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Findings Show that Patients with First-episode Schizophrenia Exhibit Impairments in Envisioning Future Events
Author: Dr. Raymond Chan      Update time: 2023/06/08
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In everyday life, people often generate inner mental representations of events happening in the future, and pre-experience these prospected events. The ability is termed prospection, and is very important in planning future action and motivating pleasure-seeking behaviour. Empirical findings suggested that people with schizophrenia might be impaired in prospection ability, however the majority of earlier work utilized samples with chronic schizophrenia, and whether prospection deficits could be found in first-episode schizophrenia has remained unclear.

Dr. Raymond Chan from the Neuropsychology and Applied Cognitive Neuroscience laboratory, Institute of Psychology, Chinese Academy of Sciences, and Dr. Simon Lui form the Department of Psychiatry, the University of Hong Kong have conducted a study to examine prospection in patients with first-episode schizophrenia. They utilized a well-validated behavior paradigm which presented pictorial cues of varied valance to invite participants’ to prospect future events, and asked participants to self-rate the phenomenal features of their prospected events, and provided a narrative. Participants’ narratives of the prospected events were then coded using a manual. The confounding effects of logical and working memory functions and estimated IQ on prospection ability in schizophrenia patients were also examined using covariate analysis.

Using a sample of 30 first-episode schizophrenia and 31 controls, they found that the two groups self-reported similar phenomenal features of the prospected events, in terms of pre-experience, temporal proximity, vividness and emotions. Moreover, the Picture Valence effect of cues on the phenomenal features of the prospected was similar to the two groups. However, the coded narratives suggested that schizophrenia patients’ prospection was less specific and rich in thought/emotion than controls, and the prospection deficits on the richness of thought and emotion persisted after controlling for schizophrenia-associated logical memory and working memory deficits.

Taken together, this empirical work supports the presence of prospection deficits in first-episode schizophrenia patients. However, differing from our earlier work in chronic schizophrenia, first-episode schizophrenia patients did not perceive closer temporal distance than controls when prospecting negative events.

This work is one of the few pioneer studies on prospection deficits in first-episode schizophrenia, and paves ways of future application of cognitive strategies such as guided episodic thinking and imagery cognitive bias modification as early interventions to improve schizophrenia patients’ functioning.

Dr. Simon Lui from the Department of Psychiatry, School of Clinical Medicine, the University of Hong Kong and Dr. Raymond Chan from NACN Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology are co-corresponding authors for this paper. This study was supported by the Scientific Foundation of Institute of Psychology, Chinese Academy of Sciences, CAS Key Laboratory of Mental Health, Institute of Psychology, and Philip K. H. Wong Foundation as well as the Seed Fund for Basic Research for New Staff from the University of Hong Kong.

The paper was published  in Schizophrenia on June 3.

Table 1. Sample characteristics. Image by Dr. Raymond Chan.  

Note: DDD = defined daily doses; DOI = duration of illness; DUP = duration of untreated psychosis, HAMD = Hamilton Depression Rating Scale; PANSS = the Positive and Negative Syndrome Scale, LNT = Letter-Number Span test, LM = logical memory, VR = visual reproduction
* = χ2 test

Table 2. Affective Prospective Task results. Image by Dr. Raymond Chan.

Note: * Data of 2 schizophrenia participants were excluded from analyses because of invalid prospective narratives.
P-values at the Bonferroni-adjusted significance level of < 0.00454 were bold.

LIU Chen
Institute of Psychology Chinese Academy of Sciences
Beijing 100101, China.
E-mail: liuc@psych.ac.cn


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