Hostname: page-component-54dcc4c588-wlffp Total loading time: 0 Render date: 2025-09-27T08:13:36.594Z Has data issue: false hasContentIssue false
  • English
  • Français

Linguistic alignment and theory of mind impairments in schizophrenia patients' dialogic interactions

Published online by Cambridge University Press:  10 September 2019

Karen Dwyer ,
Anthony S. David ,
Rosaleen McCarthy ,
Peter McKenna  and
Emmanuelle Peters
Karen Dwyer*
Affiliation:
Department of English Language and Literature, University College London, London, UK Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
Anthony S. David
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK Institute of Mental Health, University College London, London, UK
Rosaleen McCarthy
Affiliation:
Department of Psychology, University of Southampton, Southampton, UK Wessex Neurological Centre, Southampton General Hospital, Southampton University Hospital Trust, Tremona Road, Southampton, UK
Peter McKenna
Affiliation:
FIDMAG Research Foundation, Germanes Hospitalàries, Barcelona, Spain CIBERSAM, Madrid , Spain
Emmanuelle Peters
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
*
Author for correspondence: Karen Dwyer, E-mail: k.dwyer@ucl.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Impairments of contextual processing and theory of mind (ToM) have both been offered as accounts of the deviant language characterising formal thought disorder (FTD) in schizophrenia. This study investigated these processes in patients' dialogue. We predicted that FTD patients would show a decrement in linguistic alignment, associated with impaired ToM in dialogue.

Methods

Speech samples were elicited via participation in an interactive computer-based task and a semi-structured interview to assess contextual processing abilities and ToM skills in dialogue, respectively, and from an interactive card-sorting task to measure syntactic alignment. Degree of alignment in dialogue and the syntactic task, and evidence of ToM in (i) dialogue and (ii) a traditional ToM task were compared across schizophrenia patients with FTD (n = 21), non-FTD patients (n = 22) and healthy controls (n = 21).

Results

FTD patients showed less alignment than the other two groups in dialogue, and than healthy controls on the syntactic task. FTD patients showed poorer performance on the ToM task than the other two groups, but only compared to the healthy controls in dialogue. The FTD group's degree of alignment in dialogue was correlated with ToM performance in dialogue but not with the traditional ToM task or with syntactic alignment.

Conclusions

In dialogue, FTD patients demonstrate an impairment in employing available contextual information to facilitate their own subsequent production, which is associated with a ToM deficit. These findings indicate that a contextual processing deficit impacts on exploiting representations via the production system impoverishing the ability to make predictions about upcoming utterances in dialogue.

