Optimization Of Stroop Task Based On Implicit Self-stigma In Schizophrenia

Schizophrenia is a complex and severe neuropsychiatric disorder.Patients with schizophrenia generally have a sense of implicit stigma.Implicit stigma is manifested in the degree of automated processing of symptomatic and characteristic words.Whether this automated processing is internalized in patients with schizophrenia,or whether this internalization differs between patients and healthy individuals are unknown.Secondly,previous researches suggested that the use of classical Stroop paradigm has high sensitivity and low specificity.We suspect that optimized Stroop paradigm can be used to improve the screening value of patients with schizophrenia,which is worthy of further study.Research purposeTo explore the mechanism of automatic processing of symptom-words and disease identity-words in patients with schizophrenia,and explore the practical value of Stroop paradigm of symptom-words and identity-words for screening schizophrenia.Research methods1.The patients with stable schizophrenia and healthy individuals were selected,matched for age,sex and educational level.The three independent IATs(stereotype,self-pattern,self-identity)were applied.The degree of automated processing of symptom-words and identity-words between the patient group and the control group was compared.2.The patients with stable schizophrenia and healthy individuals were selected,matched for age,sex and educational level.Classic Stroop paradigm and the optimized Stroop paradigm of symptom-words and identity-words were applied.The reaction time was compared between the patient group and the control group.The ROC curve is used to compare the differences of two Stroop paradigm.Research results1.On the IAT of schizophrenia-bad task,implicit effect score of the patient group was 0.81±0.33,implicit effect score of the control group was 0.91±0.25,which was suggested that there was an automated negative stereotype in both groups.There was no significant difference between the two groups(P=0.066).On the IAT of self-bad task,implicit effect score of the patient group was-0.38±0.24,implicit effect score of the control group was-0.47±0.24,suggested that there was an automated positive self-schema in both groups.But the patient group showed lower positive automatic self-schema than did the control group,and the difference was statistically significant(P=0.034).On the IAT of self-schizophrenia task,implicit effect score of the patient group was-0.21±0.28,implicit effect score of the control group was-0.34±0.21,suggested that there was an automated positive self-identity in both groups.But the patient group showed lower associations between healthy and self than did the control group,and the difference was statistically significant(P=0.004).2.In Classic Stroop paradigm,the reaction times of schizophrenic patients 1406.28±547.63 ms was longer than that of the controls 1171.96±543.21ms(P=0.001).The reaction times of schizophrenic patients 1206.65±476.39 ms was longer than that of the controls 916.01±395.85 ms in symptom-word Stroop task(P<0.001).The reaction times of schizophrenic patients 1256.22±630.18 ms was longer than that of healthy controls 927.85±419.98 ms in identity-word Stroop task(P<0.001).3.In Classic Stroop paradigm,the areas under the ROC curve of words whose colors are inconsistent with the meaning and words whose colors are consistent with the meaning were 0.657 and 0.682,respectively.And there was no significant difference between the two(P=0.512).In Stroop paradigm of symptom-words,the areas under the ROC curve of negative,positive and neutral words were 0.765,0.752 and 0.747,respectively.And there was no significant difference between the three.In Stroop paradigm of identity-words,the areas under the ROC curve of schizophrenic,healthy and neutral words were 0.762,0.753 and 0.751,respectively.And there was no significant difference between the three.The sensitivity and specificity were obtained by Receiver Operating Characteristic curves.In Classic Stroop paradigm,when the reaction times of words whose colors are inconsistent with the meaning was 1117 ms,the sensitivity and specificity of that were 75% and 44%,respectively.In Stroop paradigm of symptom-words,when the reaction times of negative words was 818 ms,the sensitivity and specificity of that were 89% and 57%,respectively.In Stroop paradigm of identity-words,when the reaction times of schizophrenic words was 904 ms,the sensitivity and specificity of that were 81% and 66%,respectively.Research conclusions1.Patients with schizophrenia didn't have an automated negative stereotype for themselves and disease identity bias for themselves.However,the intensity of patients with schizophrenia who automatically link themselves to "self-positive words " and " self-physical and mental health" is significantly lower than that of healthy controls.Symptom-words and identity-words have an impact on the automated cognitive processing of patients with schizophrenia.2.The reaction times of schizophrenic patients was longer than that of healthy controls in both symptom-word Stroop task and identity-word Stroop task,indicating that the executive function of selective attention and interference in patients with schizophrenia was significantly impaired.3.Symptom-word Stroop paradigm and identity-word Stroop paradigm showed moderate practical value for the identification of schizophrenic patients with executive dysfunction,and its sensitivity and specificity were also improved compared with the classic Stroop paradigm.