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Application of the Audio Recorded Cognitive Screen and its relation to functioning in schizophrenia

  • Brooke M. Gelder (a1), Carmel M. Loughland (a2), Vaughan J. Carr (a3) (a4) and Peter W. Schofield (a2) (a5) (a6)

This study investigated the ability of the Audio Recorded Cognitive Screen (ARCS) to detect cognitive deficit in individuals with schizophrenia, relative to the Mini Mental State Examination (MMSE) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and explored the associations between the ARCS and functional outcomes. We hypothesised that the ARCS would be able to better discriminate between individuals with schizophrenia and healthy controls than the MMSE, and that ARCS performance would be correlated with measures of social and vocational functioning.


The participants were 19 community-dwelling individuals with schizophrenia or schizoaffective disorder and 19 healthy controls recruited from the Australian Schizophrenia Research Bank (ASRB). Participants completed the ARCS, MMSE, and self-report measures of social and vocational functioning. Clinical and diagnostic data stored by the ASRB were also utilised.


The schizophrenia group performed worse than the control group on the ARCS, with memory, t(36)=2.49, p=0.02, 95% CI [−1.84, −18.79] and fluency, t(36)=2.40, p=0.02, 95% CI [−1.87, −22.24] domains being the main discriminating measures. The RBANS also discriminated between the two groups, and ARCS and RBANS total scores were moderately to strongly correlated. There was no difference between the two groups on the MMSE after controlling for demographic variables. ARCS performance was associated with employment status [χ2(1)=7.16, p=0.007].


