Episodic memory functions in first episode psychosis and clinical high risk individuals

Abstract

Objective Individuals with schizophrenia have disproportionate memory impairments when encoding relational versus item-specific information, and when using recollection versus familiarity during retrieval. It is unclear whether this pattern is unique to people with chronic schizophrenia, or if it occurs in individuals after a first episode of psychosis (FE), or when at clinical high-risk for psychosis (CHR). Methods We administered the Relational and Item-Specific Memory task (RiSE) to 22 CHR, 101 FE, and 58 typically developing (TD) participants. We examined group differences in item and relational encoding, and familiarity-based and recollection-based retrieval using parametric analysis and structural equation modeling (SEM). Longitudinal data allowed us to examine relations between baseline RiSE performance and change in clinical symptoms at 1-year follow-up in the FE group. Results Groups did not differ on familiarity. FE and CHR groups were equally impaired on overall recognition accuracy. Although recollection was impaired in both FE and CHR groups following relational encoding, only the FE group had impaired recollection following item encoding. SEM showed atypical relationships between familiarity and recollection, as well as familiarity and item recognition for both the FE and CHR groups. For FE individuals, better baseline recognition accuracy predicted less severe negative symptoms at 1-year follow-up. Conclusions Impaired relational and recollective memory may reflect neurodevelopmental abnormalities predating conversion to psychosis. These memory deficits appear related to negative symptom changes. In contrast, item specific recollection deficits appear to occur after the development of full psychosis. Familiarity appears to be a relatively preserved memory function across the psychosis spectrum.

Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective

“…C. Liu et al 2015). Impairments similar to first-episode patients have been reported for sustained attention (Francey et al 2005) and relational memory (Greenland-White et al 2017). Overall, ultra-high risk participants demonstrate global impairments that are intermediate in magnitude between healthy controls and first-episode.…”

Differential patterns of contextual organization of memory in first-episode psychosis

“…Poor episodic memory is among the most reliable deficit in psychosis. 1 – 4 These impairments are present across all phases of the illness, 5 – 7 and are one of the strongest neurocognitive predictors of conversion to psychosis in high-risk populations. 8 Characterizing the mechanisms underlying the organization and retrieval of memory in psychosis is critical in order to understand the complex array of cognitive deficits associated with the disorder.…”

“…Compared to controls, psychosis patients are more likely to retrieve memories in the absence of contextual details about the event. 1 , 5 , 7 , 13 – 15 For example, patients may have equivalent memory for recognizing objects, but show deficits when they have to identify when they saw an object in a sequence of events (i.e., temporal context) or when they have to sort objects into pre-existing categories (i.e., semantic context). In fact, prior research using the CMR framework has shown deficits in using temporal context to support memory recall in chronic schizophrenia.…”

Seeing minds: A Signal Detection Study of Agency Attribution in Autism and Psychosis

“…ASD and psychosis have been linked to, for example, deficits in social cognition (Solomon et al, 2011), impaired recollection (Greenland-White, Ragland, Niendam, Ferrer, & Carter, 2017;Solomon, McCauley, Iosif, Carter, & Ragland, 2016), and language difficulties (Nunn & Peters, 2001;Solomon et al, 2011).…”