People with schizophrenia suffer from hallucinations and delusions as well as from significant cognitive impairments. Working memory is a critical resource for many complex cognitive operations and is a critical area of impairment in schizophrenia. Here we present our hyperfocusing hypothesis, which suggests that an overly narrow and intense focusing of attention may underlie the working memory deficits seen in schizophrenia. The hyperfocusing hypothesis also provides an account of some areas of surprisingly intact cognitive performance also seen in people with schizophrenia.
ElahipanahA.ChristensenB. K.ReingoldE. M. (2011). Controlling the spotlight of attention: Visual span size and flexibility in schizophrenia. Neuropsychologia, 49(12), 3370–3376. https://doi.org/10.1016/j.neuropsychologia.2011.08.011
2.
EricksonM. A.HahnB.LeonardC. J.RobinsonB.GrayB. E.LuckS. J.GoldJ. M. (2015). Impaired working memory capacity is not caused by failures of selective attention in schizophrenia. Schizophrenia Bulletin, 41(2), 366–373. https://doi.org/10.1093/schbul/sbu101
3.
FukudaA.AwhE.VogelE. K. (2010). Discrete capacity limits in visual working memory. Current Opinion in Neurobiology, 20(2), 177–182. https://doi.org/10.1016/j.conb.2010.03.005
4.
GoldJ. M.BarchD. M.FeuerstahlerL. M.CarterC. S.MacDonaldA. W.RaglandJ. D.SilversteinS. M.StraussM. E.LuckS. J. (2019). Working memory impairment across psychotic disorders. Schizophrenia Bulletin, 45(4), 804–812. https://doi.org/10.1093/schbul/sby134
5.
GoldJ. M.FullerR. L.RobinsonB. M.McMahonR. P.BraunE. L.LuckS. J. (2006). Intact attentional control of working memory encoding in schizophrenia. Journal of Abnormal Psychology, 115(4), 658–673. https://doi.org/10.1037/0021-843X.115.4.658
6.
Goldman-RakicP. S. (1999). The physiological approach: Functional architecture of working memory and disordered cognition in schizophrenia. Biological Psychiatry, 46(5), 650–661. https://doi.org/10.1016/s0006-3223(99)00130-4
7.
GrayB. E.HahnB.RobinsonB.HarveyA.LeonardC. J.LuckS. J.GoldJ. M. (2014). Relationships between divided attention and working memory impairment in people with schizophrenia. Schizophrenia Bulletin, 40(6), 1462–1471. https://doi.org/10.1093/schbul/sbu0156
8.
GreenM. F.HoranW. P.LeeJ. (2019). Nonsocial and social cognition in schizophrenia: Current evidence and future directions. World Psychiatry, 18, 146–161. https://doi.org/10.1002/wps.20624
9.
HahnB.BaeG.-Y.RobinsonB. M.LeonardC. J.LuckS. J.GoldJ. M. (2020). Cortical hyperactivation at low working memory load: A primary processing abnormality in people with schizophrenia?Neuroimage Clinical, 26, Article 102270. https://doi.org/10.1016/j.nicl.2020.102270
10.
HahnB.HollingworthA.RobinsonB. M.KaiserS. T.LeonardC. J.BeckV. M.KappermanE. S.LuckS. J.GoldJ. M. (2012). Control of working memory content in schizophrenia. Schizophrenia Research, 134(1), 70–75. https://doi.org/10.1016/j.schres.2011.10.008
11.
HahnB.RobinsonB. M.HarveyA. N.KaiserS. T.LeonardC. J.LuckS. J.GoldJ. M. (2012). Visuospatial attention in schizophrenia: Deficits in broad monitoring. Journal of Abnormal Psychology, 121(1), 119–128. https://doi.org/10.1037/a0023938
12.
HahnB.RobinsonB. M.KaiserS. T.HarveyA. N.BeckV. M.LeonardC. J.KappenmanE. S.LuckS. J.GoldJ. M. (2010). Failure of schizophrenia patients to overcome salient distracters during working memory encoding. Biological Psychiatry, 68(7), 603–609. https://doi.org/10.1016/j.biopsych.2010.04.014
13.
