Positive and Negative Symptoms in Psychosis: Description, Research, and Future Directions

By Philip D. Harvey; Elaine E. Walker | Go to book overview

RELATING COGNITIVE PROCESSES TO SYMPTOMS: A STRATEGY TO COUNTER METHODOLOGICAL DIFFICULTIES

Raymond A. Knight Ph.D.

There is a growing consensus that some form of an early information input dysfunction constitutes a central deficit in schizophrenia. A substantial body of evidence (cf. Nuechterlein & Dawson, 1984b, for a review) indicates that an input dysfunction might predate the onset of the disorder and be a consistent trait of schizophrenics in both their acute and remitted stages. For example, input dysfunctions have been found in nonpsychotic schizotypic individuals ( Balogh & Merritt, 1985; Braff, 1981; Steronko & Woods, 1978), and in a significant subset of children at increased risk for adult schizophrenia ( Asarnow, Steffy, MacCrimmon, & Cleghorn, 1978; Nuechterlein, 1983; but see also Harvey, Weintraub, & Neale, 1985). In addition, input dysfunctions have been identified in the first degree relatives of schizophrenics ( DeAmicis & Cromwell, 1979; Spring, Levitt, Briggs, & Benet, 1983), further supporting the potential of such deficits as genetic vulnerability markers for the disorder. Finally, input dysfunctions also seem to have prognostic utility ( Cancro, Sutton, Kerr, & Sugarman, 1971; Elliott & Knight, 1982; Knight, Elliott, Roff, & Watson, 1986), and may serve as important predictors of the course of the disorder.

The hypothesis that deficiencies in such elemental cognitive/perceptual processes may contribute substantially to thought disorder symptoms has remained a viable one, despite its reliance for support primarily on armchair theorizing. Surprisingly few studies report data on the relation between laboratory tasks purportedly measuring cognitive deficiencies and symptomatology (e.g., Cornblatt, Lenzenweger, Dworkin, & Erlenmeyer-Kimling, 1985; Green & E. Walker, 1984; Heilbrun, 1980; Knight et al., 1986; Mintz & Alpert, 1972; Neale, Oltmanns, & Harvey, 1985). Recently, several investigators ( George & Neufeld, 1985; Knight et al., 1986; Neale et al., 1985) have challenged the complacent acceptance of this situation and have encouraged researchers to address the problem of the crucial interface. The major purpose of this

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