Keywords

Alignmentcontextual processingformal thought disorderprimingtheory of mind

Information

Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 13 , October 2020 , pp. 2194 - 2202
Check for updates
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th Edn. Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edn. Washington, DC: American Psychiatric Association.Google Scholar
Andreasen, NC (1979) Thought, language and communication disorders: II. Diagnostic significance. Archives of General Psychiatry 36, 1322–1325.10.1001/archpsyc.1979.01780120055007CrossRefGoogle Scholar
Andreasen, NC (1982) The scale for the assessment of Thought Language and Communication (TLC). Schizophrenia Bulletin 12, 473–482.10.1093/schbul/12.3.473CrossRefGoogle Scholar
Andreasen, NC (1984) The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City: University of Iowa.Google Scholar
Andreasen, NC, Flaum, M and Arndt, S (1992) The comprehensive assessment of symptoms and history. An instrument for assessing diagnosis and psychopathology, CASH. Archives of General Psychiatry 49, 615–623.10.1001/archpsyc.1992.01820080023004CrossRefGoogle Scholar
Bagner, DM, Melinder, MRD and Barch, DM (2003) Language comprehension, working memory and working memory deficits in patients with schizophrenia. Schizophrenia Research 60, 299–309.10.1016/S0920-9964(02)00280-3CrossRefGoogle Scholar
Bora, E and Pantelis, C (2013) Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in first-degree relatives of schizophrenia: systematic review and meta-analysis. Schizophrenia Research 144, 31–36.10.1016/j.schres.2012.12.013CrossRefGoogle Scholar
Bora, E, Yucel, M and Pantelis, C (2009) Theory of mind impairment in schizophrenia: meta-analysis. Schizophrenia Research 109, 1–9.10.1016/j.schres.2008.12.020CrossRefGoogle Scholar
Branigan, HP, Pickering, MJ and Cleland, AA (2000) Syntactic co-ordination in dialogue. Cognition 75, B13–B25.10.1016/S0010-0277(99)00081-5CrossRefGoogle Scholar
Brown, M and Kuperberg, GR (2015) A hierarchical generative framework of language processing: linking language perception, interpretation, and production abnormalities in schizophrenia. Frontiers in Human Neuroscience 9, 643.10.3389/fnhum.2015.00643CrossRefGoogle Scholar
Brüne, M (2005) “Theory of mind” in schizophrenia: a review of the literature. Schizophrenia Bulletin 31, 21–42.10.1093/schbul/sbi002CrossRefGoogle Scholar
Cohen, JD and Servan-Schreiber, D (1992) Context, cortex, and dopamine: a connectionist approach to behaviour and biology in schizophrenia. Psychological Review 99, 45.10.1037/0033-295X.99.1.45CrossRefGoogle Scholar
Cohen, JD, Barch, DM, Carter, CS and Servan-Schreiber, D (1999) Context-processing deficits in schizophrenia: converging evidence from three theoretically motivated cognitive tasks. Journal of Abnormal Psychology 108, 120–133.10.1037/0021-843X.108.1.120CrossRefGoogle Scholar
Davidson, PR and Wolpert, DM (2005) Widespread access to predictive models in the motor system: a short review. Journal of Neural Engineering 2, S313.10.1088/1741-2560/2/3/S11CrossRefGoogle Scholar
de Villiers, PA (2005) The role of language in theory of mind development: what deaf children tell us. In Astington, JW and Baird, J (eds), Why Language Matters for Theory of Mind. Oxford, United Kingdom: Oxford University Press, pp. 266–297.10.1093/acprof:oso/9780195159912.003.0013CrossRefGoogle Scholar
Docherty, NM (2005) Cognitive impairment and disordered speech in schizophrenia: thought disorder, disorganisation, and communication failure perspectives. Journal of Abnormal Psychology 114, 269–278.10.1037/0021-843X.114.2.269CrossRefGoogle Scholar
Docherty, NM and Gordinier, SW (1999) Immediate memory, attention, and communication disturbances in schizophrenia patients and their relatives. Psychological Medicine 29, 189–197.10.1017/S0033291798007843CrossRefGoogle Scholar
