Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-30T23:16:39.312Z Has data issue: false hasContentIssue false

Biological and Cognitive Vulnerability Factors in Schizophrenia: Implications for Treatment

Published online by Cambridge University Press:  06 August 2018

Hans D. Brenner
Affiliation:
Psychiatrische Universitätsklinik, Bern, Switzerland
Bettina Hodel
Affiliation:
Psychiatrische Universitätsklinik, Bern, Switzerland
Ruth Genner
Affiliation:
Psychiatrische Universitätsklinik, Bern, Switzerland
Volker Roder
Affiliation:
Psychiatrische Universitätsklinik, Bern, Switzerland
Patrick W. Corrigan
Affiliation:
Department of Psychiatry, The University of Chicago, Chicago, USA

Extract

Cognitive disorders have long assumed a central position in describing the pathognomonic characteristics of schizophrenia. Kraepelin's (1902) and Bleuler's (1911) uniquely innovative descriptions of attentional dysfunctions and associational loosening in thought processes laid the groundwork for the concept of basic disorder devised by authors who embraced a phenomenological approach to psychopathology in German-speaking countries (Huber, 1983; Janzarik, 1983), and for experimental research endeavours in English-speaking countries to identify a ‘core psychological deficit’ in schizophrenia (Lang & Buss, 1965). Recent research has identified specific information-processing deficits in affected individuals. These include (a) problems with elementary functions such as selective attention towards relevant stimuli and sustained attention over prolonged periods of time (Oltmanns & Neale, 1975; Nuechterlein, 1977); (b) problems with more complex functions such as encoding and recognition of familiar cues, storing information for future retrieval, or drawing deductive or analogous conclusions from available information (Broga & Neufeld, 1981; Brenner, 1983; Nuechterlein & Dawson, 1984b); and (c) problems with executive functions and response selection (Broen & Storms, 1967; Weinberger et al, 1986, 1988).

