Is implicit sequence learning impaired in schizophrenia? A meta-analysis

Cognition in schizophrenia seems to be characterized by impaired performance on most tests of explicit or declarative learning contrasting with relatively intact performance on most tests of implicit or procedural learning. At the same time there have been conflicting results for studies that have used the Serial Reaction Time (SRT) task to examine implicit learning in people with schizophrenia. In the present research, we used meta-analysis to clarify whether or not people with schizophrenia show impaired performance on the SRT task. A systematic review found nine studies published in peer review journals that had each compared the performance of a group of people with schizophrenia with healthy controls on the standard SRT task or a variant of it. The resulting meta-analysis represented the responses of 205 participants with schizophrenia and 159 healthy controls on the SRT task. The analysis found that participants with schizophrenia perform less well than controls reflected by a pooled effect size of 0.51. A secondary analysis of all nine studies found that they all reported a point estimate of the change in reaction time between sequence and random trials that was greater for the controls. We conclude that there is a moderate impairment in implicit sequence learning among people with schizophrenia and speculate on the implications of this for understanding this disorder. Suggestions for improving the methodological quality and statistical reporting of studies of this topic are made.