Elsevier

Biological Psychiatry

Volume 65, Issue 6, 15 March 2009, Pages 455-463
Biological Psychiatry

Archival Report
Extinction Memory Is Impaired in Schizophrenia

https://doi.org/10.1016/j.biopsych.2008.09.017Get rights and content

Background

Schizophrenia is associated with abnormalities in emotional processing and social cognition, which might result from disruption of the underlying neural mechanism(s) governing emotional learning and memory. To investigate this possibility, we measured the acquisition and extinction of conditioned fear responses and delayed recall of extinction in schizophrenia and control subjects.

Methods

Twenty-eight schizophrenia and 18 demographically matched control subjects underwent a 2-day fear conditioning, extinction learning, and extinction recall procedure, in which skin conductance response (SCR) magnitude was used as the index of conditioned responses.

Results

During fear acquisition, 83% of the control subjects and 57% of the patients showed autonomic responsivity (“responders”), and the patients showed larger SCRs to the stimulus that was not paired with the unconditioned stimulus (CS−) than the control subjects. Within the responder group, there was no difference between the patients and control subjects in levels of extinction learning; however, the schizophrenia patients showed significant impairment, relative to the control subjects, in context-dependent recall of the extinction memory. In addition, delusion severity in the patients correlated with baseline skin conductance levels.

Conclusions

These data are consistent with prior evidence for a heightened neural response to innocuous stimuli in schizophrenia and elevated arousal levels in psychosis. The finding of deficient extinction recall in schizophrenia patients who showed intact extinction learning suggests that schizophrenia is associated with a disturbance in the neural processes supporting emotional memory.

Section snippets

Participants

Twenty-eight patients with DSM-IV–diagnosed schizophrenia and 18 control subjects, between 18 and 65 years old, were studied. Clinically stable, medicated patients with schizophrenia were recruited through the Massachusetts General Hospital (MGH) Schizophrenia Clinical and Research Program (Table 1). Healthy control subjects were recruited via advertisement. The healthy control subjects did not have any psychiatric, neurologic, or severe medical disorders or history of substance abuse during

Characteristics of the Participants

There were no differences between the patients and control subjects in age, mean parental education, socioeconomic status, or in level of electrical stimulation chosen (Table 1). Mean verbal IQ was lower in the patients than in the control subjects [t(43) = 2.07, p = .04].

Baseline SCL and Fear Acquisition

The mean SCL at baseline was nonsignificantly higher in the control subjects than in the patients [control subjects: 3.55 ± .84 μS; patients: 1.97 ± .37 μS; t(29) = 1.93, p = .06].

Within-group analyses revealed that the

Summary of Findings

In this study, a substantial proportion (43%) of the patients with schizophrenia displayed minimal autonomic responsivity, consistent with previous findings (37). The patients who had intact autonomic responses (responders) demonstrated levels of fear acquisition and extinction learning that were comparable to the control subjects; however, these patients showed impairment and loss of context sensitivity in delayed recall of extinction. Moreover, the reduction in extinction recall manifested by

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