Docherty, NM, Rakfeldt, J, Hawkins, KA, Hoffman, RE, Quinlan, DM and Sledge, WH (1996) Working memory, attention, and communication disturbances in schizophrenia. Journal of Abnormal Psychology 105, 212–219.10.1037/0021-843X.105.2.212CrossRefGoogle Scholar
Doughty, OJ and Done, DJ (2009) Is semantic memory impaired in schizophrenia? A systematic review and meta-analysis of 91 studies. Cognitive Neuropsychiatry 14, 473–509.10.1080/13546800903073291CrossRefGoogle Scholar
Dwyer, K, David, A, McCarthy, R, McKenna, P and Peters, E (2014 a) Higher-order semantic processing in formal thought disorder in schizophrenia. Psychiatry Research 216, 168–176.10.1016/j.psychres.2014.02.011CrossRefGoogle Scholar
Dwyer, K, Peters, E, McKenna, P, David, A and McCarthy, R (2014 b) Verbatim recall in schizophrenia: a study of contextual influences. Cognitive Neuropsychiatry 19, 337–358.10.1080/13546805.2013.870069CrossRefGoogle Scholar
Federmeier, KD (2007) Thinking ahead: the role and roots of prediction in language comprehension. Psychophysiology 44, 491–505.10.1111/j.1469-8986.2007.00531.xCrossRefGoogle Scholar
Frith, CD (1992) The Cognitive Neuropsychology of Schizophrenia. London: Psychology Press.Google Scholar
Frith, CD and Corcoran, R (1996) Exploring ‘theory of mind’ in people with schizophrenia. Psychological Medicine 26, 521–530.10.1017/S0033291700035601CrossRefGoogle Scholar
Frith, CD (2004) Schizophrenia and theory of mind. Psychological medicine 34, 385–389.10.1017/S0033291703001326CrossRefGoogle Scholar
Garrod, S and Anderson, A (1987) Saying what you mean in dialogue: a study in conceptual and semantic co-ordination. Cognition 27, 181–218.10.1016/0010-0277(87)90018-7CrossRefGoogle Scholar
Garrod, S and Clark, A (1993) The development of dialogue co-ordination skills in schoolchildren. Language and Cognitive Processes 8, 101–126.10.1080/01690969308406950CrossRefGoogle Scholar
Garrod, S and Doherty, G (1994) Conversation, coordination and convention: an empirical investigation of how groups establish linguistic conventions. Cognition 53, 181–215.10.1016/0010-0277(94)90048-5CrossRefGoogle Scholar
Hardy-Baylé, MC (1994) Organisation de l'action, phénomènes de conscience et représentation mentale de l'action chez des schizophrènes. Actualités psychiatriques 24, 9–18.Google Scholar
Harrington, L, Siegert, R and McClure, J (2005) Theory of mind in schizophrenia: a critical review. Cognitive Neuropsychiatry 10, 249–286.10.1080/13546800444000056CrossRefGoogle Scholar
Kaschak, M and Glenberg, G (2004) Comment in M.J. Pickering and S. Garrod towards a mechanistic psychology of dialogue. Behavioural and Brain Sciences 27, 169–226.Google Scholar
Kerns, JG and Berenbaum, H (2002) Cognitive impairments associated with formal thought disorder in people with schizophrenia. Journal of Abnormal Psychology 111, 211.10.1037/0021-843X.111.2.211CrossRefGoogle Scholar
Kircher, TTJ and David, A (2003) Self consciousness: an integrative approach from philosophy, psychopathology and the neurosciences. In Kircher, TTJ and David, A (eds), The Self in Neuroscience and Psychiatry. Cambridge, UK: Cambridge University Press, pp. 445–473.10.1017/CBO9780511543708.023CrossRefGoogle Scholar
Kuperberg, GR and Jaeger, TF (2016) What do we mean by prediction in language comprehension? Language, Cognition and Neuroscience 31, 32–59.10.1080/23273798.2015.1102299CrossRefGoogle Scholar
Kuperberg, GR, McGuire, PK and David, AS (1998) Reduced sensitivity to linguistic context in schizophrenic thought disorder. Evidence from on-line monitoring for words in linguistically anomalous sentences. Journal of Abnormal Psychology 107, 423–434.10.1037/0021-843X.107.3.423CrossRefGoogle Scholar
