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Dimensions of Attention Impairment and Negative Symptoms in Schizophrenia: A Multidimensional Approach Using the Conners Continuous Performance Test in a Spanish Population

Sanz, Juan Carlos PhD*,†; Gómez, Vanessa PhD; Vargas, Martín L. MD§; Marín, Juan José PhD

Cognitive and Behavioral Neurology: June 2012 - Volume 25 - Issue 2 - p 63–71
doi: 10.1097/WNN.0b013e318255feaf
Original Studies

Objectives: The aim of this study was to assess the specific features of attention impairment in patients with schizophrenia and the correlation between those features and the patients' clinical status.

Methods: We administered the Conners Continuous Performance Test (CPT-II), with cognitive and clinical scales, to 40 Spanish inpatients with schizophrenia and 40 healthy controls, and used a cross-sectional design to compare the groups' performances. We identified correlations between the measures and used multiple regression analyses to develop models showing how attention impairment contributed to clinical status.

Results: The patients with schizophrenia showed significantly poorer performance than controls in 5 CPT-II measures that were related to focused attention. We also found that CPT-II measures primarily linked to focused attention had a significant association with negative symptoms. These CPT-II measures predicted 37% of the variability in negative symptoms in the regression model. We observed a more modest relationship among CPT-II measures of disorganized thought symptoms, global functioning, and general cognitive performance.

Conclusions: Attention impairment in schizophrenia primarily involves difficulty in focusing attention, mainly related to negative symptoms. By contrast, sustained attention and vigilance seem to be affected only as a secondary consequence of the impairment to focusing attention.

*University of Extremadura, Mérida University Center

Mental Health Unit, Hospital of Mérida, Mérida, Spain

Psychiatric Hospital of Mérida, Mérida, Spain

§Psychiatry Department, Complejo Asistencial de Segovia, Segovia, Spain

Department of Clinical Psychology, Carlos Albizu University, San Juan de Puerto Rico, Puerto Rico

Supported by grant PRI08A012 from the Fundación para la Formación y la Investigación de los Profesionales de la Salud de Extremadura (FundeSalud), Spain.

The authors declare no conflicts of interest.

Reprints: Juan Carlos Sanz, PhD, Mental Health Unit, Hospital of Mérida, Polígono Nueva Ciudad s/n., Mérida 06800, Spain (e-mail:

Received August 31, 2011

Accepted January 23, 2012

© 2012 Lippincott Williams & Wilkins, Inc.