Type
Treatment
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abel, D. (1961) Konzentrations-Verlaufs-Test. Göttingen: Hogrefe. American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Annismann, H., Ritch, M. & Sklar, S. (1991) Noradrenergic and dopaminergic interaction in escape behaviour: analysis of uncontrollable stress effects. Psychopharmacology, 74, 263268.CrossRefGoogle Scholar
Arbeitsgemeinschaft Für Methodik Und Dokumentation In Der Psychiatrie AMDP (1979) Das AMDP-System. Manual zur Dokumentation psychiatrischer Befunde. Berlin: Springer.Google Scholar
Arnold, S. E., Hyman, B. T., Van Hoesen, G. W., et al (1991) Some cytoarchitectural abnormalities of the entorhinal cortex in schizophrenia. Archives of General Psychiatry, 48, 625632.CrossRefGoogle ScholarPubMed
Benton, A. L. (1968) Der Benton-Test. Bern: Huber.Google Scholar
Bleuler, E. (1911) Dementia praecox oder die Gruppe der Schizophrenien. Leipzig, Wien: Deuticke.Google Scholar
Bogerts, B. (1989) Limbic and paralimbic pathology in schizophrenia: interaction with age- and stress-related factors. In Schizophrenia: Scientific Progress (eds S. C. Schulz & C. A. Tamminga), pp. 216226. New York: Oxford University Press.Google Scholar
Bogerts, B. (1990) Die Hirnstruktur Schizophrener und ihre Bedeutung für die Pathophysiologie und Psychopathologie der Erkrankung. Stuttgart: Thieme.Google Scholar
Braff, D. L. (1985) Attention, habituation, and information processing in psychiatric disorders. In Psychiatry III (ed. Cavenar, J. O.). Philadelphia: Lippincott.Google Scholar
Brenner, H. D. (1983) Störungen der Selektion und Analyse von akustischem Reizmaterial bei Schizophrenen: Eine experimentelle Untersuchung zur Informationsverarbeitung. In Empirische Schizophrenieforschung in Empirische Schizophrenieforschung (eds H. D. Brenner, E.-R. Rey & W. G. Stramke), pp. 97116. Bern: Huber.Google Scholar
Brenner, H. D. (1987) On the importance of cognitive disorders in treatment and rehabilitation. In Psychosocial Treatment of Schizophrenia (eds J. S. Strauss, W. Böker & H. D. Brenner), pp. 136166. Toronto, Lewinston N. Y.: Huber.Google Scholar
Brenner, H. D., Hodel, B., Kube, G., et al (1987) Kognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse. Nervenarzt, 58, 7283.Google Scholar
Brenner, H. D., Hodel, B. & Merlo, M. (1991) Nonpharmalogical treatment concepts of negative symptomatology. In Proceedings of the European-American Workshop “Negative versus Positive Schizophrenia” (eds A. Marneros, N. C. Andreasen & M. T. Tsuang), pp. 399424. Berlin: Springer.CrossRefGoogle Scholar
Brenner, H. D., Hodel, B., Roder, V., et al (1992) Treatment of cognitive dysfunctions and behavioral deficits in schizophrenia: integrated psychological therapy. Schizophrenia Bulletin, 18, 2126.CrossRefGoogle Scholar
Brenner, H. D., Kraemer, S., Hermanutz, M., et al (1990) Cognitive treatment in schizophrenia. In Schizophrenia: Concepts, Vulnerability and Intervention (eds E. R. Straube & K. Hahlweg), pp. 161191. Berlin: Springer.CrossRefGoogle Scholar
Brenner, H. D., Roder, V., Hodel, B., et al (in preparation) Integrated Psychological Therapy for Schizophrenic Patients (IPT). Toronto: Hogrefe.Google Scholar
Brickenkamp, R. (1978) Test D2, Aufmerksamkeits-Belastungs-Test. Göttingen: Hogrefe.Google Scholar
Broen, W. E. Jr. & Storms, L. H. (1967) A theory of response interference in schizophrenia. In Progress in Experimental Personality Research IV (ed. Maher, B. A.), pp. 269312. New York: Academic Press.Google Scholar
Broga, M. I. & Neufeld, R. W. J. (1981) Evaluation of information sequential aspects of schizophrenic performance: framework and current finding. Journal of Nervous and Mental Disease, 169, 558568.CrossRefGoogle Scholar
Cips, Collegium Internationale Psychiatriae Scalarum (1981) Internationale Skalen für Psychiatrie. Weinheim: Beltz.Google Scholar
Dahl, G. (1972) WIP. Meisenheim am Glan: Anton Hain.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The Global Assessment Scale. Archives of General Psychiatry, 33, 766772.CrossRefGoogle ScholarPubMed
Fahrenberg, I., Kuhn, M., Kulick, B., et al (1977) Methoden-entwicklung für psychologische Zeitreihenstudien. Diagnostika, 23, 15–36d.Google Scholar
Funke, B., Reinecker, H. & Commichau, A. (1989) Grenzen kognitiver Trainingsmethoden bei schizophrenen Langzeitpatienten. Nervenarzt, 60, 750756.Google Scholar
Gjerde, P. F. (1983) Attention capacity dysfunction and arousal in schizophrenia. Psychological Bulletin, 93, 5772.CrossRefGoogle ScholarPubMed
Granholm, E., Asarnow, R. F. & Marder, S. R. (1991) Controlled information processing resources and the development of automatic detection responses in schizophrenia. Journal of Abnormal Psychology, 100, 2230.CrossRefGoogle ScholarPubMed
Hathaway, S. R. & McKinley, J. C. (1977) MMPI Saarbrücken. Bern: Huber.Google Scholar
Hersen, M. & Bellack, A. S. (1978) Behavior-Therapy in the Psychiatric Setting. Baltimore: Williams & Wilkins.Google Scholar
Hermanutz, M. & Gestrich, J. (1987) Kognitives Training mit Schizophrenen. Nervenarzt, 58, 9196.Google Scholar
Hodel, B., (1988) The Self-image Scale (SIS). Unpublished manuscript of the Department for Theoretical and Evaluative Psychiatry, University of Bern, Switzerland.Google Scholar
Hodel, B., Brenner, H. D. & Merlo, M. (1990) Cognitive and social training for chronic schizophrenic patients: a comparison between two types of therapeutic interventions. In Psychiatry: A World Perspective, vol. 3 (eds Stefanis, C. N., Rabavilas, A. D. & Soldatos, C. R.), pp. 768773. Amsterdam: Excerpta Medica.Google Scholar
Huber, G. (1983) Das Konzept substratnaher Basissymptome und seine Bedeutung für Theorie und Therapie schizophrener Erkrankungen. Nervenarzt, 54, 2332.Google Scholar
