Cross-diagnostic analysis of cognitive control in mental illness: Insights from the CNTRACS consortium

Jason Smucny, Deanna M. Barch, James M. Gold, Milton E. Strauss, Angus W. MacDonald, Megan A. Boudewyn, J. Daniel Ragland, Steven M. Silverstein, Cameron S. Carter

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: In recent years, psychiatry research has increasingly focused on understanding mental illnesses from a cross-diagnostic, dimensional perspective in order to better align their neurocognitive features with underlying neurobiological mechanisms. In this multi-site study, we examined two measures of cognitive control (d-prime context and lapsing rate) during the Dot Probe Expectancy (DPX) version of the AX-Continuous Performance Task in patients with either schizophrenia (SZ), schizoaffective disorder (SZ-A), or Type I bipolar disorder (BD) as well as healthy control (HC) subjects. We hypothesized significantly lower d-prime context and higher lapsing rate in SZ and SZ-A patients and intermediate levels in BD patients relative to HC. Methods: 72 HC, 84 SZ, 77 SZ-A, and 58 BD patients (ages 18–56) were included in the final study sample. Results: Significant main effects of diagnosis were observed on d-prime context (F(3,279) = 9.59, p < 0.001) and lapsing (F(3,279) = 8.08, p < 0.001). A priori linear contrasts suggesting intermediate dysfunction in BD patients were significant (p < 0.001), although post-hoc tests showed the BD group was only significantly different from HC on d-prime context. Group results for d-prime context remained significant after covarying for lapsing rate. Primary behavioral measures were associated with mania and disorganization symptoms as well as everyday functioning. Conclusions: These findings suggest a continuum of dysfunction in cognitive control (particularly d-prime context) across diagnostic categories in psychiatric illness. These results further suggest that lapsing and d-prime context, while related, make unique contributions towards explaining deficits in cognitive control in these disorders.

Original languageEnglish (US)
Pages (from-to)377-383
Number of pages7
JournalSchizophrenia Research
StatePublished - Jun 2019

Bibliographical note

Funding Information:
This study was supported by a research grant from the National Institutes of Mental Health (NIMH) ( 5R01-MH059883 ).


  • Ax-cpt
  • Bipolar disorder
  • Cognitive control
  • D-prime context
  • Schizoaffective disorder
  • Schizophrenia

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article
  • Research Support, N.I.H., Extramural

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