Schizophrenia Research Trends

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36Reiko Koide and Akira Tamaokaclearly that anatomical, that is, the visual or the spatial, component is intact in schizophreniaand limited their aberration mainly to functional component.The fact that schizophrenics have aberrant body images in function, i.e., they haveunmovable body images, is controversial with regard to the possibility that it reflectsperseverance in motor activity. Schizophrenic patients might have difficulty in the shiftingthe response set in motor activity in light of the feedback that a previous response wasincorrect and consequently “persevere” in making the same response, creating difficulty inmovement cognition. Perseveration is a cardinal feature of frontal lobe disease (Bilder &Goldberg, 1987). It is one of the presenting basic neurocognitive deficits, observed since thetime of Bleuler (1911/1950), who wrote that schizophrenic patients “remain fixed to the samecircle of ideas, the same words, the same sentence structure or at any rate, return to themagain and again without any logical need.”The degree of perseverance of schizophrenic patients is similar to that of patients withknown frontal pathology (Levin, 1984). Since Weinberger et al. (1986) reported a negativecorrelation between the percentage perseveration as measured by the Wisconsin Card SortingTest, WCST, (Milner, 1963) and prefrontal blood flow, these associations have supported thehypothesis that schizophrenic patients have an impairment of the frontal or prefrontal cortex.Because the clinical interpretation of test data can often point to multiple studies thatconverge on a set of frequent severe and selective deficits, patients with schizophreniatypically demonstrate abnormalities in attention, memory, and executive function that standout against a background of diffuse impairment (Pantelis et al., 1996). However, some areasof function appear to be relatively more intact than others, i.e., some aspects of language(Gold et al., 1994; Saykin et al., 1991; Daniels et al., 1988; Barr et al., 1989; Frith, 1993) andsome types of visual spatial processing (Kolb & Whishaw, 1983; Goldberg et al., 1990;Goldberg et al., 1993a). These neuropsychological profiles implicate specific brain regions,i.e., frontal-medial dysfunction (Kolb & Whishaw, 1983; Taylor and Abrams, 1984). Thefinding that the aberration referred to functional body imageries would imply body imagedeficits that have some relation to dorsolateral deficits, and the fact that the anatomical, thatis, visual and spatial, imageries remain intact is consistent with the previous finding thatsome types of visual spatial processing is intact in the neuropsychological profile ofschizophrenics.In Study 3, body image aberration was considered through an attempt to detect specificbody image characteristics related to depression in schizophrenia by comparing the BIQfactor scores between depressive and non-depressive groups comprised by Zung’s Self-ratingDepression Scale (SDS) in normal and schizophrenic groups respectively. The results showedsome body image factors related uniquely to depression in schizophrenia, which, again,referred to functional body images. The result of this part of the study might cast light onfuture prospects of the study of body image aberration using a device such as the BIQbecause of its link with DSS which has become a target for treatment of schizophrenia, withthe novel antipsychotic medications. The studies performed for this chapter all revealed thatneuroleptics did not relate to body image aberration; however, novel antipsychotic agentswere not discussed or studied. This would be relevant to the final question as to whether ornot the body image aberration is remediable.
