Effects of contextual processing on visual conditional associative learning in schizophrenia

Background: We adapted visual conditional associative learning paradigms to assess the contextual processing deficit model of schizophrenic cognitive impairment proposed by J.D. Cohen and D. Servan-Schreiber in 1992. In this task subjects learn the associations between four sets of stimuli through t he use of feedback. We administered two experimental conditional associativ e learning conditions: in one, the eight stimuli used to make Sour pairs we re all different; in the other, the pairs were made from different combinat ions of four identical stimuli, requiring the use of contextual information to mediate correct performance. Two additional associative learning tasks were administered where subjects generated the stimulus pairings or observe d the experimenter form the pairs, eliminating the need to learn from feedb ack. Methods: We tested 37 patients with schizophrenia and 20 healthy control su bjects in each conditional associative learning task condition. Results: Patients demonstrated significant impairments on all four conditio nal associative learning tasks. The demand to process contextual informatio n did not differentially impact patient performance. Patients were better a ble to learn associations if they generated or observed the pairings rather than utilized feedback to guide learning. Conclusions: Patients with schizophrenia demonstrate pronounced deficits in the ability to utilize feedback to guide learning. We found no evidence of an additional deficit in processing of contextual information. (C) 2000 So ciety of Biological Psychiatry.