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Considering the Multidimensional Structure of Schizotypy and Schizophrenia is Essential for Understanding Cognitive Impairment
Decades of research demonstrate that schizophrenia is characterized by gross cognitive impairment, which is in turn associated with impaired functioning. However, studies are often unable to tease apart the extent to which cognitive impairments represent etiologically relevant processes as opposed to disease markers or sequelae. Schizotypy provides a promising framework for this work given that the same pathognomonic processes are presumed to underlie the subclinical and clinical expressions of the schizotypy continuum. Across a series of studies, we demonstrate that considering the multidimensionality of schizotypy and schizophrenia is essential for understanding this complex and heterogeneous psychopathology. Assessment of recognition memory revealed that negative schizotypy is associated with reduced hit rates, without affecting false alarm rates, whereas positive schizotypy is associated with increased false alarms without a decrement in hits. Extending these findings to examine the relationship of schizotypy with directed forgetting (DF) tasks, positive schizotypy showed deficits in item-method DF, despite preserved performance in list-method DF, whereas negative schizotypy showed deficits in list-method DF, despite preserved item-method performance. Overall, the results indicate different underlying mechanisms producing cognitive impairment in positive and negative schizotypy and underscore the importance of considering multidimensionality of schizotypy to accurately characterize cognitive impairment in schizophrenia.