Schizophrenia and language Flashcards
What did Andreason (1979a) investigate? (2)
- Evaluated patients with mania, depression and schizophrenia to investigate subtypes of thought, language and communication disorders.
- Devised the definitions for schizophrenia in the DSM-III
Give 9 examples of the abnormalities of thought, language and communication found in schizophrenia
- Poverty of speech
- Pressure of speech
- Distractible speech
- Tangentiality
- Illogicality
- Derailment
- Perseveration
- Incoherence
- Clanging
What are other examples of abnormalities found in Andreason’s (1979a) framework?
- Neologisms
- Word approximations
- Circumstantiality
- Blocking
- Stilted speech
- Echolalia
- Missing information references
- Ambiguous word meaning
- Self-reference
What is stilted speech? (4)
- Speech characterised by situationally-inappropriate formality
- Speech conveying more information than necessary
- Accompanied by atypical prosody, volume, pitch and nasality
- Overly formal in grammar and vocabulary, unsuitable for conversational speech
Describe poverty of speech (3)
- Restriction in the amount of spontaneous speech
- Replies to questions tend to be brief, concrete and unelaborated
- Unprompted additional information is rarely provided.
Describe pressure of speech (2)
- Increase in the amount of spontaneous speech as compared with what is considered typical
- Talks rapidly and is difficult to interrupt.
Describe distractible speech (2)
- Patient repeatedly stops talking in the middle of a sentence and changes the subject in response to a nearby stimulus.
- No markers to expect topic changes.
Describe tangentiality (2)
- Replying to a question in an oblique, tangential or even irrelevant manner.
- Or the reply may be unrelated and seem totally irrelevant.
Describe derailment
A pattern of spontaneous speech in which the ideas slip off the track on to another one that is clearly but obliquely related or on to one that is completely unrelated
Describe incoherence
A pattern of speech that is essentially incomprehensible at times
Describe illogicality
A pattern of speech in which conclusions are reached that do not follow logically
Describe perseveration
Persistent repetition of words, ideas or subjects. Continually returns to it.
Describe clanging
- Sounds rather than meaningful relationships appear to govern word choice, so that intelligibility is impaired and redundant words are introduced.
Eg. Rhyming - sound of the word takes precedence over the meaning
Do SLC disorders vary in schizophrenia? (3)
- Mild cases may show very little/if any change in form of their speech
- Severe cases may show a wide variety of deficits
- Mutism as one extreme, compared to no change in another extreme
What can perceptual changes cause?
- Quantity and quality of personal interaction can suffer
2. Perceptual changes caused by the illness which reduce and distort visual and listening skills
What are the implications if speech problems are present prior to the onset of schizophrenia?
- Development of symptoms may influence communication breakdown by gradual social withdrawal and isolation, inhibiting the continuing development of adult language
What 3 changes can occur in voice?
- Changes in pitch, volume and quality
- Vocalisation may be influenced by behaviour such as vocalising on inspiration rather than expiration, nasalised speech and sub-vocal speech
- Breathiness, tension, irregular volume and uncontrolled pitch
Give 4 ways in which the structure of language is affected in schizophrenia
- Phonetics is often atypical manifesting as flat intonation or unusual voice quality
- Phonological structure, morphology and syntax are normal or mildly impaired
- Access to lexicon is impaired, manifesting as stilted speech, word approximation and neologisms
- Prosody: flattened intonation and difficulty comprehending intonation contours eg. irony (Cutting, 1985). Contains more pauses and hesitations than typical speech
What are the 3 major kinds of language dysfunction Chen et al. (1996) found in schizophrenic patients?
- Syntactic: affects structure of language on all levels, including lexical access
- Semantic: affects ability to map thoughts onto language and pursue a communicative goal (thought disorder def)
- Production: comprises poverty of speech, lack of detail and intonation (negative symptoms)
Compare Schizophrenia and Wernicke’s aphasia characteristics of language
Pinard & Lecours (1983)
- Schizophasic discourse has a preferred theme, aphasia doesn’t
- Schizophrenics jump from one subject to another based on word/sound association (glossomania), rarely seen in aphasia
- Schizophrenia discourse includes rare, large and intact vocabulary whereas aphasia shows a restricted vocabulary
- Schizophrenic speech includes conscious creation of neologisms whereas aphasia speakers do not seem to be fully aware
Summarise the 4 differences between Schizophrenia and aphasia language
- Preferred theme
- Glossomania
- Large, intact vocab
- Conscious creation of neologisms
How does Taylor (1999) distinguish between the language of schizophrenia and aphasia?
- Overlap between formal thought disorder and aphasia
2. Distinguishes by verbal comprehension which is relatively intact in schizophrenia
According to Gerston et al (1977) what is a difference between schizophrenia and aphasia language?
- Patients with aphasia have more insight than those with schizophrenia into the fact that communication is failing
Discuss schizophrenia language and Grice’s maxims (2)
De Decker and Van de Craen (1987) found schizophrenic speakers do not follow maxims - answers are off-topic, rambling and unco-operative
2. Maxims involve extralinguistic conscious thinking and “theory of mind” which is disordered in schizophrenia (Frith, 1992).
