Attentional functioning in schizotypal personality disorder [published erratum appears in Am J Psychiatry 1997 Aug;154(8):1180]

Abstract

I t has been suggested that the boundaries of schizophrenia extend beyond the core psychotic illness to include milder schizophrenia-related personality disorders and that the genetic and neurocognitive factors implicated in schizophrenia are expressed across the full range of schizophrenia-related illnesses. Furthermore, results from family studies suggest that schizotypal personality disorder, the prototype for the milder schizophrenia-spectrum personality disorders, may be a more common phenotypic expression of the schizophrenia-related genotype than chronic schizophrenia (1-4). Because of the genetic relationship between schizophrenia and schizotypal personality disorder, the study of the phenomenology, biology, and neurocognition of patients with schizotypal personality disorder provides an opportunity to investigate the pathophysiology of schizophrenia without the confounding factors (such as medication effects, hospitalization, and psychosis) often found in research with chronic schizophrenic patients.Although attention, as measured by the Continuous Performance Test, has been identified as a potential phenotypic indicator of schizophrenia (5, 6), attentional functioning in subjects with schizotypal personality disorder has not been extensively studied. Attentional impairments have been found in both actively psychotic schizophrenic patients and those in remission (7-9), as well as in first-degree relatives of schizophrenic individuals (10-12) and psychometrically defined schizotypic volunteers (13). These studies suggest that abnormal attention is centrally related to the biology of schizophrenia spectrum disorders and raise the possibility that attentional difficulties may provide a biobehavioral indicator of liability to schizophrenia (5).

Assessing Long-Term Test-Retest Reliability of the CPT-IP in Schizophrenia

“…Here subjects have to respond to a second stimulus in any pair of identical stimuli that may include 2, 3 or 4 digits and shapes, which activate the verbal and spatial attentional neuronal systems [7]. Especially in its more challenging versions CPT-IP performance deficits were also found in prodromal stages of schizophrenia, in first episode neuroleptic-naive schizophrenic patients [8], in individuals within the schizophrenia spectrum, including schizotypal personality traits [9]–[11], and in asymptomatic first-degree relatives of patients with schizophrenia [12].…”

Functional outcomes, functional capacity, and cognitive impairment in schizotypal personality disorder

“…Patients with Schizotypal Personality Disorder (SPD), a schizophrenia spectrum disorder that is phenomenologically and biologically related to schizophrenia (Siever et al, 1993), have impairments in several areas of cognitive functioning, such as episodic memory (Cadenhead et al, 1999), inhibition (Moritz and Mass, 1997), abstraction (Voglmaier et al, 1997), sustained attention (Roitman et al, 1997), working memory (Mitropoulou et al, 2005; Roitman et al, 2000) and context processing (McClure et al, 2008). These deficits are qualitatively similar but less severe than those seen in schizophrenia.…”

The Effects of Risperidone on the Cognitive Performance of Individuals With Schizotypal Personality Disorder

“…7–10 We have previously demonstrated that the cognitive impairments of individuals with SPD are amenable to treatment with pharmacological agents, in particular those that modulate catecholamine functioning. In particular, 4 weeks of treatment with guanfacine, significantly improved the context processing abilities of SPD participants compared with those treated with placebo.…”