Distinct contribution of working memory and social comprehension failures in neuropsychological impairment in schizophrenia.

Neuropsychological impairment represents a core characteristic of schizophrenia, but its underlying components have yet to be clearly established. Using a comprehensive battery of standardized measures of intelligence, declarative episodic memory, and executive function, we hypothesized that the variance in neuropsychological performance in schizophrenia may reflect at least 2 distinct sources related to failures of (a) the central executive division of working memory and (b) social comprehension. In comparison to age-matched controls, patients with schizophrenia showed not only overall reduced scores on Wechsler intelligence and memory scales and Wisconsin Card Sorting Test (WCST) of executive function, but they also demonstrated different patterns of performance for each of these tests. Hierarchical regression revealed executive attentional control, measured by Trails B performance speed, and social comprehension, measured by Wechsler IQ Comprehension and Picture Arrangement subtests, each accounted for a unique and specific proportion of variance in test scores for the patient group, even when controlling for general intelligence. Failures in social comprehension and executive attentional control may account for distinct sources of variance in the neuropsychological impairment of schizophrenia.