General and Specific Cognitive Deficits in Schizophrenia: Goliath Defeats David?

Background Our earlier work suggested that the cognitive performance impairment in individuals with schizophrenia relative to healthy control subjects was generalized, cutting across narrower cognitive ability dimensions. Current analyses sought to extend these findings. Methods Seventeen neuropsychological variables, available for 148 schizophrenia subjects and 157 control subjects, were subjected to structural equation modeling. Analyses incorporated a hierarchical model, grouping the variables into six familiar cognitive domains and linking these to a higher-order, general cognitive ability factor. We added diagnosis to the model as a grouping factor and estimated loadings from diagnosis to the general cognitive factor and, separately, to the domain factors. Results The fit of the final model was good (e.g., Non-Normed Fit Index [NNFI] = .988). Approximately 63.6% of the diagnosis-related variance in cognitive performance was mediated through the general factor, with smaller direct effects on verbal memory (13.8%) and processing speed (9.1%). Conclusions The schizophrenia cognitive deficit is largely generalized across performance domains, with small, direct effects of diagnostic group confined to selected domains. This generalized deficit sometimes has been seen as a function of the psychometric limitations of traditional cognitive test batteries. Alternatively, it may be a fundamental manifestation of schizophrenia, with similarly general neurobiological underpinnings.