16 - Schizophrenic delusions and the construction of autobiographical memory

Summary

In recent years, the study of normal cognitive function has gained substantially from the study of patients with cognitive deficits. Research on autobiographical memory is no exception, and research on retrograde amnesia and on confabulation in patients suffering from brain damage featured prominently in an earlier volume on this topic (Rubin, 1986). However, while the contribution of neuropsychology to the understanding of normal function is well established, neuropsychiatry has so far been less influential. One of the reasons is that psychiatry itself has been far from unanimous in its approach to the most appropriate conceptualization of its subject matter. There has, for example, been prolonged controversy as to whether schizophrenia should be regarded as a physical disorder resulting from some form of dysfunction of the brain, or as others would claim, a psychological response to psychosocial stress.

While there is still little agreement as to what, if any, physical changes in the brain are associated with schizophrenia (see Waddington, 1993, for an overview), the application of neuropsychological techniques to the study of schizophrenic patients makes it clear that cognitive deficits are characteristic, and in particular tend to produce an impairment in memory (see McKenna, Clare, & Baddeley, 1995, for a review), and in executive functions (see Frith, 1992). These deficits do not appear to be a result of drug treatment, nor can they readily be explained in terms of problems of motivation, or disruption by positive symptoms such as hallucinations and delusions.