Reconsidering the Gospel According to Group Studies: A Neuropsychological Case Study Approach to Schizophrenia

Individual patterns of performance on tests of: visual perception, language, executive function, memory, and face-processing, were examined in 10 schizophrenic patients who were preselected for having current WAIS IQ and premorbid NART IQ scores in the normal range. Although the patients showed some heterogeneity in the type, pervasiveness, and degree of cognitive impairment, a majority had severely impaired verbal recall and familiar face-naming. This contrasted with the low incidence and severity of impairment on tests of executive function, visual recall, recognition memory, naming, and unfamiliar faceprocessing. Contrasts between individual patients indicated that verbal recall and executive performance are independent in some patients and that memory appears to be the core deficit. The profile of impaired and preserved cognitive function revealed some important dissimilarities from the pattern that has emerged from group studies. Finally, face-naming correlated highly with the learning of unrelated paired associates, confirming a similarity with neurological patients who have person name anomia. It is suggested that both deficits might reflect a problem with learning ''meaninglessness'' associations; this interpretation is discussed with reference to a deficit at the level of the Supervisory Attentional System (Shallice, 1988).