Kuperberg, GR, McGuire, PK and David, AS (2000) Sensitivity to linguistic anomalies in spoken sentences: a case study approach to understanding thought disorder in schizophrenia. Psychological Medicine 30, 345–357.10.1017/S0033291700001744CrossRefGoogle Scholar
Kuperberg, GR, Krecher, DA, Goff, D, McGuire, PK and David, AS (2006 a) Building up linguistic context in schizophrenia: evidence from self-paced reading. Neuropsychology 20, 442–452.10.1037/0894-4105.20.4.442CrossRefGoogle Scholar
Kuperberg, GR, Kreher, DA, Sitnikova, T, Caplan, DN and Holcomb, PJ (2007) The role of animacy and thematic relationships in processing active English sentences: evidence from event-related potentials. Brain and language 100, 223–237.10.1016/j.bandl.2005.12.006CrossRefGoogle Scholar
Kuperberg, GR, Kreher, DA and Ditman, T (2010) What can event-related potentials tell us about language, and perhaps even thought, in schizophrenia? International Journal of Psychophysiology 75, 66–76.10.1016/j.ijpsycho.2009.09.005CrossRefGoogle Scholar
Kutas, M and Federmeier, KD (2011) Thirty years and counting: finding meaning in the N400 component of the event related brain potential (ERP). Annual Review of Psychology 62, 621.10.1146/annurev.psych.093008.131123CrossRefGoogle Scholar
Langdon, R, Michie, PT, Ward, PB, McConaghy, N, Catts, S and Coltheart, M (1997) Defective self and/or other mentalizing in schizophrenia: a cognitive neuropsychological approach. Cognitive Neuropsychiatry 2, 167–193.10.1080/135468097396324CrossRefGoogle Scholar
Laws, KR, Kondel, TK and McKenna, PJ (1999) Receptive language deficits in schizophrenic thought disorder: evidence for impaired semantic access and monitoring. Cognitive Neuropsychiatry 4, 89–105.10.1080/135468099395981CrossRefGoogle Scholar
Lee, J and Park, S (2005) Working memory impairments in schizophrenia: a meta-analysis. Journal of Abnormal Psychology 114, 599–611.10.1037/0021-843X.114.4.599CrossRefGoogle Scholar
Manschreck, TC, Maher, BA, Milavetz, JJ, Ames, D, Weisstein, CC and Schneyer, ML (1988) Semantic priming in thought disordered schizophrenic patients. Schizophrenia Research 1, 61–66.10.1016/0920-9964(88)90041-2CrossRefGoogle Scholar
Martin, CD, Branzi, FM and Bar, M (2018) Prediction is production: the missing link between language production and comprehension. Scientific Reports 8, 1079.10.1038/s41598-018-19499-4CrossRefGoogle Scholar
McCabe, R, Leudar, I and Antaki, C (2004) Do people with schizophrenia display theory of mind deficits in clinical interactions? Psychological Medicine 34, 401–411.CrossRefGoogle Scholar
McGrath, J (1991) Ordering thoughts on thought disorder. British Journal of Psychiatry 158, 307–316.10.1192/bjp.158.3.307CrossRefGoogle Scholar
McGrath, J, Scheldt, S, Hengtsberger, P and Dark, F (1997) Thought disorder and executive ability. Cognitive Neuropsychiatry 2, 303–314.10.1080/135468097396306CrossRefGoogle Scholar
Nelson, HE (1982) The National Adult Reading Test (NART). Windsor: NFER.Google Scholar
Pickering, MJ and Garrod, S (2013) An integrated theory of language production and comprehension. Behavioural Brain Science 36, 329–392.10.1017/S0140525X12001495CrossRefGoogle Scholar
Pomarol-Clotet, E, Oh, TMSS, Laws, KR and McKenna, PJ (2008) Semantic priming in schizophrenia: systematic review and meta-analysis. The British Journal of Psychiatry 192, 92–97.10.1192/bjp.bp.106.032102CrossRefGoogle Scholar
Pulvermüller, F and Fadiga, L (2010) Active perception: sensorimotor circuits as a cortical basis for language. Nature Reviews Neuroscience 11, 351.10.1038/nrn2811CrossRefGoogle Scholar
Russell, T, Reynaud, E, Herba, C, Morris, R and Corcoran, R (2006) Do you see what I see? Interpretations of intentional movement in schizophrenia. Schizophrenia Research 81, 101–111.10.1016/j.schres.2005.10.002CrossRefGoogle Scholar