Body Image Deviation in Chronic Schizophrenia: New Research 37Study 4 and Study 5 are reports of subsidiary findings of our main studies using the BIQ,in which schizophrenic patients produced Rorschach responses implying or referring to“mass of flesh.” Study 4 is composed of the initial observations. In Study 5, the Rorschachtest was given to schizophrenic and non-schizophrenic subjects to determine whetherschizophrenic patients more frequently produced the “mass of flesh” percept than the nonschizophrenicgroups did. These findings suggest that there might be a fear of immobility inschizophrenia that is congruent with our main findings.ConclusionSchizophrenic body image aberration was considered in the current context. Theschizophrenic body image aberration was unrelated to symptoms, insight, or conventionalneuroleptic medication, but proved to be germane to schizophrenia. The schizophrenic bodyimage aberration also proved to be limited to functional imagery while anatomical imageriesremained intact.ACKNOWLEDGEMENTSWe would like to express our appreciation to Dr. Chin-Piao Chien, professor emeritus ofUCLA, and Dr. Shoji Shin’ichi and Dr. Susumu Oda, professors emeriti of TsukubaUniversity. We also thank Dr. Toshihiko Maeda of tne Institute of Statistical Mathematics forthe statistical consultation.Part of the text was re-edited from Psychiatry and Clinical Neurosciences, Vol. 56, pp9-15, “Body image, symptoms and insight in chronic schizophrenia” by Koide et al (2002),with permission from Blackwell Publishing, and from Comprehensive Psychiatry, Vol.43,pp474-477, “A mass of flesh: Schizophrenic Rorschach Percepts” by Koide R., et al (2002),with permission from Elsevier.REFERENCESAmador, X. F., Flaum, M,, Andreasen, N.C., Strauss, D. H., Yale, S. A., Clark, S. C. &Gorman, J. M. (1994). Awareness of illness in schizophrenia and schizoaffective andMood disorders. Archives of General Psychiatry, 51, 826-836.Amador, X. F., Strauss, D.H., Yale, S.A., & Gorman JM. (1991). Awareness of illness inschizophrenia. Schizophrenia Bulletin, 17,113-132.American Psychiatric Association. (1980). Diagnostic and statistical manual of mentaldisorders (3rd edition). Washington, DC: American Psychiatric Association.American Psychiatric Association. (1987). Diagnostic and statistical manual of mentaldisorders (3rd edition revised). Washington, DC: American Psychiatric Association.American Psychiatric Association. (1994). Diagnostic and statistical manual of mentaldisorders (4th edition). Washington, DC: American Psychiatric Association.
Page 3: SCHIZOPHRENIA RESEARCH TRENDS
Page 6 and 7: Copyright © 2008 by Nova Science P
Page 9 and 10: PREFACESchizophrenia is a chronic,
Page 11 and 12: Prefaceixdisorder with symptoms man
Page 13 and 14: In: Schizophrenia Research Trends I
Page 15 and 16: Body Image Deviation in Chronic Sch
Page 47: Body Image Deviation in Chronic Sch
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Page 68 and 69: 56Guy SandnerSubsets of the Disease
Page 72 and 73: 60Guy Sandnerlinked to the ongoing
Page 74 and 75: 62Guy Sandnercorrelated with its pr
Page 76 and 77: 64Guy Sandner(general thought disor
Page 78 and 79: 66Guy Sandneramnesic patients. Thes
Page 80 and 81: 68Guy Sandneras soon as their early
Page 82 and 83: 70Guy Sandnerrole games [106, 142].
Page 84 and 85: 72Guy Sandnerand the cause of the d
Page 86 and 87: 74Guy SandnerA third explanation pl
Page 88 and 89: 76Guy Sandner2. Rats with neonatal
Page 90 and 91: 78Guy SandnerBOX 1DiagnosisPositive
Page 92 and 93: 80Guy SandnerBOX 2Cognitive Science
Page 94 and 95: 82Guy SandnerREFERENCES[1] Alberts
Page 96 and 97: 84Guy Sandner[36] Corcoran R, Merce
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86Guy Sandner[71] Frank N, Farrer C
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88Guy Sandner[103] Jeon YW, Polich
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90Guy Sandner[136] McGurk SR, Muese
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92Guy Sandner[168] Sato Y, Yabe H,
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In: Schizophrenia Research Trends I
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NMDA Receptor Hypofunction in Schiz
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Evolution and Schizophrenia 117In 1
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Evolution and Schizophrenia 119Over
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Evolution and Schizophrenia 121psyc
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Evolution and Schizophrenia 123deri
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Evolution and Schizophrenia 125indi
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Evolution and Schizophrenia 127pred
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Evolution and Schizophrenia 129one
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Evolution and Schizophrenia 131REFE
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Evolution and Schizophrenia 133[41]
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Evolution and Schizophrenia 135[80]
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Latent Inhibition and Learned Irrel
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164M. Nieznański, A. Chojnowska, W
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184Special Book Bibliography on Sch
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INDEXAabdomen, 38abnormal, 132abuse
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Index 251BMA, 216body, vii, viii, 1
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Index 253CRR, 90CTA, 139, 140, 143,
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Index 255eyes, 6, 24, 25, 50, 52, 6
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Index 257inhibition, ix, x, 60, 64,
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Index 259metabolism, 97, 103, 105,
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Index 261personal accounts, 123pers
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Index 263risk, 23, 26, 30, 39, 48,
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Index 265Ttactile stimuli, 85Taiwan
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