The ARCS may be sensitive to the cognitive deficits in outpatients with schizophrenia and an indicator of functional outcomes in this population.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Associate Prof. Peter Schofield, Neuropsychiatry Service, Hunter Region Mail Centre, Newcastle, NSW, Australia. Tel: +(02) 4033 5739; Fax: +(02) 4033 5606; E-mail:
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1. Tracey JI, Mattson R, King C, Bundick T, Celenza MA, Glosser G. A comparison of memory for verbal and non-verbal material in schizophrenia. Schizophr Res 2001;50:199211.
2. Silver H, Feldman P, Bilker W, Gur RC. Working memory deficit as a core neuropsychological dysfunction in schizophrenia. Am J Psychiat 2003;160:18091816.
3. Brebion G, David AS, Jones H, Pilowsky LS. Semantic organization and verbal memory efficiency in patients with schizophrenia. Neuropsychology 2004;18:378383.
4. Fuller RL, Luck SJ, Mcmahon RP, Gold JM. Working memory consolidation is abnormally slow in schizophrenia. J Abnorm Psychol 2005;114:279290.
5. Lee J, Park S. Working memory impairments in schizophrenia: a meta-analysis. J Abnorm Psychol 2005;114:599611.
6. Chan RC, Chen EY, CW Law. Specific executive dysfunction in patients with first-episode medication-naive schizophrenia. Schizophr Res 2006;82:5164.
7. Kurtz MM, Ragland JD, Bilker W, Gur RC, Gur RE. Comparison of the continuous performance test with and without working memory demands in healthy controls and patients with schizophrenia. Schizophr Res 2001;48:307316.
8. Kamio S, Nakagome K, Murakami T et al. Impaired supression of processing in schizophrenic patients suggested by ERPs obtained in a selective attention task. Schizophr Res 2001;49:213221.
9. Censits DM, Ragland D, Gur RC, Gur RE. Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study. Schizophr Res 1997;24:289298.
10. Heaton RK, Gladsjo JA, Palmer BW, Kuck J, Marcotte TD, Jeste DV. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001;58:2432.
11. Addington J, Saaedi H, Addinton D. The course of cognitive functioning in first episode psychosis: changes overtime and impact on outcome. Schizophr Res 2005;78:3543.
12. Revheim N, Schechter I, Kim D et al. Neurocognitive and symptom correlates of daily problem-solving skills in schizophrenia. Schizophr Res 2006;83:237245.
13. Cohen AS, Forbes CB, Mann MC, Blanchard JJ. Specific cognitive deficits and differential domains of social functioning impairment in schizophrenia. Schizophr Res 2006;81:227238.
14. Mcgurk SR, Meltzer HY. The role of cognition in vocational functioning in schizophrenia. Schizophr Res 2000;45:175184.
15. Hofer A, Baumgartner S, Bodber T et al. Patient outcomes in schizophrenia II: the impact of cognition. Eur Psychiatry 2005;20:395402.
16. Gold JM. Cognitive deficits as treatment targets in schizophrenia. Schizophr Res 2004;72:2128.
17. Folstein MF, Folstein SE, Mchugh PR. ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189198.
18. Moore DJ, Palmer BW, Jeste DV. Use of the mini-mental state exam in middle-aged and older outpatients with schizophrenia: cognitive impairment and its associations. Am J Geriatr Psychiatry 2004;12:412419.
19. Keefe RS, Goldberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The brief assessment of cognition in schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 2004;68:283297.
20. Gold JM, Queern C, Iannone VN, Buchanana RW. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia, 1: sensitivity, reliability, and validity. Am J Psychiat 1999;156:19441950.
21. Wilk CM, Gold JM, Humber K, Dickerson F, Fenton WS, Buchanana RW. Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status. Schizophr Res 2004;70:175186.
22. Keefe RS, Poe M, Walker TM, Harvey PD. The relationship of the Brief Assessment of Cognition in Schizophrenia (BACS) to functional capacity and real-world functional outcome. J Clin Exp Neuropsychol 2006;28:260269.
23. Faustman WO, Moses JA, Csernansky JG. Limitations of the mini-mental state examination in predicting neuropsychological functioning in a psychiatric sample. Acta Psychiatr Scand 1990;81:126131.
24. Manning V, Wanigaratne S, Best D, Strathdee G, Schrover I, Gossop M. Screening for cognitive functioning in psychiatric outpatients with schizophrenia, alcohol dependence, and dual diagnosis. Schizophr Res 2007;91:151158.
25. Schofield PS, Lee SJ, Lewin TJ et al. The Audio Recorded Cognitive Screen (ARCS): a flexible hybrid cognitive test instrument. J Neurol, Neurosurg and Psychiatr 2010;81:602607.
26. Loughland CM, Allen J, Gianacas L et al. Brief neuropsychological profiles in psychosis: a pilot study using the Audio Recorded Cognitive Screen (ARCS). Acta Neuropsychiatr 2010;22:243252.
27. Torniainen M, Suvisaari J, Partonen T et al. Cognitive impairments in schizophrenia and schizoaffective disorder: relationship with clinical characteristics. J Nerv Ment Dis 2012;200:316322.
28. Loughland C, Draganic D, Mccabe K et al. Australian Schizophrenia Research Bank: a database of comprehensive clinical, endophenotypic and genetic data for aetiological studies of schizophrenia. Aust N Z J Psychiatry 2010;44:10291035.
29. Castle DJ, Jablenskey A, Mcgrath JJ et al. The diagnostic interview for psychoses (DIP): development, reliability and applications. Psychol Med 2006;36:6980.
30. Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales, 2nd edn. Sydney: Psychology Foundation, 1995.
31. Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S. The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry 1990;157:853859.
32. Andreasen NC. Scale for the assessment of negative symptoms: SANS. Lowa: University of Lowa, 2000.
33. Heinrichs RW, Zakzanis KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998;12:426445.
34. Crum RM, Anthony JC, Bassett SS, Folstein MF. Population-based norms for the Mini-Mental State Examination by age and educational level. J Am Med Assoc 1993;269:23862391.
35. Loughland CM, Carr VJ, Lewin TJ, Barnard RE, Chapman JL, Walton JM. Potential sampling and recruitment source impacts in schizophrenia research. Psychiatry Res 2004;125:117127.
36. Loughland CM, Lewin TJ, Carr VJ, Sheedy J, Harris AW. RBANS neuropsychological profiles within schizophrenia samples recruited from non-clinical settings. Schizophr Res 2007;89:232242.
37. Ganguli J, Brar JS, Vemulapalli H et al. Mini-Mental State Examination (MMSE) performance of partially remitted community-dwelling patients with schizophrenia. Schizophr Res 1998;33:4552.
38. Fett A-KJ, Viechtbauer W, Dominguez MD, Penn DL, Van Os J, Krabbendam L. The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci & Biobehav Rev 2011;35:573588.
39. Hoff AL, Sventina C, Shields G, Stewart J, Delisi LE. Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophr Res 2005;78:2734.
40. Zanello A, Curtis L, Badan BAM, Merlo MCG. Working memory impairments in first-episode psychosis and chronic schizophrenia. Psychiatry Res 2009;165:1018.
41. Szoke A, Trandafir A, Dupont M-E, Meary A, Schurhoff F, Leboyer M. Longitudinal studies of cognition in schizophrenia: meta-analysis. Br J Psychiatry 2008;192:248257.
42. Wykes T, Huddy V, Cellard C, Mcgurk SR, Czobor P. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiat 2011;168:472485.
43. Ibrahim HM, Tamminga CA. Treating impaired cognition in schizophrenia. Curr Pharm Biotechnol 2012;13:15871594.
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Acta Neuropsychiatrica
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  • EISSN: 1601-5215
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