COGNITIVE ASSESSMENT OF SCHIZOPHRENIC PATIENTS.
Contributors: New York University.
Published: 1989
Number of pages: 568
Subjects: Health Sciences, Nursing.; Health Sciences, Mental Health.
Description: Whether schizophrenia is one or many mental disorders has been debated since 1896 when Kraepelin first organized several previously distinct disorders into a single diagnostic category. The acceptance of Kraepelin's work led to a shift in the debate from whether or not schizophrenia was a single disorder to what was the nature of schizophrenia. Some subsequent researchers, following Kraepelin, concluded that deficits in the physiological processes of sensation produced an arrest of development and led to schizophrenic patients' misperceptions of reality. Others, following Bleuler (1911) argued that disturbances in the psychological processes of association produced abnormal thinking which led to the schizophrenic patients' misperceptions.

Piaget (1923) provided a framework for resolving the controversy over the nature of schizophrenia. He observed that the thinking of schizophrenic patients was not abnormal but was arrested at a lower, child-like level of development. The work begun by Kraepelin, Bleuler, and Piaget was expanded in the study into a cognitive-perceptual model to illustrate how both sensation and association are involved in schizophrenic reactions.

The results of applying the cognitive-perceptual model to the symptoms of schizophrenic patients indicate that a disturbance in the physiological processing of sensation occurs at onset. This physiological deficit blocks further learning and the development of more mature cognitive levels. The age at which learning and cognitive development are stopped is determined by the patient's age at onset. Those having earlier onset would have less developed cognitive structures, while later onset patients have more advanced abilities. Neurotic subjects were not expected to have the learning block which produces the arrest of cognitive development.

The cognitive arrest portion of the model was tested empirically by administering Piaget-type tasks to neurotic and earlier and later onset schizophrenic patients. The results supported the predictions derived from the model. The schizophrenic group had lower cognitive levels compared to the neurotic subjects. Furthermore, the earlier onset schizophrenic subjects scored lower on the cognitive development scale than later onset subjects. These results suggested that assessment of cognitive level would be useful for selecting appropriate treatment strategies for schizophrenic patients.
Notes: Source: Dissertation Abstracts International, Volume: 50-12, Section: B, page: 5546.

Thesis (PH.D.)--NEW YORK UNIVERSITY, 1989.

School code: 0146.