Tasha M. Nienow

Stability of formal thought disorder and referential communication disturbances in schizophrenia.

This study examined the degree to which different types of communication disturbances in the speech of 48 schizophrenia patients and 28 controls were variable and state related versus stable and traitlike. Clinically rated formal thought disorder and 5 types of referential disturbance showed substantial stability within participants over time. The sixth type of referential disturbance, the vague reference, was not stable over time. Formal thought disorder was associated with the severity of core psychotic symptoms in patients. whereas referential disturbances showed little or no association with positive or negative symptom severity. Furthermore, changes in psychotic symptoms over time were accompanied by corresponding changes in formal thought disorder but not referential disturbances. These results support the idea that some types of referential disturbances are traitlike and may be reflective of vulnerability as well as manifest illness.

Neurocognitive and social cognitive correlates of formal thought disorder in schizophrenia patients

The neurocognitive and social cognitive correlates of two types of formal thought disorder (i.e., bizarre-idiosyncratic and concrete thinking) were examined in 47 stable outpatients with schizophrenia. Both types of thinking disturbance were related to impairments in verbal learning, intrusions in verbal memory, immediate auditory memory, sustained attention, and social schema knowledge. Distractibility during an immediate memory task was associated with more frequent bizarre verbalizations but not concreteness. Impaired verbal learning rate and intrusions in verbal memory independently contributed to the prediction of bizarre responses, whereas intrusions in verbal memory and impaired immediate memory independently contributed to concrete thinking. This pattern of findings is consistent with the view that neurocognitive and, possibly, social cognitive deficits underlie these two aspects of formal thinking disturbance in schizophrenia.

Attentional Dysfunction, Social Perception, and Social Competence: What Is the Nature of the Relationship?

The aim of this study was to examine the nature of the relationship between attentional dysfunction and social competence deficits in patients with schizophrenia. Attentional functioning, social perception, and social competence were assessed in 56 inpatients. Measures of vigilance and span of apprehension were administered to assess attentional functioning. Social perception was assessed with an audiovisual measure of affect recognition. Social competence was rated from a role-play task. Span of apprehension and auditory vigilance emerged as specific predictors of social competence. Affect recognition was tested as a mediator and a moderator of the relationship between attentional dysfunction and social competence. Affect recognition was found to moderate the relationship between span of apprehension and social competence.

Internal source monitoring and thought disorder in schizophrenia.

A new task was developed to examine source monitoring in 52 patients with schizophrenia. Patients and nonpsychiatric controls were not found to differ on recognition memory, source discrimination, or attribution bias when the between group difference in IQ was controlled. However, among patients, source discrimination was significantly related to severity of thought disorder. After controlling for IQ and verbal working memory, thought-disordered patients were significantly poorer than nonthought-disordered patients at discriminating the source of previously presented information. Results suggest that internal source monitoring is specifically related to thought disorder in patients with schizophrenia.

Stress and arousability in schizophrenia

This paper examines trait arousability (TA), a temperament characteristic, in 47 stable outpatients with schizophrenia and 50 non-psychiatric controls. Self-reported levels of stress were obtained during a negative and positive memory speech task. Levels of TA, and the association of TA scores with reported stress during the speech tasks, were examined both between and within groups. In addition, TA scores were examined in relation to symptom presentation in the patient group. Patients reported higher levels of trait arousability and higher levels of stress than controls. Trait arousability scores were significantly associated with reported stress in one of the speech condition in patients, and with the severity of positive and affective symptoms. These results suggest that temperament characteristics of an individual with schizophrenia may be related to stress responsiveness and symptom presentation.

Affective Reactivity of Language Symptoms, Startle Responding, and Inhibition in Schizophrenia

The speech of some schizophrenia patients becomes markedly more disordered when negative affect is aroused. The authors tested associations between affective reactivity of speech and responsiveness and inhibition on an acoustic startle task in a sample of 27 outpatients. Patients whose language was reactive to negative affect showed significantly higher initial startle amplitudes than those whose language was not reactive. However, they also showed greater habituation to repeated startle stimuli over trials, even after differences in initial amplitudes were controlled statistically. These findings suggest that affective reactivity of speech is associated with higher initial startle responsiveness but also with greater habituation and, conversely, that patients who are relatively nonreactive to excitatory affective and sensory stimuli are also less reactive to inhibitory input.

