Abstract
Schizophrenia patients have been reported to have impairments in attention. In this study, we investigated their selective attention and tested whether they have difficulties in segmenting cues from the context. Twenty-one patients with schizophrenia and twenty-one healthy controls performed an arrow Flanker task, in which a potential cue was presented above the middle stimulus in the target display. Both groups had an accuracy of over 97%. In early trials, healthy controls demonstrated flanker interference on incongruent trials (RTIncongruent > RTNeutral) and facilitation on congruent trials (RTCongruent < RTNeutral), which aligns with previous research. They exhibited sustained flanker interference on incongruent trials and a decreased or non-significant effect on congruent trials in later trials. Patients with schizophrenia, on the other hand, did not show any temporal effects or attentional adjustments. Instead, they displayed flanker interference on incongruent trials and an inverse disadvantage effect on congruent trials both early and later in the experiment. Furthermore, compared to healthy controls, patients experienced a more pronounced flanker interference effect. These findings suggest that patients with schizophrenia have impairments in both information selection and attentional adjustment. This study extends prior research by demonstrating that the impairments of attention in schizophrenia extend beyond executive control and manifest in earlier stages of bottom-up processing.
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The data are available from the corresponding author upon reasonable request.
Notes
We conducted a corresponding analysis of covariance (ANCOVA) with age as the covariate to control for this potential confound. The results were similar, with a significant interaction between congruency and group, F(2, 78) = 3.22, p = .045, η2 = .08, and significant main effects of congruency and group, F(1, 63) = 7.90, p = .002, η2 = .17, and F(1, 39) = 5.19, p = .028, η2 = .12. The covariate, age, was not significant, F(1, 39) = .41, p = .527, η2 = .01. Therefore, our findings were not due to the influence of age differences between two groups.
The corresponding ANCOVA revealed a significant main effect of group, F(1, 39) = 5.91, p = .02, η2 = .13. There were no significant interaction, F(2, 78) = .05, p = .95, η2 = .01, or main effect of congruency, F(2, 78) = .77, p = .49, η2 = .02. The covariate, age, was not significant as well, F(1, 39) = 1.48, p = .23, η2 = .01.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
Barch, D. M., & Ceaser, A. (2012). Cognition in schizophrenia: Core psychological and neural mechanisms. Trends in Cognitive Sciences, 16(1), 27–34.
Barch, D. M., Carter, C. S., Perlstein, W., Baird, J., Cohen, J. D., & Schooler, N. (1999). Increased Stroop facilitation effects in schizophrenia are not due to increased automatic spreading activation. Schizophrenia Research, 39(1), 51–64.
Behrmann, M., Geng, J. J., & Shomstein, S. (2004). Parietal cortex and attention. Current Opinion in Neurobiology, 14(2), 212–217.
Boucart, M., Mobarek, N., Cuervo, C., & Danion, J. M. (1999). What is the nature of increased Stroop interference in schizophrenia? Acta Psychologica, 101(1), 3–25.
Bowie, C. R., & Harvey, P. D. (2005). Cognition in schizophrenia: Impairments, determinants, and functional importance. Psychiatric Clinics, 28(3), 613–633.
Bowie, C. R., & Harvey, P. D. (2006). Cognitive deficits and functional outcome in schizophrenia. Neuropsychiatric Disease and Treatment, 2(4), 531–536.
Carter, C. S., Robertson, L. C., & Nordahl, T. E. (1992). Abnormal processing of irrelevant information in chronic schizophrenia: Selective enhancement of Stroop facilitation. Psychiatry Research, 41(2), 137–146.
Chen, E. Y. H., Wong, A. W. S., Chen, R. Y. L., & Au, J. W. Y. (2001). Stroop interference and facilitation effects in first-episode schizophrenic patients. Schizophrenia Research, 48(1), 29–44.
Chuderski, A., & Smolen, T. (2016). An integrated utility-based model of conflict evaluation and resolution in the Stroop task. Psychological Review, 123(3), 255–290.
Cohen, J. D., Barch, D. M., Carter, C., & Servan-Schreiber, D. (1999). Context-processing deficits in schizophrenia: Converging evidence from three theoretically motivated cognitive tasks. Journal of Abnormal Psychology, 108(1), 120–133.
Davelaar, E. J., & Stevens, J. (2009). Sequential dependencies in the Eriksen flanker task: A direct comparison of two competing accounts. Psychonomic Bulletin & Review, 16(1), 121–126.
Davranche, K., Hall, B., & McMorris, T. (2009). Effect of acute exercise on cognitive control required during an Eriksen flanker task. Journal of Sport and Exercise Psychology, 31(5), 628–639.
Eriksen, B. A., & Eriksen, C. W. (1974). Effects of noise letters upon the identification of a target letter in a nonsearch task. Perception & Psychophysics, 16(1), 143–149.
