Psychiatric Quarterly

, Volume 68, Issue 4, pp 343–359 | Cite as

Attention and Clinical Symptoms in Schizophrenia

  • Barbara Cornblatt
  • Michael Obuchowski
  • David B. Schnur
  • John D. O'Brien


Attentional deficits, long established to characterize patients with schizophrenia spectrum disorders, have traditionally been regarded as part of the disorder's clinical syndrome. In this paper we provide evidence to indicate that: a) impaired attention is a dimension of schizophrenia that is independent of clinical state, and b) that attention does not appear to respond to the medication (i.e. standard neuroleptics) most typically used to treat clinical symptoms. Since intact attention and other cognitive processes appear critical to successful functioning in the community after hospital discharge, these findings have major implications for treatment.


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  1. 1.
    Wohlberg GW, Kornetsky C: Sustained attention in remitted schizophrenics. Archives of General Psychiatry 28:533–537, 1973.Google Scholar
  2. 2.
    Asarnow RF, MacCrimmon D: Residual performance deficit in clinically remitted schizophrenics: A marker of schizophrenia? Journal of Abnormal Psychology 87:597–608, 1978.Google Scholar
  3. 3.
    Mussgay L, Hertwig R: Signal detection indices in schizophrenics on a visual, auditory and bimodal Continuous Performance Test. Schizophrenia Research 3:303–310, 1990.Google Scholar
  4. 4.
    Cornblatt B, Erlenmeyer-Kimling L: Global attentional deviance as a marker of risk for schizophrenia: Specificity and predictive validity. Journal of Abnormal Psychology 94:470–485, 1985.Google Scholar
  5. 5.
    Lees Roitman SE, Cornblatt BA, Bergman A, et al: Attentional functioning in schizotypal personality disorder. American Journal of Psychiatry, 154:655–660, 1997.Google Scholar
  6. 6.
    Cornblatt BA, Lenzenweger MF, Dworkin RH, et al: Childhood attentional dysfunctions predict social deficits in unaffected adults at risk for schizophrenia. British Journal of Psychiatry 161:59–64, 1992.Google Scholar
  7. 7.
    Cornblatt BA, Keilp JG: Impaired attention, genetics, and the pathophysiology of schizophrenia. Schizophrenia Bulletin 20:31–46, 1994.Google Scholar
  8. 8.
    Erlenmeyer-Kimling L, Cornblatt B: The New York High Risk Project: A Follow up Report. Schizophrenia Bulletin 13:451–461, 1987.Google Scholar
  9. 9.
    Andreasen NC: Negative symptoms in schizophrenia. Archives of General Psychiatry 39:784–788, 1982.Google Scholar
  10. 10.
    Nuechterlein KH, Edell WS, Norris M, et al: Attentional vulnerability indicators, thought disorder and negative symptoms. Schizophrenia Bulletin 12:408–426, 1986.Google Scholar
  11. 11.
    Pandurangi AK, Kenji WS, Pelonero AL, et al: Sustained attention and positive formal thought disorder in schizophrenia. Schizophrenia Research 13:109–116, 1994.Google Scholar
  12. 12.
    Strauss ME, Buchanan RW, Hale J: Relations between attentional deficits and clinical symptoms in schizophrenic outpatients. Psychiatry Research 74:205–213, 1993.Google Scholar
  13. 13.
    Earle-Boyer EA, Serper MR, Davidson M, et al: Continuous performance tests in schizophrenic patients: Stimulus and medication effects on performance. Psychiatry Research 37:47–56, 1991.Google Scholar
  14. 14.
    Nester PG, Fauz SF, McCarley RW, et al: Neuroleptics improve sustained attention in schizophrenia: A study using signal detection theory. Neuropsychopharmacology 4:145–149, 1991.Google Scholar
  15. 15.
    Orzack MH, Kornetsky C, Freemen H: The effects of daily administration of carphenazine on attention in the schizophrenic patient. Psychopharmacologia 11:31–38, 1967.Google Scholar
