day living, by offering the chance to improve coping skills: how to remember to take medications reliably, how to manage in stressful situations, how to interact socially with others.
Research on schizophrenia has also brought neuroscientists a step closer to an understanding of how the prefrontal cortex functions in normal circumstances. Current scientific thinking is that the region guides behavior by its representations, or working memory, of stimuli rather than by direct perception of the stimuli themselves. (Hence the inability in schizophrenia to predict the location of a moving target or to foresee an expectable outcome in given circumstances, for instance, in social interactions.) In a general sense it can be said that this area of the brain—which is greatly enlarged in humans, relative to our near-cousins, the other primates—provides the physiological basis for abstract thought and the ability to plan.
Vigorous investigation into the many forms and factors of mental illness is thus a central task for neuroscience. Observations from clinical practice, laboratory study of the mechanisms of disease and the ability of chemical compounds to harm or help, and genetic analysis of family history all build on one another, offering the prospect of more efficacious treatments and of theoretical accounts that grow more solid as new details are filled in. While neuroscience looks more closely at the brain, it continues to enlarge our options for treating the mind.
Chapter 4 is based on presentations by Patricia Goldman-Rakic, Richard Johnson, Lewis Judd, and Guy McKhann.