Eyler Zorrilla, L. T., Heaton, R. K., McAdams, L. A., Zisook, S., Harris, M. J., & Jeste, D. V. (2000). Cross-sectional study of older outpatients with schizophrenia and healthy comparison subjects: No differences in age-related cognitive decline. American Journal of Psychiatry, 157(8), 1324–1326.
Giraldo-Chica, M., Rogers, B. P., Damon, S. M., Landman, B. A., & Woodward, N. D. (2018). Prefrontal-thalamic anatomical connectivity and executive cognitive function in schizophrenia. Biological Psychiatry, 83(6), 509–517.
Gold, J. M., Hahn, B., Strauss, G. P., & Waltz, J. A. (2009). Turning it upside down: Areas of preserved cognitive function in schizophrenia. Neuropsychology Review, 19(3), 294–311.
Goldberg, T. E., Weinberger, D. R., Berman, K. F., Pliskin, N. H., & Podd, M. H. (1987). Further evidence for dementia of the prefrontal type in schizophrenia?: A controlled study of teaching the Wisconsin card sorting test. Archives of General Psychiatry, 44(11), 1008–1014.
Granholm, E., Link, P., Fish, S., Kraemer, H., & Jeste, D. (2010). Age-related practice effects across longitudinal neuropsychological assessments in older people with schizophrenia. Neuropsychology, 24(5), 616–624.
Henik, A., & Salo, R. (2004). Schizophrenia and the stroop effect. Behavioral and Cognitive Neuroscience Reviews, 3(1), 42–59.
Hepp, H. H., Maier, S., Hermle, L., & Spitzer, M. (1996). The Stroop effect in schizophrenic patients. Schizophrenia Research, 22(3), 187–195.
Hu, K., Bauer, A., Padmala, S., & Pessoa, L. (2012). Threat of bodily harm has opposing effects on cognition. Emotion, 12(1), 28–32.
Hu, F. K., He, S., Fan, Z., & Lupiáñez, J. (2014). Beyond the inhibition of return of attention: Reduced habituation to threatening faces in schizophrenia. Frontiers in Psychiatry, 5(7), 1–11.
Hu, K., Fan, Z., & He, S. (2015a). Uncovering the interaction between empathetic pain and cognition. Psychological Research, 79(6), 1054–1063.
Hu, K., Lijffijt, M., Beauchaine, T. P., Fan, Z., Shi, H., & He, S. (2015b). Influence of empathetic pain processing on cognition in schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 265(7), 623–631.
Jennings, J. R., & Wood, C. C. (1976). The e-adjustment procedure for repeated-measures analyses of variance. Psychophysiology, 13, 277–278.
Kalanthroff, E., & Henik, A. (2013). Individual but not fragile: Individual differences in task control predict Stroop facilitation. Consciousness and Cognition, 22(2), 413–419.
Kopp, B., Mattler, U., & Rist, F. (1994). Selective attention and response competition in schizophrenic patients. Psychiatry Research, 53(2), 129–139.
Laere, E., Tee, S. F., & Tang, P. Y. (2018). Assessment of cognition in schizophrenia using trail making test: A meta-analysis. Psychiatry Investigation, 15(10), 945–955.
Lee, J., & Park, S. (2005). Working memory impairments in schizophrenia: A meta-analysis. Journal of Abnormal Psychology, 114(4), 599–611.
Lewandowski, K. E., Baker, J. T., McCarthy, J. M., Norris, L. A., & Öngür, D. (2018). Reproducibility of cognitive profiles in psychosis using cluster analysis. Journal of the International Neuropsychological Society, 24(4), 382–390.
Lipszyc, J., & Schachar, R. (2010). Inhibitory control and psychopathology: A meta-analysis of studies using the stop signal task. Journal of the International Neuropsychological Society, 16(6), 1064–1076.
Loewenstein, D. A., Czaja, S. J., Bowie, C. R., & Harvey, P. D. (2012). Age-associated differences in cognitive performance in older patients with schizophrenia: A comparison with healthy older adults. The American Journal of Geriatric Psychiatry, 20(1), 29–40.
Luck, S. J., & Gold, J. M. (2008). The construct of attention in schizophrenia. Biological Psychiatry, 64(1), 34–39.
Luck, S. J., Hahn, B., Leonard, C. J., & Gold, J. M. (2019). The hyperfocusing hypothesis: A new account of cognitive dysfunction in schizophrenia. Schizophrenia Bulletin, 45(5), 991–1000.
MacLeod, C. M., & MacDonald, P. A. (2000). Interdimensional interference in the Stroop effect: Uncovering the cognitive and neural anatomy of attention. Trends in Cognitive Sciences, 4(10), 383–391.
Mayr, U., Awh, E., & Laurey, P. (2003). Conflict adaptation effects in the absence of executive control. Nature Neuroscience, 6(5), 450–452.