Self-Reported Stress and the Deficit Syndrome of Schizophrenia

Abstract Generally speaking, schizophrenia is not associated with diminished positive and negative emotions. Even patients with negative symptoms such as blunted affect have generally not differed in their levels of self-reported emotionality compared to patients without negative symptoms. However, there is evidence to suggest that a subgroup of patients with negative symptoms, those with the deficit syndrome, have a diminished capacity to experience positive and negative emotions. The present study examined whether ratings of the deficit and negative syndrome were associated with lower levels of self-reported stress during a laboratory-based, emotion-induction manipulation. Thirty-six participants with schizophrenia were asked to produce separate affectively positive and affectively negative narratives. Immediately following each narrative, participants were asked to report the level of stress they had experienced while recounting their memories. The deficit syndrome ratings, analyzed in a continuous and a categorical manner, were associated with lower levels of self-reported stress in the affectively negative condition. Moreover, the deficit and negative syndrome ratings significantly differed in their associations to levels of self-reported stress during both tasks, supporting the notion that there are appreciable differences between the two syndromes. Given that stress has been an essential component in conceptualizations of schizophrenia onset and relapse, the possibility of stress-resistant properties associated with the deficit syndrome should be tested in future research.

Arousability in schizophrenia: relationship to emotional and physiological reactivity and symptom severity.

Objective:  Socioenvironmental stressors have been linked with increased symptom severity and relapse in those with schizophrenia. However, little is known about how individual differences in stress reactivity may contribute to these outcomes.

Attribution biases in schizophrenia: relationship to clinical and functional impairments.

Background: Patients with schizophrenia exhibit impairment in their ability to accurately recognize facial emotions in others, and the severity of this emotion perception deficit has been associated with poorer functioning. However, the mechanisms underlying facial emotion perception deficits are poorly understood. There is evidence to suggest that patients, particularly those with certain positive symptoms, may misinterpret other people’s facial expressions as having an overly negative valence. The present study examined the degree to which attribution biases in facial emotion perception are associated with psychiatric symptomatology and social and occupational impairments. Sampling and Methods: The error profiles from a facial emotion perception test were analyzed and compared for 67 schizophrenic state hospital inpatients and 21 nonpsychiatric controls. Attribution bias scores were separately computed for each of six types of emotion. Results: The error profiles were remarkably similar for patients as a group and controls. Within the patient group, severity of positive symptoms was associated with more ‘fear’ misperceptions. Patients with relatively high levels of ‘anger’ misperceptions tended to have more severe disorganization and negative symptoms and more pronounced functional impairments. Interestingly, patients who erroneously reported seeing relatively high levels of ‘shame’ and ‘happiness’ showed better functioning and less severe symptoms. Conclusions: Attribution biases appear to play a role in contributing to functional impairments in patients with schizophrenia. The lack of an isomorphic attribution bias across patients highlights the importance of considering schizophrenia heterogeneity when attempting to understand and treat social cognitive deficits.

Internal source monitoring and communication disturbance in patients with schizophrenia

BACKGROUND This study examined the relationship between internal source monitoring and disordered speech in patients with schizophrenia or schizoaffective disorder. It was predicted that internal source monitoring would relate specifically to one type of communication disturbance, the missing information reference. METHOD Immediate, working, and internal source memory were assessed in 47 out-patients diagnosed with schizophrenia or schizoaffective disorder. Speech samples were also collected from this sample and coded for six types of communication disturbance. RESULTS Of the six types of communication disturbance coded in this study, internal source monitoring indices were uniquely related to the frequency of the missing information reference. Furthermore, internal source monitoring was the only type of short-term memory process assessed in this study that was related to the missing information reference. Neither immediate nor working-memory capacity was related significantly to the frequency of this type of communication disturbance. CONCLUSIONS This study adds to our knowledge of the neurocognitive processes that underlie communication disturbance in the speech of patients with schizophrenia.