Not All Distraction Is Bad: Working Memory Vulnerability to Implicit Socioemotional Distraction Correlates with Negative Symptoms and Functional Impairment in Psychosis
This study investigated implicit socioemotional modulation of working memory (WM) in the context of symptom severity and functional status in individuals with psychosis ( ). A delayed match-to-sample task was modified wherein task-irrelevant facial distracters were presented early and briefly during the rehearsal of pseudoword memoranda that varied incrementally in load size (1, 2, or 3 syllables). Facial distracters displayed happy, sad, or emotionally neutral expressions. Implicit socioemotional modulation of WM was indexed by subtracting task accuracy on nonfacial geometrical distraction trials from facial distraction trials. Results indicated that the amount of implicit socioemotional modulation of high WM load accuracy was significantly associated with negative symptoms ( , ), role functioning ( , ), social functioning ( , ), and global assessment of functioning ( , ). Specifically, greater attentional distraction of high WM load was associated with less severe symptoms and functional impairment. This study demonstrates the importance of the WM-socioemotional interface in influencing clinical and psychosocial functional status in psychosis. 1. Introduction Attentional impairments are commonly observed in psychosis [1]. A classic view of attentional distraction is that it reflects cognitive impairment, that is, reduced ability to accurately maintain information in the presence of task-irrelevant stimuli. Yet, there are real-world situations wherein attentional distraction is adaptive. Consider a dyadic social encounter wherein the communicatee’s changing facial expressions appropriately disrupt the communicator’s thoughts. Here, attentional distraction adaptively permits the communicator to modulate ongoing cognition and attend to changing facial expressions in the communicatee. In other words, effective and reciprocal social encounters are those that demonstrate flexibility whereby communicators are sensitive to the facial expressions of the communicatee and are capable of modulating ongoing thoughts to attend to the communicatee. The present study aimed to capture the adaptability of this everyday challenge and gather proof of concept evidence by examining implicit socioemotional modulation of working memory (WM) in relation to symptom severity and functional status in individuals with psychosis. We reasoned that individuals with relatively severe psychosis have a WM system that is less sensitive to the moment-to-moment modulation of socioemotional stimuli. Though individuals with psychosis have general cognitive impairments, the WM construct was
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