HahnB.RobinsonB. M.LeonardC. J.LuckS. J.GoldJ. M. (2018). Posterior parietal cortex dysfunction is central to working memory storage and broad cognitive deficits in schizophrenia. Journal of Neuroscience, 38(39), 8378–8387. https://doi.org/10.1523/JNEUROSCI.0913-18.2018
14.
JohnsonM. K.McMahonR. P.RobinsonB. M.HarveyA. N.HahnB.LeonardC. J.LuckS. J.GoldJ. M. (2013). The relationship between working memory capacity and broad measures of cognitive ability in healthy adults and people with schizophrenia. Neuropsychology, 27(2), 220–229. https://doi.org/10.1037/a0032060
15.
KreitherJ.Lopez-CalderonJ.LeonardC. J.RobinsonB. M.RuffleA.HahnB.GoldJ. M.LuckS. J. (2017). Electrophysiological evidence for hyperfocusing of spatial attention in schizophrenia. Journal of Neuroscience, 37(14), 3813–3823. https://doi.org/10.1523/JNEUROSCI.3221-16.2017
16.
LeonardC. J.KaiserS. T.RobinsonB. M.KappenmanE. S.HahnB.GoldJ. M.LuckS. J. (2013). Toward the neural mechanisms of reduced working memory capacity in schizophrenia. Cerebral Cortex, 23(7), 1582–1592. https://doi.org/10.1093/cecor/bhs148
17.
LeonardC. J.RobinsonB. M.HahnB.LuckS. J.GoldJ. M. (2017). Altered spatial profile of distraction in people with schizophrenia. Journal of Abnormal Psychology, 126(8), 1077–1086. https://doi.org/10.1037/abn0000314
18.
LuckS. J.HahnB.LeonardC. J.GoldJ. M. (2019). The hyperfocusing hypothesis: A new account of cognitive dysfunction in schizophrenia. Schizophrenia Bulletin, 45(5), 991–1000. https://doi.org/10.1007/7854_2022_380
ParkS.HolzmanP. S. (1992). Schizophrenics show spatial working memory deficits. Archives of General Psychiatry, 49(12), 975–982. https://doi.org/10:1001/archpsyc.1992.01820120063009
22.
SawakiR.KreitherJ.LeonardC. J.KaiserS. T.HahnB.GoldJ. M.LuckS. J. (2017). Hyperfocusing of attention on goal-related information in schizophrenia: Evidence from electrophysiology. Journal of Abnormal Psychology, 126(1), 106–116. https://doi.org/10.1037/abn0000209
23.
SchaferJ.GiangrandeE.WeinbergerD. R.DickinsonD. (2012). The global cognitive impairment in schizophrenia: Consistent over decades and around the world. Schizophrenia Research, 150(1), 42–50. https://doi.org/10.1016/j.schres.2013.07.009
24.
SmucnyJ.HanksT. D.LeshT. A.CarterC. S. (2023). Altered associations between task performance and dorsolateral prefrontal activation during cognitive control in schizophrenia. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 8(10), 1050–1057. https://doi.org/10.1016/j.bpsc.2023.05.010
25.
SpencerK. M.NestorP. G.ValdmanO.NiznikiewiczM. A.ShentonM. E.McCarleyR. W. (2011). Enhanced facilitation of spatial attention in schizophrenia. Neuropsychology, 25(1), 76–85. https://doi.org/10.1037/a0020779
26.
VogelE. K.MachizawaM. G. (2004). Neural activity predicts individual differences in visual working memory capacity. Nature, 428(6984), 748–751. https://doi.org/10.1038/nature02447
27.
VogelE. K.McCulloughA. W.MachizawaM. G. (2005). Neural measure reveal individual differences in controlling access to working memory. Nature, 238(24), 500–503. https://doi.org/10.1038/nature04171
