Value-directed remembering in first-episode schizophrenia

Abstract

Objective: Memory deficits in individuals with schizophrenia are well-established, but less is known about how schizophrenia affects metacognitive processes such as metamemory. We investigated metamemory ability using the value-directed remembering task, which assesses the degree to which participants use value cues to guide their learning of a list of items (i.e., their memory selectivity).

Method: Participants were patients undergoing treatment following a recent first episode of schizophrenia (n = 20) and demographically comparable healthy controls (n = 18). Participants viewed six lists of 24 words where each word was paired with either a low value (1-3 points) or a high value (10-12 points), and they were instructed to maximize their score on free recall tests given after each list. After the final free recall test, participants completed a recognition test where they gave remember/know judgments.

Results: On tests of free recall, patients showed reduced memory selectivity relative to healthy controls. On the recognition test, patients failed to show an effect of value on recognition of nonrecalled words, in contrast to healthy controls, who showed a significant value effect that was characterized by greater "remember" judgments. Patients initially overestimated their memory capacity but were able to adjust their estimates to be more accurate based on task experience. Patients' self-reports of memory selectivity were unrelated to their actual memory selectivity.

Conclusions: Patients with first-episode schizophrenia had substantial impairments on the value-directed remembering task, but areas of preserved metamemory ability were also observed. These findings have potential implications for cognitive training interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Figure 1. Free Recall Test Performance

Note. (A) Mean proportion of items recalled by each group. (B) Mean selectivity index score for each group. (C) Mean proportion of items recalled by each group as a function of item value. Error bars represent ± 1 standard error. HC, healthy control; SZ, schizophrenia.

Figure 2. Recognition Test Performance

Note. Recognition test performance as a function of group and trial type, broken down by items marked as “remember” versus items marked as “know.” Error bars represent ± 1 standard error. HC, healthy control; SZ, schizophrenia; LV, low value; HV, high value; FA, false alarm.

Figure 3. Pre-Test and Post-Test Calibration Scores

Note. Mean calibration scores for each group before and after completion of the value-directed remembering task. Error bars represent ± 1 standard error. HC, healthy control; SZ, schizophrenia.

Figure 4. Selectivity as a Function of Self-Reported Value Sensitivity

Note. Mean selectivity index scores for each group as a function of self-reported sensitivity to value. Error bars represent ± 1 standard error. HC, healthy control; SZ, schizophrenia.