Janzarik, W. (1983) Basisstörungen. Eine Revision mit struktur-dynamischen Mitteln. Nervenarzt, 54, 122130.Google Scholar
Killian, G. A., Holzman, P. S., Davis, J. M., et al (1984) Effects of psychotropic medication on selected cognitive and perceptual measures. Journal of Abnormal Psychology, 93, 5870.CrossRefGoogle ScholarPubMed
Kirkpatrick & Buchanan, R. W. (1990) The neural basis of the deficit syndrome of schizophrenia. Journal of Nervous and Mental Disease, 178, 545555.Google Scholar
Kraemer, S., Sulz, K. H. D., Schmid, R., et al (1987) Kognitive Therapie bei standardversorgten schizophrenen Patienten. Nervenarzt, 58, 8490.Google Scholar
Kraepelin, E. (1902) Clinical Psychiatry: A Textbook for Students and Physicians (6th edn) (Translated by A. R. Diefendorf). New York: MacMillan.Google Scholar
Lang, P. J. & Buss, A. H. (1965) Psychological deficit in schizophrenia: II. Interference and activation. Journal of Abnormal Psychology, 70, 77106.CrossRefGoogle ScholarPubMed
Liberman, R. P. & Green, M. F. (1992) Whither cognitive-behaviour therapy for schizophrenia? Schizophrenia Bulletin, 18, 2738.CrossRefGoogle ScholarPubMed
Mussgay, L. & Olbrich, R. (1988) Trainingsprogramme in der Behandlung kognitiver Defizite Schizophrener. Zeitschrift für Klinische Psychologie, 17, 341353.Google Scholar
Nuechterlein, K. H. (1977) Refocusing on attentional dysfunctions in schizophrenia. Schizophrenia Bulletin, 3, 457469.CrossRefGoogle ScholarPubMed
Nuechterlein, K. H. & Dawson, E. M. (1984a) A heuristic vulnerability/stress model of schizophrenic episodes. Schizophrenia Bulletin, 10, 300312.CrossRefGoogle ScholarPubMed
Nuechterlein, K. H. & Dawson, E. M. (1984b) Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophrenia Bulletin, 10, 160203.CrossRefGoogle ScholarPubMed
Olbrich, R. & Mussgay, L. (1990) Reduction of schizophrenic deficits by cognitive training: an evaluative study. European Archives of Psychiatry & Neurological Sciences, 239, 366369.CrossRefGoogle ScholarPubMed
Oltmanns, T. F. & Neale, J. M. (1975) Schizophrenic performance when distractors are present: Attentional deficit or differential task difficulty. Journal of Abnormal Psychology, 84, 205209.CrossRefGoogle ScholarPubMed
Perris, C. (1989) Cognitive Psychotherapy and the Schizophrenic Disorders. New York: Guilford Press.Google Scholar
Riegel, K. F. (1967) Der sprachliche Leistungstest SASKA. Göttingen: Hogrefe.Google Scholar
Roberts, G. W. (1990) Schizophrenia: the cellular biology of a functional psychosis. Trends in Neurosciences, 13, 207212.CrossRefGoogle ScholarPubMed
Roberts, G. W. (1991) Schizophrenia: a neuropathological perspective. British Journal of Psychiatry, 158, 817.CrossRefGoogle ScholarPubMed
Roder, V. (1988) Untersuchungen zur Effektivität kognitiver Therapie mit schizophrenen Patienten. Unpublished dissertation, University of Bern, Switzerland.Google Scholar
Roder, V., Studer, K. & Brenner, H. D. (1987) Erfahrungen mit einem integrierten psychologischen Therapieprogramm zum Training kommunikativer und kognitiver Fahigkeiten in der Rehabilitation schwer chronisch schizophrener Patienten. Schweizer Archiv für Neurologie und Psychiatrie, 138, 3144.Google Scholar
Roder, V., Brenner, H. D., Kienzle, N. et al (1988) Integriertes Psychologisches Therapieprogramm für schizophrene Patienten (IPT). München: Psychologie Verlags Union.Google Scholar
Roder, V., Hirsbrunner, A., Schwab, T., et al (1991) Residential, vocational and recreational rehabilitation of schizophrenic patients (abstract). Abstracts Book: International Congress on Schizophrenia and Affective Psychoses, Geneva, Switzerland, Sept. 12-14, 1991, p. 61. Geneva: Institutions Universitaires de Psychiatrie Geneva(IUPG)-WHO.Google Scholar
Sandner, M., Hodel, B. & Brenner, H. D. (1991) Treatment of emotional and cognitive vulnerability of schizophrenic patients (abstract). Abstracts Book: International Congress on Schizophrenia and Affective Psychoses, Geneva, Switzerland, Sept. 12-14, 1991, p. 62. Geneva: Institutions Universitaires de Psychiatrie Geneva (IUPG)-WHO.Google Scholar
Spaulding, W. D. & Sullivan, M. (1991) From the laboratory to the clinic: psychological methods and principles in psychiatric rehabilitation. In Handbook of Psychiatric Rehabilitation (ed. Liberman, R. P.). Elmsford, NY: Pergamon Press.Google Scholar
Spohn, H. E., Lacoursiere, R. B., Thompson, K., et al (1977) Phenothiazine effects on psychological and psychophysiological dysfunctions in chronic schizophrenics. Archives of General Psychiatry, 34, 633644.CrossRefGoogle ScholarPubMed
Spohn, H. E. & Patterson, T. (1979) Recent studies of psychophysiology in schizophrenia. Schizophrenia Bulletin, 5, 581611.CrossRefGoogle ScholarPubMed
Süllwold, L. & Huber, G. (1986) Schizophrene Basisstörungen. Berlin: Springer.CrossRefGoogle Scholar
Wallace, C. J., Liberman, R. P., Mac Kain, S., et al (1989) Cognitive Training of Basic Psychological Deficits in Schizophrenia. Clinical Research Center for Schizophrenia & Psychiatric Rehabilitation, P. O. Box 6022, Camarillo, CA 93011–6022.Google Scholar
Weinberger, D. R., Berman, K. F. & Illowsky, B. P. (1988) Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. III. A new cohort and evidence for a monoaminergic mechanism. Archives of General Psychiatry, 45, 609615.CrossRefGoogle Scholar
Weinberger, D. R., Berman, K. F. & Zec, R. F. (1986) Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. Archives of General Psychiatry, 43, 114124.CrossRefGoogle ScholarPubMed
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO Google Scholar
Zubin, J. & Spring, B. J. (1977) Vulnerability – a new view of schizophrenia. Journal of Abnormal Psychology, 86, 103126.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.