Skip to main content Accessibility help

Reduced Cognitive Control of a Visually Bistable Image in Schizophrenia

  • Ryan McBain (a1), Daniel J. Norton (a2), Jejoong Kim (a3) and Yue Chen (a1) (a4)


Schizophrenia is associated with the inability to control and coordinate thoughts, actions, and perceptions. In conventional assessments of cognitive control, multiple sensory features of stimuli are concomitantly manipulated, introducing a confounding role of bottom-up perceptual information. To overcome this difficulty, we used an ambiguous visual stimulus (Necker cube), which allowed measurement of cognitive control with constant sensory input. Subjects (20 patients, 20 controls) were asked to control their perception of a transparent Necker cube by keeping a designated plane at the front or back of the stimulus, the position of which is perceptually bistable. Patients were highly deficient at controlling their perception of the cube. When a visual feature (the luminance contrast between a designated cube plane and the other planes) was systematically manipulated, an interaction was found whereby schizophrenia patients no longer under-performed on the highest contrast condition. These results show patients’ impairment of controlling perception in the absence of visual modulation and suggest the potential utility of perceptually based approaches to cognitive remediation in schizophrenia. (JINS, 2011, 551–556)


Corresponding author

Correspondence and reprint requests to: Ryan McBain, McLean Hospital, 115 Mill Street, Belmont, MA, 02478. E-mail:


Hide All
Barrett, S.L., Mulholland, C.C., Cooper, S.J., Rushe, T.M. (2009). Patterns of neurocognitive impairment in first-episode bipolar disorder and schizophrenia. British Journal of Psychiatry, 195, 6772.
Butler, P.D., Javitt, D.C. (2005). Early-stage visual processing deficits in schizophrenia. Current Opinions in Psychiatry, 18, 151157.
Butler, P.D., Schechter, I., Zemon, V., Schwartz, S.G., Greenstein, V.C., Gordon, J., Javitts, D. (2001) (Dysfunction of early-stage visual processing in schizophrenia. American Journal of Psychiatry, 158, 11261133.
Chen, Y., Levy, D.L., Nakayama, K., Matthysse, S., Palafox, G., Holzman, P.S. (1999). Dependence of impaired eye tracking on deficient velocity discrimination in schizophrenia. Archives of General Psychiatry, 56, 155161.
Chen, Y., Nakayama, K., Levy, D.L., Matthysse, S., Holzman, P.S. (1999). Psychophysical isolation of a motion-processing deficit in schizophrenics and their relatives and its association with impaired smooth pursuit. Proceedings of the National Academy of Sciences of the United States of America, 96, 47244729.
Chen, Y., Norton, D., McBain, R. (2008). Can persons with schizophrenia appreciate visual art? Schizophrenia Research, 105, 245251.
Chen, Y., Palafox, G.P., Nakayama, K., Levy, D.L., Matthysse, S., Holzman, P.S. (1999). Motion perception in schizophrenia. Archives of General Psychiatry, 56, 149154.
Danckert, J., Saoud, M., Maruff, P. (2004). Attention, motor control and motor imagery in schizophrenia: implications for the role of the parietal cortex. Schizophrenia Research, 70, 241261.
First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B. (2002). Structured clinical interview for DSM-IV-TR axis I disorders -patient edition (SCID—I/P, 11/2002 revision). New York, NY: Biometrics Research Department.
Fisher, M., Holland, C., Merzenich, M.M., Vinogradov, S. (2009). Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. American Journal of Psychiatry, 166, 805811.
Gold, J.M., Fuller, R.L., Robinson, B.M., Braun, E.L., Luck, S.J. (2007). Impaired top-down control of visual search in schizophrenia. Schizophrenia Research, 94, 148155.
Green, M.F., Butler, P.D., Chen, Y., Geyer, M.A., Silverstein, S., Wynn, J.K., Zemon, V. (2009) (Perception measurement in clinical trials of schizophrenia: promising paradigms from CNTRICS. Schizophrenia Bulletin, 35, 163181.
Henik, A., Salo, R. (2004). Schizophrenia and the Stroop effect. Behavioral and Cognitive Neuroscience Reviews, 3, 4259.
Hugdahl, K. (2009). “Hearing voices”: auditory hallucinations as failure of top-down control of bottom-up perceptual processes. Scandinavian Journal of Psychology, 50, 553560.
Hugdahl, K., Løberg, E.M., Jørgensen, H.A., Lundervold, A., Lund, A., Green, M.F., Rund, B.R. (2008). Left hemisphere lateralization of auditory hallucinations in schizophrenia: a dichotic listening study. Cognitive Neuropsychiatry, 13, 166179.
Hugdahl, K., Rund, B.R., Lund, A., Asbjornsen, A., Egeland, J., Landro, N.I., Sundet, K. (2003) (Attention and executive dysfunctions in schizophrenia and depression: evidence from dichotic listening performance. Biological Psychiatry, 53, 609616.
Joyce, E., Hutton, S., Mutsatsa, S., Gibbins, H., Webb, E., Paul, S., Barnes, T. (2002) (Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: the West London Study. British Journal of Psychiatry Supplement, 43, s38s44.
Kay, S.R., Fiszbein, A., Opler, L.A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261276.
Kim, J.J., Park, H.J., Jung, Y.C., Chun, J.W., Kim, H.S., Seok, J.H., Lee, J.D. (2009) (Evaluative processing of ambivalent stimuli in patients with schizophrenia and depression: a [150] H20 PET study. Journal of the International Neuropsychological Society, 15, 9901001.
McBain, R., Norton, D., Chen, Y. (2010). Differential roles of low and high spatial frequency contents in abnormal facial emotion perception in schizophrenia. Schizophrenia Research, 122, 151155.
Nuechterlein, K.H., Luck, S.J., Lustig, C., Sarter, M. (2009). CNTRICS final task selection: control of attention. Schizophrenia Bulletin, 35(1), 182196.
O'Leary, D.S. (2003). Effects of attention on hemispheric asymmetry. Cambridge, MA: MIT Press.
Peterson, M.A., Hochberg, J. (1983). Opposed-set measurement procedure: a quantitative analysis of the role of local cues and intention in form perception. Journal of Experimental Psychology: Human Performance and Perception, 9, 183193.
Sereno, A.B., Holzman, P.S. (1996). Spatial selective attention in schizophrenic, affective disorder, and normal subjects. Schizophrenia Research, 20(1–2), 3350.
Slotnick, S.D., Yantis, S. (2005). Common neural substrates for the control and effects of visual attention and perceptual bistability. Brain research. Cognitive Brain Research, 24, 97108.
Wechsler, D. (1981). Manual for the adult intelligence scale-revised. New York: Psychological Corporation.


Reduced Cognitive Control of a Visually Bistable Image in Schizophrenia

  • Ryan McBain (a1), Daniel J. Norton (a2), Jejoong Kim (a3) and Yue Chen (a1) (a4)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed