Review
Special Issue: Cognition in Neuropsychiatric Disorders
Cognition in schizophrenia: core psychological and neural mechanisms

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The challenge in understanding cognitive impairment in schizophrenia is that people with this illness have deficits in an array of domains. Here, we briefly review evidence regarding the pattern of deficits within three domains: context processing, working memory and episodic memory. We suggest that there may be a common mechanism driving deficits in these domains – an impairment in the ability to actively represent goal information in working memory to guide behavior, a function we refer to as proactive control. We suggest that such deficits in proactive control reflect impairments in dorsolateral prefrontal cortex, its interactions with other brain regions, such as parietal cortex, thalamus and striatum, and the influence of neurotransmitter systems, such as dopamine, GABA and glutamate.

Section snippets

Centrality of cognition in schizophrenia

When we think of the core symptoms of illness, such as schizophrenia, we think of people who hear voices, see visions and have false beliefs about reality (i.e., delusions). However, clinicians have long recognized that abnormalities in cognitive function are a key component of schizophrenia, one of the most debilitating psychiatric disorders. As such, the last three decades have witnessed a relative explosion of research on cognition in schizophrenia, much of it couched within the framework of

Context, proactive control and goal representation in schizophrenia

In previous work based in part upon computational modeling, Cohen and colleagues put forth the hypothesis that intact function of dopamine in DLPFC was responsible for the processing of context, and that a disturbance in this mechanism was responsible for a range of cognitive deficits in schizophrenia (e.g., 7, 8, 9). In this framework context refers to prior task-relevant information, including task instructions, the results of processing prior stimuli, and goals that are represented and

Working memory in schizophrenia

Although there is an enormous amount of work on executive function and proactive cognitive control in schizophrenia, there are perhaps even more data on working memory deficits in this illness 3, 33. However, simply saying that individuals with schizophrenia have deficits on working memory tasks is not particularly informative, as working memory is a complex construct with different subprocesses. To understand what specific aspects of working memory might be impaired in schizophrenia and how

Episodic memory in schizophrenia

When one discusses episodic memory functions a typical focus is on encoding, binding, relational and retrieval mechanisms that are frequently associated with the function of medial temporal regions, including the hippocampus 56, 57. In schizophrenia, there is meta-analytic evidence for greater impairments in relational than item memory [58]. More recently, clinical researchers have begun to use tasks derived from the animal literature on hippocampal function, such as the transitive interference

Concluding remarks

As this brief review highlights, individuals with schizophrenia show significant deficits in a number of different cognitive domains, including executive function, working memory and episodic memory. We have suggested that there is a common mechanism contributing to these deficits – an impairment in proactive control that can influence performance in a wide variety of cognitive domains. Moreover, we have suggested that at the neural level, a common denominator to such deficits may be impaired

Acknowledgements

Deanna Barch receives funding from the NIH, the McDonnell Center for Higher Brain Function, and NARSAD. Alan Ceaser has been funded by the National Science Foundation.

Glossary

Context
information that can be used to modify the interpretation of an event or the response of an individual to stimuli in their environment. Context is information that must be ‘actively’ held in mind so that it can be used to mediate task appropriate behavior. Context information can be a specific prior stimulus, the result of processing a sequence of prior stimuli, or more abstract information, such as task instructions. Language processing provides a useful example of context information,

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