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Tower of London versus Real Life Analogue Planning in Schizophrenia with Disorganization and Psychomotor Poverty Symptoms

Published online by Cambridge University Press:  08 April 2011

Kathryn E. Greenwood*
Department of Psychology, Kings College London, Institute of Psychiatry, London, United Kingdom Department of Psychology, University of Sussex, Falmer, Brighton, United Kingdom Early Intervention in Psychosis Service, Sussex, United Kingdom
Til Wykes
Department of Psychology, Kings College London, Institute of Psychiatry, London, United Kingdom
Thordur Sigmundsson
Department of Psychiatry, Landspitalinn, The University Hospital, Reykjavik, Iceland
Sabine Landau
Department of Biostatistics and Computing, Kings College London, Institute of Psychiatry, London, United Kingdom
Robin G. Morris
Department of Psychology, Kings College London, Institute of Psychiatry, London, United Kingdom
Correspondence and reprint requests to: Kathryn Greenwood, School of Psychology, Pevensey Building, University of Sussex, Falmer, Brighton, United Kingdom. BN1 9QH. E-mail:


Neuropsychological models propose qualitatively distinct planning impairments in the psychomotor poverty and disorganization syndromes in schizophrenia. It was proposed that poor plan initiation in psychomotor poverty would lead to longer initial planning times, while poor plan execution in disorganization would lead to greater inefficiency. Participants with psychomotor poverty (n = 30) and disorganization (n = 29) symptoms were contrasted with healthy controls (n = 28) to elucidate distinct planning impairments. Planning was compared in the Tower of London task versus real life analogue performance in the form of a board-game style diary planning task. The specificity of planning impairments was investigated by controlling for current IQ. The disorganization group demonstrated inefficient planning across both tasks, with poor performance on the Tower of London but not on the real life analogue task remaining after intelligence levels were taken into account. Initial planning times did not differ between groups. Previous associations between poor planning and symptoms may have been driven by poor planning with disorganization symptoms and associated lower order impairments in executive function or the semantic system. Targeting these impairments in people with disorganization symptoms may lead to a greater chance of success in promoting generalization to the real world. (JINS, 2011, 17, 474–484)

Research Articles
Copyright © The International Neuropsychological Society 2011

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