The attentional blink in schizophrenia: Isolating the perception/attention interface

https://doi.org/10.1016/j.jpsychires.2011.04.002Get rights and content

Abstract

Previous work has demonstrated that several aspects of visual processing are impaired in schizophrenia, including early perceptual processes and later higher-order processes. However, it remains unclear whether the stage of processing where early perception and later higher-order processes interact is impaired in schizophrenia. The current research examined this interface in schizophrenia using the attentional blink (AB) paradigm. We administered two rapid serial visual processing (RSVP) tasks to 143 patients with schizophrenia or schizoaffective disorder and 80 healthy controls: 1) a single target detection task, to measure basic visual perception; and 2) a dual target detection task, to measure the AB effect. In the dual target task, the two target stimuli (T1 and T2) were presented at varying positions or “lags” within a rapid sequential stream of distractor stimuli. Participants verbally identified the target stimuli. Both groups showed the expected AB effect, with T2 accuracy being poorest 200–500 ms after presentation of T1. However, patients showed an exaggerated AB effect compared to the healthy controls, with significantly reduced detection of T2, even after correcting for performance on the single target task. The reduction in accuracy was steeper and more pronounced in the patients during the AB lags, and it extended to lags before and after the typical AB. This performance pattern on the AB task suggests that patients with schizophrenia exhibit both deficits in visual processing at the interface of perceptual and attentional processing and a general attentional deficit.

Section snippets

Participants

The participants in this study included 143 (32 female) patients meeting DSM-IV criteria for schizophrenia (n = 132) or schizoaffective disorder (n = 11) recruited from the outpatient treatment clinics of the VA Greater Los Angeles Healthcare System (VAGLAHS) and from board-and-care residences in the community through staff presentations and referral. Diagnoses were confirmed using the patient version of the Structured Clinical Interview for DSM-IV Axis I Disorders (First et al., 1997)

Demographic and clinical characteristics

Demographic and symptom ratings can be seen in Table 1. Schizophrenia patients were significantly older compared to healthy controls, t(221) = 5.80, p < 0.001, and the patient sample included significantly more African Americans, X2 = 13.85, p < 0.05, but there were no significant differences in gender distribution, X2 = 0.425, p > 0.05, or parental education, t(205) = 1.85, p > 0.05. As shown in Table 1, schizophrenia patients had a relatively long duration of illness and exhibited mild levels

Discussion

The current study examined the interface of visual perception and attention in schizophrenia using two RSVP tasks: a single target task to assess group differences in visual perception and a dual-target task to elicit the AB effect. The single target task showed the expected perceptual deficits in perceiving a brief target within a stream of distractors in patients. The conditional probability data from the dual target task revealed significant performance deficits in the patients but

Contributors

JKW, BB, KHN, and MFG designed this study and developed the protocol. KIM, JKW, and MFG analyzed the data and developed the interpretation of the findings. KIM, JKW, and MFG wrote the first draft of the manuscript with BB and KH providing feedback and edits. All authors have contributed to and approved the final manuscript.

Role of funding source

Funding for this study was provided by NIH Grants MH043292 and MH065707 (MFG); the NIH had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Conflict of interest

All authors declare that they have no conflicts of interest arising from this manuscript.

Acknowledgements

The authors would like to thank Gerhard Hellemann for providing expert consultation on the statistical analyses included in this manuscript.

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