SUBTYPING IN CHRONIC SCHIZOPHRENIA: CLINICAL, NEUROPSYCHOLOGICAL, AND STRUCTURAL INDICES OF DETERIORATION (CT-SCAN, ATROPHY, COGNITIVE).
Item
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Title
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SUBTYPING IN CHRONIC SCHIZOPHRENIA: CLINICAL, NEUROPSYCHOLOGICAL, AND STRUCTURAL INDICES OF DETERIORATION (CT-SCAN, ATROPHY, COGNITIVE).
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Identifier
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AAI8501116
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identifier
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8501116
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Creator
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BILDER, ROBERT M., JR.
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Contributor
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Jeffrey J. Rosen
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Date
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1984
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Physiological
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Abstract
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Researchers have proposed that a "subtype" of chronic schizophrenia may exist that is marked by degeneration of both brain and behavior. This theoretical syndrome has been characterized as one in which: (a) "negative" symptoms and history of poor premorbid social adjustment are pominent, (b) neuropsychological deficits are conspicuous, and (c) structural abnormalities of the brain such as ventricular enlargement and cortical atrophy may be seen on computed tomographic (CT) scans.;The association of these characteristics was studied in a sample of 32 chronic schizophrenic or schizoaffective inpatients on a research unit. Correlations within and between predefined sets of symptoms did not support the hypothetical distinction between positive and negative symptoms. Although clusters of "core" negative and positive symptoms were identified, a nonspecific cluster including both positive and negative components was prominent.;The core clusters of symptoms related to some of the other subtyping measures along hypothesized lines. The core negative symptoms (affective flattening, avolition/apathy, anhedonia) were related to poor premorbid social adjustment, neuropsychological deficits, and evidence of deterioration from previously higher levels of functioning. The core positive symptoms (delusions, hallucinations, breadth of psychosis) were unrelated to these defects. The nonspecific group of positive and negative symptoms (alogia, attentional impairment, formal thought disorder, and bizarre behavior) was associated with the most severe neuropsychological deficit and evidence of poor premorbid intelligence, but not with CT-scan abnormalities.;Evidence of ventricular enlargement and cortical atrophy was strongly correlated with indices of intellectual deterioration, and surprisingly, with higher estimates of premorbid intelligence and educational achievement. The results indicate that CT-scan abnormalities were related to better premorbid functioning; or conversely, that patients not manifesting structural degeneration of the brain had never developed adequate cognitive abilities.;Sample selection is probably critical to the interpretation of these findings and the results of other investigators. In this sample, a process characterized by symptoms of cognitive/attentional disturbance and severe neuropsychological impairment was independent of the current definitions of positive and negative symptoms and unrelated to CT-scan abnormalities. This pattern of associations is discussed in the context of the abnormal development of cerebral systems.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
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Program
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Psychology
