A simple clinical assessment of attention in schizophrenia

Although attentional dysfunction is considered a predominant feature of schizophrenia, it is seldom quantitatively assessed in clinical practice. A simple paper-and-pencil test of selective attention (Ruff et al., 1986) provides a 5-min assessment with theoretical relevance for schizophrenia. Thirty schizophrenic subjects performed the 2 and 7 Selective Attention Test, which measures speed and accuracy, and compares controlled and automatic information processing. Ninety percent of the subjects displayed automatic processing. Speed was severely impaired, and accuracy was less so. Sixty-seven percent of the schizophrenic subjects performed in the normal range (+/-1 SD) for accuracy, but only 23% scored in the normal range for speed. Speed and accuracy were moderately correlated. Although theories of a lateralized deficit were not supported, the results are consistent with a hypothesized frontal lobe dysfunction. The automatic processing demonstrated may represent old learning. Poor controlled processing may preclude the acquisition of automatic functioning. This selective attention test may provide a measure of severity of cognitive impairment relevant to daily life functioning.