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Leveraging Stacked Classifiers for Multi-task Executive Function in Schizophrenia Yields Diagnostic and Prognostic
Tongyi Zhang1, Xin Zhao1, B T Thomas Yeo2,3,4,5,6
1School of Psychology, Northwest Normal University, Lanzhou 730070, China.
Schizophrenia Bulletin
|March 21, 2026
Summary
Executive function (EF) impairments, particularly inhibitory control and working memory (WM), help diagnose schizophrenia (SZ) and predict remission. Specific EF deficits link to symptom severity and patient outcomes.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Executive function (EF) impairments are common in schizophrenia (SZ), impacting patient outcomes.
- The specific contribution of different EF dimensions to SZ diagnosis and prognosis is unclear.
Purpose of the Study:
- To investigate the diagnostic and prognostic utility of specific EF dimensions in schizophrenia.
- To explore the association between EF performance, symptom dimensions, and treatment outcomes.
Main Methods:
- Utilized stacking classification models on 6 EF tasks to differentiate 195 SZ patients from healthy controls.
- Employed baseline EF measurements to predict remission status.
- Analyzed EF feature importance and linked individual scores to symptom dimensions.
Main Results:
- Inhibitory control and working memory (WM) were key predictors for SZ diagnosis (AUC=0.87) and remission (AUC=0.81).
- Poorer interference inhibition correlated with more severe negative symptoms in diagnosed patients.
- Better WM updating predicted milder cognitive symptoms in remitted patients.
Conclusions:
- Specific EF dimensions in SZ are distinctly associated with symptom load and prognostic outcomes.
- EF-based assessments and models show promise for clinical evaluation in schizophrenia.