  16. 16.
    Serper MR, Bergman RL, Harvey PD: Medication may be required for the development of automatic information processing in schizophrenia. Psychiatry Research 32:281–288, 1990.Google Scholar
  17. 17.
    Spohn HE, Lacoursiere RB, Thompson K, et al: Phenothiazine effects on psychological and psychophysiological dysfunction in chronic schizophrenics. Archives of General Psychiatry 34:633–643, 1977.Google Scholar
  18. 18.
    Cannon TD, Mednick SA, Parnes J: Antecedents of predominantly negative-and predominantly positive-symptom schizophrenia in a high-risk population. Archives of General Psychiatry 47:622–632, 1990.Google Scholar
  19. 19.
    Saykin AJ, Shtasel DL, Gur RE, et al: Neuropsychological deficits in neuroleptic naive patients with first-episode schizophrenia. Archives of General Psychiatry 51:124–131, 1994.Google Scholar
  20. 20.
    Seidman LJ, Pepple JR, Faraone SV, et al: Neuropsychological performance in chronic schizophrenia in response to neuroleptic dose reduction. Biological Psychiatry 33:575–584, 1993.Google Scholar
  21. 21.
    Serafetinides EA, Collins S, Clark ML: Haloperidol, clopenthixol, and chlorpromazine in chronic schizophrenia. Journal of Nervous and Mental Disease 154:31–42, 1972.Google Scholar
  22. 22.
    Walker E: Attentional and neuromotor functions in schizophrenics, schizoaffectives, and patients with other affective disorders. Archives of General Psychiatry 38:1344–1358, 1981.Google Scholar
  23. 23.
    Walker E, Green M: Motor proficiency and attentional task performance by psychotic patients. Journal of Abnormal Psychology 91:261–268, 1982.Google Scholar
  24. 24.
    Walker E, Shaye J: Familial schizophrenia: A predictor of neuromotor and attentional abnormalities in schizophrenia. Archives of General Psychiatry 39:1153–1156, 1982.Google Scholar
  25. 25.
    Medalia A, Gold J, Merriam A: The effects of neuroleptics on neuropsychological test results of schizophrenics. Archives of Clinical Neuropsychology 3:249–271, 1988.Google Scholar
  26. 26.
    Cornblatt B, Erlenmeyer-Kimling L: Global attentional deviance as a marker of risk for schizophrenia: Specificity and predictive validity. Journal of Abnormal Psychology 94:470–485, 1985.Google Scholar
  27. 27.
    Erlenmeyer-Kimling L, Cornblatt B: The New York High Risk Project: A Follow up Report. Schizophrenia Bulletin 13:451–461, 1987.Google Scholar
  28. 28.
    Mirsky AF, Kugelmass S, Ingraham LJ, et al: Overview and summary: 25 year follow-up of high risk children. Schizophrenia Bulletin 21:227–239, 1995.Google Scholar
  29. 29.
    Cornblatt BA, Lenzenweger M, Erlenmeyer-Kimling L: The Continuous Performance Test-Identical Pairs (CPT-IP): II. Contrasting profiles of attentional deficits in schizophrenic and depressed patients. Psychiatry Research 29:65–85, 1989.Google Scholar
  30. 30.
    Winters L, Cornblatt BA, Erlenmeyer-Kimling L: The prediction of psychiatric disorders in late adolescence, in Schizophrenia: A life-Course Developmental Perspective. Edited by Walker E. New York, Academic Press, 1991.Google Scholar
  31. 31.
    Cornblatt B, Obuchowski M, O'Brien JD, Siever L: Are attentional deficits independent of clinical symptoms in schizophrenia? American Congress of Neuropsychopharmacology, Annual Meeting, San Juan, Puerto Rico, December 9–13, 1996.Google Scholar
  32. 32.
    Dworkin RH, Green SR, Small NE, et al: Positive and negative symptoms and social competence in adolescents at risk for schizophrenia and affective disorder. American Journal of Psychiatry 147:1234–1236, 1990.Google Scholar
  33. 33.
