The relationship between skin conductance hyporesponsivity and perseverations in schizophrenia patients

Background: It has been reported that approximately 45% of schizophrenia patients versus 10% of normal comparison subjects are classified as skin conductance hyporesponders (SCOR-HR: the lack of a robust orienting response) when exposed to innocuous tones. We studied the skin conductance orienting response (SCOR) of schizophrenia patients during the exposure to complex and abstract stimuli. We investigated two questions: 1) would the same percentage of schizophrenia patients be classified as SCOR-HR when the orienting stimuli are complex and abstract as when they are innocuous tones; and 2) whether SCOR-HR schizophrenia patients have associated frontally mediated neurocognitive deficits. Methods: Thirty-one schizophrenia patients and 29 normal comparison subjects were presented with the Rorschach inkblot test while their SCORs were recorded. Schizophrenics were divided in two groups: SCOR-HR and SCOR responders. Demographic and clinical comparisons were made between the two groups. Rorschach responses were scored for the presence of perseverations. Results: Forty-five percent of the schizophrenia patients were classified as SCOR-HR versus 10% of the normal comparison subjects. Among the schizophrenia patients, SCOR-HR was associated with increased perseverations, which were in turn correlated with the Scale for the Assessment of Negative Symptoms scores. Conclusions: It appears that SCOR-HR in schizophrenia is not a function of the “meaningfulness” of the stimuli. When SCOR status was combined with the measure of stuck-in-set perseverations, a pattern of results emerged lending indirect support to the hypothesis that relates SCOR-HR to frontal impairment and to the idea that SCOR-HR schizophrenia patients may represent a specific subgroup.