Schenkel, LS, Spaulding, WD and Silverstein, SM (2005) Poor premorbid social functioning and theory of mind deficit in schizophrenia: evidence of reduced context processing? Journal of Psychiatric Research 39, 499–508.10.1016/j.jpsychires.2005.01.001CrossRefGoogle Scholar
Scott, SK and Johnsrude, IS (2003) The neuroanatomical and functional organization of speech perception. Trends in Neurosciences 26, 100–107.10.1016/S0166-2236(02)00037-1CrossRefGoogle Scholar
Scott, SK, McGettigan, C and Eisner, F (2009) A little more conversation, a little less action—candidate roles for the motor cortex in speech perception. Nature Reviews Neuroscience 10, 295.10.1038/nrn2603CrossRefGoogle Scholar
Silbert, LJ, Honey, CJ, Simony, E, Poeppel, D and Hasson, U (2014) Coupled neural systems underlie the production and comprehension of naturalistic narrative speech. Proceedings of the National Academy of Sciences 111, E4687–E4696.10.1073/pnas.1323812111CrossRefGoogle Scholar
Sitnikova, T, Salisbury, DF, Kuperberg, G and Holcomb, PI (2002) Electrophysiological insights into language processing in schizophrenia. Psychophysiology 39, 851–860.10.1111/1469-8986.3960851CrossRefGoogle Scholar
Spitzer, M, Braun, U, Hermle, L and Maier, S (1993) Associative network dysfunction in thought disordered schizophrenic patients: direct evidence from indirect priming. Biological Psychiatry 34, 864–877.10.1016/0006-3223(93)90054-HCrossRefGoogle Scholar
Sprong, M, Schothorst, P, Vos, E, Hox, J and van Engeland, H (2007) Theory of mind in schizophrenia: meta-analysis. British Journal of Psychiatry 191, 5–13.10.1192/bjp.bp.107.035899CrossRefGoogle Scholar
Stewart, SLK, Corcoran, R and Drake, RJ (2008) Alignment and theory of mind in schizophrenia. Cognitive Neuropsychiatry 13, 431–448.10.1080/13546800802405610CrossRefGoogle Scholar
Stewart, SLK, Corcoran, R and Drake, RJ (2009) Mental states in psychosis: a pilot study of prompted implicit mentalizing during dialogue and its relationship to social functioning. Cognitive Neuropsychiatry 14, 53–75.10.1080/13546800902743449CrossRefGoogle Scholar
Tan, EJ, Neill, E and Rossell, SL (2015) Assessing the relationship between semantic processing and thought disorder symptoms in schizophrenia. Journal of the International Neuropsychological Society 21, 629–638.10.1017/S1355617715000648CrossRefGoogle Scholar
Titone, D, Levy, DL and Holzman, PS (2000) Contextual insensitivity in schizophrenic language processing: evidence from lexical ambiguity. Journal of Abnormal Psychology 109, 761–767.10.1037/0021-843X.109.4.761CrossRefGoogle Scholar
Truscott, IP (1970) Contextual constraint and schizophrenic language. Journal of Consult Clinical Psychology 35, 189–194.10.1037/h0030122CrossRefGoogle Scholar
Wang, K, Cheung, EF, Gong, QY and Chan, RC (2011) Semantic processing disturbance in patients with schizophrenia: a meta-analysis of the N400 component. PLoS One 6, e25435.10.1371/journal.pone.0025435CrossRefGoogle Scholar
Wechsler, D (1981) Wechsler Adult Intelligence Scale - Revised. San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D (1997) WAIS-III Manual; Wechsler Adult Intelligence Scale, 3rd Edn. San Antonio, TX: The Psychological Corporation.Google Scholar
Wilson, SM, Saygin, AP, Sereno, MI and Iacoboni, M (2004) Listening to speech activates motor areas involved in speech production. Nature Neuroscience 7, 701.10.1038/nn1263CrossRefGoogle Scholar
Wolpert, DM (1997) Computational approaches to motor control. Trends in Cognitive Sciences 1, 209–216.10.1016/S1364-6613(97)01070-XCrossRefGoogle Scholar
Supplementary material: File

Dwyer et al. supplementary material

Dwyer et al. supplementary material

Download Dwyer et al. supplementary material(File)
File 149 KB