Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-18T05:13:57.072Z Has data issue: false hasContentIssue false

Decreased processing speed might account for working memory span deficit in schizophrenia, and might mediate the associations between working memory span and clinical symptoms

Published online by Cambridge University Press:  15 April 2020

C. Stephan-Otto
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
E. Huerta-Ramos
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
J. Usall
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
M. Perez del Olmo
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
M. Contel
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
J.M. Haro
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
S. Ochoa
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAMC/Doctor Antoni Pujadas 42 Sant Boi de Llobregat, Barcelona 08830Spain
Get access

Abstract

Objective

Verbal working memory span is decreased in patients with schizophrenia, and this might contribute to impairment in higher cognitive functions as well as to the formation of certain clinical symptoms. Processing speed has been identified as a crucial factor in cognitive efficiency in this population. We tested the hypothesis that decreased processing speed underlies the verbal working memory deficit in patients and mediates the associations between working memory span and clinical symptoms.

Method

Forty-nine schizophrenia inpatients recruited from units for chronic and acute patients, and forty-five healthy participants, were involved in the study. Verbal working memory span was assessed by means of the letter-number span. The Digit Copy test was used to assess motor speed, and the Digit Symbol Substitution Test to assess cognitive speed.

Results

The working memory span was significantly impaired in patients (F(1,90) = 4.6, P < 0.05). However, the group difference was eliminated when either the motor or the cognitive speed measure was controlled (F(1,89) = 0.03, P = 0.86, and F(1,89) = 0.03, P = 0.88). In the patient group, working memory span was significantly correlated with negative symptoms (r = –0.52, P < 0.0001) and thought disorganisation (r = –0.34, P < 0.025) scores. Regression analyses showed that the association with negative symptoms was no longer significant when the motor speed measure was controlled (β = –0.12, P = 0.20), while the association with thought disorganisation was no longer significant when the cognitive speed measure was controlled (β = –0.10, P = 0.26).