    Erlenmeyer-Kimling L, Cornblatt BA, Bassett AS, et al: High-risk children in adolescence and young adulthood: Course of global adjustment, in Straight and Devious Pathways from Childhood to Adulthood. Edited by Robins L, Rutter M. Cambridge, Cambridge University Press, 1990.Google Scholar
  34. 34.
    Green MF: What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry 153:321–330, 1996.Google Scholar
  35. 35.
    American Psychiatric Association: DSM-III-R: Diagnostic and statistical manual of mental disorders. 3rd ed., revised. Washington, D.C., American Psychiatric Press, 1987.Google Scholar
  36. 36.
    Andreasen NC: Comprehensive assessment of symptoms and history. University of Iowa College of Medicine, Iowa City, 1987.Google Scholar
  37. 37.
    Orvaschel H, Puig-Antich J: Schedule for affective disorder and schizophrenia for school-age children. Epidemiologic version. Medical College of Pennsylvania, Philadelphia, 1987.Google Scholar
  38. 38.
    Weinberger DR: Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry 44:660–669, 1987.Google Scholar
  39. 39.
    Cornblatt B, Obuchowski M: Update of high risk research: 1987–1997. International Review of Psychiatry, In press.Google Scholar
  40. 40.
    Cornblatt BA, Rish N, Faris G, et al: The Continuous Performance Test-Identical Pairs (CPT-IP): I. New findings about sustained attention in normal families. Psychiatry Research 26:223–238, 1988.Google Scholar
  41. 41.
    Neuchterlein KH: Vigilance in schizophrenia and related disorders, in Handbook of Schizophrenia: Neuropsychology, Psychophysiology and Information Processing, vol. 5. Edited by Steinhauer S, Zubin J, Gruzelier JH. Amsterdam, Elsevier Science Publishers, 1991.Google Scholar
  42. 42.
    Rutschmann J, Cornblatt B, Erlenmeyer-Kimling L: Sustained attention in children at risk for schizophrenia. Archives of General Psychiatry 34:571–575, 1977.Google Scholar
  43. 43.
    Orzack MH, Kornetsky C: Attention dysfunction in chronic schizophrenia. Archives of General Psychiatry 14:323–326, 1966.Google Scholar
  44. 44.
    Orzack MH, Kornetsky C: Environmental and familial predictors of attention behavior in chronic schizophrenics. Journal of Psychiatric Research 9:21–35, 1971.Google Scholar
  45. 45.
    Kay SR, Opler LA, Fiszbein A: The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13:261–276, 1987.Google Scholar
  46. 46.
    StatSoft, Inc: STATISTICA for Windows (Computer program manual). Tulsa, StatSoft, Inc., 1995.Google Scholar
  47. 47.
    Murray RM, O'Callaghan E, Castle DJ, et al: A neurodevelopmental approach to the classification of schizophrenia. Schizophrenia Bulletin 18:319–332, 1992.Google Scholar
  48. 48.
    Cannon TD, Zorrilla LE, Shtasel D, et al: Neuropsychological functioning in siblings discordant for schizophrenia and healthy volunteers. Archives of General Psychiatry 51: 651–661, 1994.Google Scholar
  49. 49.
    Borison RL, Pathiraja AP, Diamond BI, et al: Risperidone: Clinical safety and efficacy in schizophrenia. Psychopharmacology Bulletin 28:213–218, 1992.Google Scholar
  50. 50.
    Lehman AF, Thompson JW, Dixon LB, et al: Schizophrenia: Treatment outcomes research-editors' introduction. Schizophrenia Bulletin 21:561–566, 1995.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1997

Authors and Affiliations

  • Barbara Cornblatt
    • 1
  • Michael Obuchowski
    • 2
  • David B. Schnur
    • 3
    • 4
  • John D. O'Brien
    • 3
  1. 1.Department of Psychiatry Research, Hillside HospitalLong Island Jewish Medical CenterGlen Oaks
  2. 2.Psychophysiology Unit, Department of Psychiatry Research, Hillside HospitalLong Island Jewish Medical CenterGlen Oaks
  3. 3.Mount Sinai School of MedicineNew York
  4. 4.Elmhurst Hospital CenterElmhurst

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