Minzenberg, M. J., Laird, A. R., Thelen, S., Carter, C. S., & Glahn, D. C. (2009). Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia. Archives of General Psychiatry, 66(8), 811–822.
Mockler, D., Riordan, J., & Sharma, T. (1997). Memory and intellectual deficits do not decline with age in schizophrenia. Schizophrenia Research, 26(1), 1–7.
O’Donnell, B. F. (2007). Cognitive impairment in schizophrenia: A life span perspective. American Journal of Alzheimer’s Disease & Other Dementias®, 22(5), 398–405.
Ro, T., Machado, L., Kanwisher, N., & Rafal, R. D. (2002). Covert orienting to the locations of targets and distractors: Effects on response channel activation in a flanker task. The Quarterly Journal of Experimental Psychology Section A, 55(3), 917–936.
Romero-Ferreiro, V., Garcia-Gutierrez, A., Torio, I., Mari-Beffa, P., Rodriguez-Gomez, P., Periañez, J., Moreno, E. M., Romero, C., Alvarez-Mon, M., & Rodriguez-Jimenez, R. (2023). Cognitive versus emotional modulation within a Stroop paradigm in patients with schizophrenia. BJPsych Open, 9(1), e19.
Schooler, C., Neumann, E., Caplan, L. J., & Roberts, B. R. (1997). A time course analysis of Stroop interference and facilitation: Comparing normal individuals and individuals with schizophrenia. Journal of Experimental Psychology: General, 126(1), 19–36.
Smid, H. G. O. M., Bruggeman, R., & Martens, S. (2016). Normal cognitive conflict resolution in psychosis patients with and without schizophrenia. Journal of Abnormal Psychology, 125(1), 88–103.
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18(6), 643–662.
Stuss, D. T. (2011). Functions of the frontal lobes: Relation to executive functions. Journal of the International Neuropsychological Society, 17(5), 759–765.
Thai, M. L., Andreassen, A. K., & Bliksted, V. (2019). A meta-analysis of executive dysfunction in patients with schizophrenia: Different degree of impairment in the ecological subdomains of the Behavioural assessment of the Dysexecutive syndrome. Psychiatry Research, 272, 230–236.
Uren, J., Cotton, S. M., Killackey, E., Saling, M. M., & Allott, K. (2017). Cognitive clusters in first-episode psychosis: Overlap with healthy controls and relationship to concurrent and prospective symptoms and functioning. Neuropsychology, 31(7), 787–797.
Van Assche, M., & Giersch, A. (2011). Visual organization processes in schizophrenia. Schizophrenia Bulletin, 37(2), 394–404.
Verdoux, H., Liraud, F., Bourgeois, M. L., Gonzales, B., Assens, F., Abalan, F., Beaussier, J. P., Gaussares, C., Etchegaray, B., & van Os, J. (1999). The association of neuropsychological deficits to clinical symptoms in first-admission subjects with psychotic disorders. Schizophrenia Research, 37(2), 198–201.
Westerhausen, R., Kompus, K., & Hugdahl, K. (2011). Impaired cognitive inhibition in schizophrenia: A meta-analysis of the Stroop interference effect. Schizophrenia Research, 133(1–3), 172–181.
Westerhausen, R., Kompus, K., & Hugdahl, K. (2013). Unaffected control of distractor interference in schizophrenia: A meta-analysis of incompatibility slowing in flanker tasks. Journal of Psychiatric Research, 47(2), 246–251.
Wright, I. C., Rabe-Hesketh, S., Woodruff, P. W. R., David, A. S., Murray, R. M., & Bullmore, E. T. (2000). Meta-analysis of regional brain volumes in schizophrenia. American Journal of Psychiatry, 157(1), 16–25.
Wysocki, J. J., & Sweet, J. J. (1985). Identification of brain-damaged, schizophrenic, and normal medical patients using a brief neuropsychological screening battery. International Journal of Clinical Neuropsychology, 7(1), 40–44.
Yücel, M., Volker, C., Collie, A., Maruff, P., Danckert, J., Velakoulis, D., & Pantelis, C. (2002). Impairments of response conflict monitoring and resolution in schizophrenia. Psychological Medicine, 32(7), 1251–1260.
Acknowledgements
We gratefully acknowledge the contributions of all participants and two anonymous reviewers for their professional comments. This study was supported by start-up funds from the University of Arkansas, Little Rock to KH; partially by the Open Research Fund of the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Key project of Bei**g Education Science Planning (BEAA21046), and National Natural Science Foundation of China (Grants 31571161) to QL; and partially by NIH grants R21AG067024 and R01AG072893 to CL.
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Qi Li and Hongmin Xu shared first authorship.
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Li, Q., Xu, H., Ren, Q. et al. Schizophrenia patients show impaired bottom-up processing and attentional adjustment. Curr Psychol 43, 14324–14334 (2024). https://doi.org/10.1007/s12144-023-05355-w
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DOI: https://doi.org/10.1007/s12144-023-05355-w