thickness/volume of these regions. We used a categorical approach whereby 27 schizophrenia patients with 'moderate to severe' VM impairments were compared to 23 patients with 'low to mild' VM impairments and 23 healthy controls. A series of between-group vertex-wise GLM on cortical thickness were performed for specific regions of interest defining the parahippocampal gyrus and the frontal cortex. When compared to healthy controls, patients with 'moderate to severe' VM impairments revealed significantly thinner cortex in the left frontal lobe, and the parahippocampal gyri. When compared to patients with 'low to mild' VM impairments, patients with 'moderate to severe' VM impairments showed a trend of thinner cortex in similar regions. Virtually no differences were observed in the frontal area of patients with 'low to mild' VM impairments relative to controls. No significant group differences were observed in the hippocampus. Our results indicate that patients with greater VM impairments demonstrate significant cortical thinning in regions known to be important in VM performance. Treating VM deficits in schizophrenia could have a positive effect on the brain; thus, subgroups of patients with more severe VM deficits should be a prioritized target in the development of new cognitive treatments.
    Full-text · Article · Dec 2015 · Clinical neuroimaging
    • "It was developed to measure the awareness of negative symptoms, their causal attribution and the distress level caused by the symptoms. However, the SANS has been criticized for conceptual reasons such as including items that measure cognitive functioning, which have now been recognized to be conceptually distinct from negative symptoms [8] [21]. It was not until recently – and driven by the Collaboration to Advance Negative Symptom Assessment in Schizophrenia (CANSAS) that attempts have intensified to further develop measures for negative symptoms. "
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    ABSTRACT: Objectives: Validated self-report instruments could provide a time efficient screening method for negative symptoms in people with schizophrenia. The aim of this study was to examine the psychometric properties of a German version of the Motivation and Pleasure Scale-Self-Report (MAP-SR) which is based on the Clinical Assessment Interview for Negative Symptoms (CAINS). Methods: In- and outpatients (N = 50) with schizophrenia or schizoaffective disorder were assessed with standardized interviews and questionnaires on negative and positive symptoms and general psychopathology in schizophrenia, depression, and global functioning. Results: The German version of the MAP-SR was found to show high internal consistency. Convergent validity was supported by significant correlations between the MAP-SR with the experience scale of the CAINS and the negative symptom scale of the Positive and Negative Syndrome Scale. The MAP-SR also exhibited discriminant validity indicated by its non-significant correlations with positive symptoms and general psychopathology, which is in line with the findings for the original version of the MAP-SR. However, the MAP-SR correlated moderately with depression. Conclusion: The German MAP-SR appears to be a valid and suitable diagnostic tool for the identification of negative symptoms in schizophrenia.
    No preview · Article · Nov 2015 · Comprehensive psychiatry
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    • "Himelhoch et al., 1996; Collins et al., 1997; Daban et al., 2002; Minzenberg et al., 2003; Lucas et al., 2004; Rund et al., 2004), while meta-analyses have generally found small to moderate correlations between negative and cognitive symptoms (Nieuwenstein et al., 2001; Dibben et al., 2009; Dominguez Mde et al., 2009; Ventura et al., 2009). These two domains have been described as separable although not conceptually independent, and models in which negative symptoms and cognitive dysfunction may have related etiologies, overlapping definitions or measurements, or shared correlations with distal outcomes have been proposed (Harvey et al., 2006). Some of the inconsistent findings regarding the relationship between negative and cognitive schizophrenic symptoms may be related to different factors that could influence this relationship, or to methodological issues. "
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    ABSTRACT: Previous studies have generally found a relationship between negative and cognitive symptoms in schizophrenia. The present study investigated the relationship between the 5 PANSS factors of a recent consensus model developed by NIMH researchers, and cognitive performance as assessed with the MATRICS Consensus Cognitive Battery (MCCB) in 80 patients with schizophrenia using correlation and regression analyses. The PANSS Cognitive factor showed a small to moderate significant association with MCCB Speed of processing, Working memory, Verbal learning, the Neurocognitive composite score, and the Overall composite score. Notably, however, no relationship was found between the PANSS Negative factor and any of the MCCB scores. The Positive, Excited and Depressed factors also did not show associations with the MCCB. These results highlight the need for refined assessment instruments and support the relative independence of cognition from other domains of psychopathology, including negative symptoms, in patients with schizophrenia.
    Full-text · Article · Oct 2015
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