Gestalt perception in schizophrenia spectrum disorders.

Abstract

The research examined the hypothesis that schizophrenia spectrum disorders are characterized by impairments in Gestalt perception. Participants with elevated levels of schizotypy, acute and chronic schizophrenia patients, and non-schizophrenia psychotic disorders were assessed on three measures of Gestalt perception. The hypothesis was that schizophrenia spectrum disorders are characterized by reduced responsiveness to Gestalt properties of visual stimuli. A pattern of performance on experimental tasks was predicted that would produce both impaired and enhanced task performance in schizophrenia spectrum disorders on measures of Gestalt perception. Impairments in Gestalt perception were hypothesized to correlate with symptoms of the disorganisation syndrome and with a specific aspect of social cognition, Theory of Mind (ToM), in schizophrenia spectrum disorders. The results of the research confirmed the main hypotheses. Schizophrenia spectrum disorders displayed in all studies reduced responsiveness to Gestalt properties of stimuli. Dysfunctional Gestalt perception emerged not as general feature of schizophrenia spectrums disorders, however. Cognitive deficits were specifically related to the disorganisation syndrome and statistical comparisons between participants with elevated and reduced levels of thought disorder found that dysfunctional Gestalt perception was only present in thought disordered participants with schizophrenia spectrum disorders. Dysfunctional Gestalt perception resulted consistently in both impaired and enhanced task performance in disorganised forms of schizophrenia spectrum disorders. It is concluded that the experimental results reflect a specific deficit in the perceptual organisation of stimuli based on context. Furthermore, the hypothesis was confirmed that dysfunctional Gestalt perception is correlated with impaired ToM in chronic and acute schizophrenia. The findings of the research are discussed from the perspective of recent models of cognition in schizophrenia spectrum disorders where impaired Gestalt perception is viewed as the result of a comprehensive impairment in the cognitive coordination of neural and cognitive activity. It is proposed that dysfunctional Gestalt perception may be related to a specific subtype of schizophrenia, neurodevelopmental schizophrenia, which is characterised by poor premorbid functioning, disorganised symptoms, and poor outcome. Further issues for research are discussed.