Journal List > Korean J Schizophr Res > v.16(1) > 1057787

Korean J Schizophr Res. 2013 Apr;16(1):25-31. Korean.
Published online April 30, 2013.  https://doi.org/10.16946/kjsr.2013.16.1.25
Copyright © 2013 Korean Society for Schizophrenia
Deficits in Abstract Thinking Assessed by Theme Identification in Patients with Schizophrenia
Jooyoung Oh, MD,1 Ji-Won Chun, PhD,2 and Jae-Jin Kim, MD, PhD1,2
1Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
2Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Jae-Jin Kim, Department of Psychiatry, Yonsei University Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel: 02-2019-3341, Fax: 02-3462-4304, Email: jaejkim@yonsei.ac.kr
Received February 25, 2013; Revised April 10, 2013; Accepted April 11, 2013.

Abstract

Objectives

Patients with schizophrenia often have a concrete thinking or an impairment in abstract thinking, but there has been a limitation in quantitatively measuring this cognitive function. The aim of the current study was to investigate a deficit in abstract thinking in patients with schizophrenia using the theme identification task.

Methods

Twenty subjects with schizophrenia and 20 healthy volunteers participated in the behavioral study for theme identification. The visual stimuli were composed of a series of pictures, which contained positive or negative emotional situations. Three words, indicating a main theme of the picture, a theme-related item and a theme-unrelated item, respectively, were presented in the bottom of the pictures, and participants had to select a theme.

Results

The patient group selected theme words at significantly lower rate in both emotional conditions than the control group (positive, p=0.002 ; negative, p=0.001). Especially, in the negative condition, the patient group more selected theme-unrelated items than the control group (p=0.001). The rates of theme identification were inversely correlated with scores of the Social Anhedonia Scale (positive, r=-0.440, p=0.007 ; negative, r=-0.366, p=0.028).

Conclusion

Patients with schizophrenia exhibited an impairment in abstract thinking, and it was remarkable in the negative condition. The ability to think abstractly was associated with the severity of social anhedonia. The impairment of abstract thinking may become one of the reasons for poor social functioning in socially anhedonic patients.

Keywords: Schizophrenia; Abstract thinking; Emotion; Theme identification; Anhedonia

Figures


Fig. 1
Examples of the theme identification task (Left) and the emotion recognition task (Right).
Click for larger image


Fig. 2
Selection rate of related versus unrelated words in the wrong trials on the theme identification task. *: p<0.01. SPR : schizophrenia.
Click for larger image

Tables


Table 1
Clinical characteristics of the subjects
Click for larger image


Table 2
Behavioral responses in the theme identification task
Click for larger image


Table 3
Behavioral responses in the emotion recognition task
Click for larger image