Conclusions

Decrement in motor and cognitive speed plays a significant role in both the verbal working memory impairment observed in patients and the associations between verbal working memory impairment and clinical symptoms.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aleman, A., Hijman, R., de Haan, E.H., Kahn, R.S.Memory impairment in schizophrenia: a meta-analysis. Am J Psychiatry 1999;156(9):13581366.Google ScholarPubMed
Andersen, R., Fagerlund, B., Rasmussen, H., Ebdrup, B.H., Aggernaes, B., Gade, A.et al.The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients. Eur Psychiatry 2013;28(6):332339.CrossRefGoogle ScholarPubMed
Baddeley, A.Working memory: theories, models, and controversies. Annu Rev Psychol 2012;63:129.CrossRefGoogle ScholarPubMed
Basso, M.R., Nasrallah, H.A., Olson, S.C., Bornstein, R.A.Neuropsychological correlates of negative, disorganized and psychotic symptoms in schizophrenia. Schizophr Res 1998;31(2–3):99111.CrossRefGoogle Scholar
Bell, M.D., Mishara, A.L.Does negative symptom change relate to neurocognitive change in schizophrenia? Implications for targeted treatments. Schizophr Res 2006;81(1):1727.CrossRefGoogle ScholarPubMed
Berman, I., Viegner, B., Merson, A., Allan, E., Pappas, D., Green, A.I.Differential relationships between positive and negative symptoms and neuropsychological deficits in schizophrenia. Schizophr Res 1997;25(1):110.CrossRefGoogle Scholar
Brébion, G., David, A.S., Jones, H.M., Pilowsky, L.S.Working memory span and motor and cognitive speed in schizophrenia. Cogn Behav Neurol 2009;22(2):101108.CrossRefGoogle Scholar
Brébion, G., Bressan, R.A., Pilowsky, L.S., David, A.S.Processing speed and working memory span: their differential role in superficial and deep memory processes in schizophrenia. J Int Neuropsychol Soc Cambridge University Press 2011;17(03):485493.CrossRefGoogle Scholar
Conklin, H.M., Curtis, C.E., Katsanis, J., Iacono, W.G.Verbal working memory impairment in schizophrenia patients and their first-degree relatives: evidence from the digit span task. Am J Psychiatry 2000;157(2):275277.CrossRefGoogle ScholarPubMed
Dickinson, D., Ramsey, M.E., Gold, J.M.Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Arch Gen Psychiatry 2007;64(5):532542.CrossRefGoogle Scholar
Docherty, N.M.On identifying the processes underlying schizophrenic speech disorder. Schizophr Bull 2012;38(6):13271335.CrossRefGoogle ScholarPubMed
Gomar, J.J., Ortiz-Gil, J., McKenna, P.J., Salvador, R., Sans-Sansa, B., Sarró, S.et al.Validation of the Word Accentuation Test (TAP) as a means of estimating premorbid IQ in Spanish speakers. Schizophr Res 2011;128(1–3):175176.CrossRefGoogle ScholarPubMed
Horan, W.P., Braff, D.L., Nuechterlein, K.H., Sugar, C.A., Cadenhead, K.S., Calkins, M.E.et al.Verbal working memory impairments in individuals with schizophrenia and their first-degree relatives: findings from the Consortium on the Genetics of Schizophrenia. Schizophr Res 2008;103(1–3);218228.CrossRefGoogle Scholar
Knowles, E.E.M., David, A.S., Reichenberg, A.Processing speed deficits in schizophrenia: reexamining the evidence. Am J Psychiatry 2010;167(7):828835.CrossRefGoogle ScholarPubMed
Leeson, V.C., Barnes, T.R.E., Harrison, M., Matheson, E., Harrison, I., Mutsatsa, S.H.et al.The relationship between IQ, memory, executive function, and processing speed in recent-onset psychosis: 1-year stability and clinical outcome. Schizophr Bull 2010;36(2):400409.CrossRefGoogle ScholarPubMed
Minzenberg, M.J., Poole, J.H., Benton, C., Vinogradov, S.Association of anticholinergic load with impairment of complex attention and memory in schizophrenia. Am J Psychiatry 2004;161(1):116124.CrossRefGoogle Scholar
Moritz, S., Andresen, B., Jacobsen, D., Mersmann, K., Wilke, U., Lambert, M.et al.Neuropsychological correlates of schizophrenic syndromes in patients treated with atypical neuroleptics. Eur Psychiatry 2001;16(6):354361.CrossRefGoogle ScholarPubMed
Morrens, M., Hulstijn, W., Van Hecke, J., Peuskens, J., Sabbe, B.G.C.Sensorimotor and cognitive slowing in schizophrenia as measured by the Symbol Digit Substitution Test. J Psychiatr Res 2006;40(3):200206.CrossRefGoogle ScholarPubMed
O’Leary, D.S., Flaum, M., Kesler, M.L., Flashman, L.A., Arndt, S., Andreasen, N.C.Cognitive correlates of the negative, disorganized, and psychotic symptom dimensions of schizophrenia. J Neuropsychiatry Clin Neurosci 2000;12(1):415.CrossRefGoogle ScholarPubMed
Ojeda, N., Peña, J., Sánchez, P., Elizagárate, E., Ezcurra, J.Processing speed mediates the relationship between verbal memory, verbal fluency, and functional outcome in chronic schizophrenia. Schizophr Res 2008;101(1–3):225233.CrossRefGoogle ScholarPubMed
Ojeda, N., Peña, J., Schretlen, D.J., Sánchez, P., Aretouli, E., Elizagárate, E.et al.Hierarchical structure of the cognitive processes in schizophrenia: the fundamental role of processing speed. Schizophr Res 2012;135(1–3):7278.CrossRefGoogle ScholarPubMed
Peralta, V., Cuesta, M.J.Dimensional structure of psychotic symptoms: an item-level analysis of SAPS and SANS symptoms in psychotic disorders. Schizophr Res 1999;38(1):1326.CrossRefGoogle ScholarPubMed
Perry, W., Heaton, R.K., Potterat, E., Roebuck, T., Minassian, A., Braff, D.L.Working memory in schizophrenia: transient “online” storage versus executive functioning. Schizophr Bull 2001;27(1):157176.CrossRefGoogle ScholarPubMed
Pukrop, R., Matuschek, E., Ruhrmann, S., Brockhaus-Dumke, A., Tendolkar, I., Bertsch, A.et al.Dimensions of working memory dysfunction in schizophrenia. Schizophr Res 2003;62(3):259268.CrossRefGoogle Scholar
Rodríguez-Sánchez, J.M., Crespo-Facorro, B., González-Blanch, C., Perez-Iglesias, R., Vázquez-Barquero, J.L.Cognitive dysfunction in first-episode psychosis: the processing speed hypothesis. Br J Psychiatry Suppl 2007;51(51):s107s110.CrossRefGoogle ScholarPubMed
Silver, H., Feldman, P., Bilker, W., Gur, R.C.Working memory deficit as a core neuropsychological dysfunction in schizophrenia. Am J Psychiatry 2003;160(10):18091816.CrossRefGoogle Scholar
Twamley, E.W., Palmer, B.W., Jeste, D.V., Taylor, M.J., Heaton, R.K.Transient and executive function working memory in schizophrenia. Schizophr Res 2006;87(1–3):185190.CrossRefGoogle Scholar
Veselinovic, T., Schorn, H., Vernaleken, I.B., Hiemke, C., Zernig, G., Gur, R.et al.Effects of antipsychotic treatment on cognition in healthy subjects. J Psychopharmacol 2013;27(4):374385.CrossRefGoogle ScholarPubMed
Weickert, T.W., Goldberg, T.E.First- and second-generation antipsychotic medication and cognitive processing in schizophrenia. Curr Psychiatry Rep 2005;7(4):304310.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.