Abstract
In recent years, interest has grown in measuring executive function in schizophrenia with ecological and virtual reality (VR) tools. However, there is a lack of critical analysis comparing those tools with traditional ones. This paper aims to characterize executive dysfunction in schizophrenia by comparing ecological and virtual reality assessments with traditional tools, and to describe the neurobiological and psychopathological correlates. The analysis revealed that ecological and VR tests have higher levels of verisimilitude and similar levels of veridicality compared to traditional tools. Both negative symptoms and disorganization correlate significantly with executive dysfunction as measured by traditional tools, but their relationships with measures based on ecological and VR methods are still unclear. Although there is much research on brain correlates of executive impairments in schizophrenia with traditional tools, it is uncertain if these results will be confirmed with the use of ecological and VR tools. In the diagnosis of executive dysfunction, it is important to use a variety of neuropsychological methods—especially those with confirmed ecological validity—to properly recognize the underlying characteristics of the observed deficits and to implement effective forms of therapy.
Highlights
Executive dysfunction, cognitive deficits, positive and negative symptoms, and disorganization are key psychopathological symptoms in schizophrenia; they are consequences of abnormalities in the structural and functional levels in the brain [1,2]
Despite the well-established links between executive impairments measured by traditional tools and psychopathological dimensions e.g., [30], links between measurement by ecological and virtual reality (VR) tools and the aforementioned dimensions have been severely neglected in systematic reviews
Future research should be based on paradigms that allow the use of VR assessment of executive functioning with methods of functional neuroimaging
Summary
Cognitive deficits, positive and negative symptoms, and disorganization are key psychopathological symptoms in schizophrenia; they are consequences of abnormalities in the structural and functional levels in the brain [1,2]. Despite the well-established links between executive impairments measured by traditional tools and psychopathological dimensions e.g., [30], links between measurement by ecological and VR tools and the aforementioned dimensions have been severely neglected in systematic reviews. This is all the more surprising as knowing these relationships helps us understand the nature of schizophrenia and to organize interdisciplinary diagnostic and support systems for patients [31]. Finding biological markers would enable faster diagnosis, earlier implementation of effective treatment, and improved quality of life [32] Given these limitations and the paucity of comprehensive analyses in the available review papers, we formulated the following objectives. Our secondary goal was to describe the neurobiological and psychopathological correlates of that dysfunction
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