References
1. Sadock BJ, Sacock VA. In: Synopsis of Psychiatry. Tenth edition. pp. 273.
2. Kim IJ, Shin MS. Assessment of concrete and abstract thinking of child-psychiatric children with the draw-a-person test and kedi-wisc similarity test. J Child Adolesc Psychiatry 1999;10:186–194.
3. Kuperberg G, Heckers S. Schizophrenia and cognitive function. Curr Opin Neurobiol 2000;10:205–210.
4. Sharma T, Antonova L. Cognitive function in schizophrenia Deficits, functional consequences, and future treatment. Psychiatr Clin North Am 2003;26:25–40.
5. Peuskens J, Demily C, Thibaut F. Treatment of cognitive dysfunction in schizophrenia. Clin Ther 2005;27:S25–S37.
6. Kim CK, Choe BM, Ha MY, Kim SH, Seo JM. Comparisons of Symptoms and Neurocogntive functions in Schizophrenic Patients Divided by Social Functioning. J Korean Neuropsychiatr Assoc 2002;41:1020–1029.
7. Lysaker PH, Bryson GJ, Davis LW, Bell MD. Relationship of impaired processing speed and flexibility of abstract thought to improvements in work performance over time in schizophrenia. Schizophr Res 2005;75:211–218.
8. Schmittmann VD, Visser I, Raijmakers MEJ. Multiple learning modes in the development of performance on a rule-based category-learning task. Neuropsychologia 2006;44:2079–2091.
9. Harrow M, Adler D. Abstract and concrete thinking in schizophrenia during the prechronic phases. Arch Gen Psychiatry 1974;31:27–33.
10. Flavell JH. Thinking and social behavior in schizophrenia. Journal of Abnormal Psychology 1956;52:208–211.
11. Kaland N, Smith L, Mortensen EL. Brief Report: Cognitive Flexibility and Focused Attention in Children and Adolescents with Asperger Syndrome or High-Functioning Autism as Measured on the Computerized Version of the Wisconsin Card Sorting Test. J Autism Dev Disord 2008;38:1161–1165.
12. Gorham DR. Use of the proverbs test for differentiating schizophrenics from normals. J Consult Psychol 1956;20:435–440.
13. Nahor AB, Vannicelli M. The influence of instructional set on schizophrenic vs. organic concreteness. Confin Psychiatr 1976;19:89–95.
14. Kiang M, Light GA, Prugh J, Coulson S, Braff DL, Kutas M. Cognitive, neurophysiological, and functional correlates of proverb interpretation abnormalities in schizophrenia. J Int Neuropsychol Soc 2007;13:653–663.
15. Kohler CG, Turner TH, Bilker WB, Brensinger CM, Siegel SJ, Kanes SJ, Gur RE, Gur RC. Facial emotion recognition in schizophrenia: intensity effects and error pattern. Am J Psychiatry 2003;160:1768–1774.
16. Linden SC, Jackson MC, Subramanian L, Wolf C, Green P, Healy D, Linden DE. Emotion-cognition interactions in schizophrenia: Implicit and explicit effects of facial expression. Neuropsychologia 2010;48:997–1002.
17. Blanchard JJ, Mueser KT, Bellack AS. Anhedonia, Positive and Negative Affect, and Social Functioning in Schizophrenia. Schizophr Bull 1998;24:413–424.
18. Chapman LJ, Chapman JP, Roulin ML. Scales for physical and social anhedonia. J Abnorm Psychol 1976;85:374–382.
19. Kay SR, Flazbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.
20. Albert MS, Wolfe J, Lafleche G. Differences in abstraction ability with age. Psychol Aging 1990;5:94–100.
21. Citron FM, Weekes BS, Ferstl EC. Effects of valence and arousal on written word recognition: Time course and ERP correlates. Neurosci Lett 2013;533:90–95.
22. Quintana J, Lee J, Marcus M, Kee K, Wong T, Yerevanian A. Brain dysfunctions during facial discrimination in schizophrenia: Selective association to affect decoding. Psychiatry Res 2011;191:44–50.
23. Vercammen A, Morris R, Green MJ, Lenroot R, Kulkarni J, Carr VJ, et al. Reduced neural activity of the prefrontal cognitive control circuitry during response inhibition to negative words in people with schizophrenia. J Psychiatry Neurosci 2012;37:379–388.
24. Kohler CG, Turner TH, Bilker WB, Brensinger CM, Siegel SJ, Kanes SJ, et al. Facial emotion recognition in schizophrenia: intensity effects and error pattern. Am J Psychiatry 2003;160:1768–1774.
25. van't Wout M, van Dijke A, Aleman A, Kessels RPC, Pijpers W, Kahn RS. Fearful faces in schizophrenia: the relationship between patient characteristics and facial affect recognition. J Nerv Ment Dis 2007;195:758–764.
26. Carpenter BN. Relationship of scales of schizophrenia proneness and premorbid adjustment to thinking deficits in schizophrenia. J Clin Psychol 1983;39:311–314.
27. Kwapil TR. Social anhedonia as a predictor of the development of schizophrenia-spectrum disorders. J Abnorm Psychol 1998;107:558–565.
28. O'Reilly PO, Harrison K. The Gorham Proverbs Test. Dis Nerv Syst 1960;21:382–385.
29. Wechsler D. In: Wechsler Adult Intelligence Scale Manual. Psychological Corp; 1955.
30. Corrigan PW. Social cue perception and intelligence in schizophrenia. Schizophr Res 1994;13:73–79.