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LANGUAGE IMPAIRMENTS AND PSYCHOPATHOLOGICAL DISORDERS
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Abstracts / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279
181 – LANGUAGE IMPAIRMENTS AND PSYCHOPATHOLOGICAL DISORDERS Giancarlo Buoiano Centro di Salute Mentale Valle del Serchio, Lucca, Italy [email protected] Introduction: Scope of this paper is to show how Chomsky’s Government and Binding theory can be applied in psychopathology. We intend to draw the neurolinguistic bases for such application. By analyzing Sigma-role impaired functions in psychopathologies, it is possible to draw a neurolinguistic psychopathological scale. Theoretically, a sigma-role deficit is strictly linked to psychopathological disorders, along the depression and schizophrenia-bipolar disorders spectrum. Semantic Phrase verbal aspect component alterations might explain mood disorders, its modal component might explain paranoid delusions. Syntactic Phrase alterations, instead, might well be linked to hallucinations, i.e. in hallucinatory states deixis would not be properly established. Deeper tense alterations suggest dreamily-confusion states. Morphosyntactic progressive deficit may generate psychopathological breakdown series along a hierarchical severity scale. Methods: Applying this model, clinical case taxonomy sequence accords both with Ey’s organo-dynamism mental illness classification and symptomatic psychosis Conrad’s Mental Involution Stages. It is worth to note the strong relation existing between these nosological classifications. Results: Our preliminary research highlights that Further Mental Involution Stages are strongly linked to progressive language breakdown. Within this frame, neurolinguistic analysis is an instrument of study and research to deepen knowledge of mental illness, both for its cognitive aspects and their neuroanatomical-neurophysiological correlates. Conclusions: By applying neurolinguistics in psychopathology, new research frames can be individuated, so that we can name this method Psychiatric NeuroLinguistics. Given these methodological premises, we elaborated a series of assessment tasks in order to test language deficits in various psychotic frames, in particular in schizophrenia and bipolar disorders. References [1] Buoiano, G. and Betti, M. Situational role processing in schizophrenia spectrum and bipolar disorder patients: A development of previous studies. In Proceedings of the First PBLRS Workshop, in press.
182 – ARE PSYCHOTIC PSYCHOPATHOLOGY AND NEUROCOGNITION ORTHOGONAL? A SYSTEMATIC REVIEW OF THEIR ASSOCIATIONS Maria de Gracia Dominguez, Wolfgang Viechtbauer, Claudia J.P. Simons, Jim van Os, Lydia Krabbendam Dept. Psychiatry And Neuropsychology, University Maastricht, Maastricht, The Netherlands [email protected] Introduction: To conduct a systematic review of associations between psychopathological dimensions of psychosis and measures of neurocognitive impairment. Methods: A meta-analysis was conducted of 56 studies (3682 patients) that evaluated the relationship between psychosis dimensions and neuropsychological performance in subjects with a lifetime history of non-affective psychosis, using standardized neuropsychological instruments. Results: Negative and disorganized dimensions were significantly but modestly associated with cognitive deficits (average correlations in the order of -0.31 to -0.12). In contrast, positive and depressive dimensions of psychopathology were not associated with neurocognitive measures. The pattern of association for the four psychosis dimensions was stable across neurocognitive domains and independent of age, gender and chronicity of illness (all p values>0.06). There were higher order contrasts in the pattern of association with neurocognition across the four psychopathological domains. Thus, correlations of the
disorganized and the depressive dimension with cognitive performance were negatively associated with each other (r = –0.49). In contrast, the correlations of the positive and the depressive dimension with cognitive performance were positively correlated with each other (r= 0.29). The correlation between the negative dimension and cognitive performance was weakly and to the same extent shared with the three other dimensions of disorganized (r = 0.15), positive (r = 0.14) and depressive symptoms (r = 0.14). Conclusions: Psychotic psychopathology and neurocognition are not entirely orthogonal, as heterogeneity in non-affective psychosis is weakly but meaningfully associated with measures of neurocognition, suggesting partly shared and partly mutually exclusive latent cerebral mechanisms underlying the cluster of disorganized and negative symptoms on the one hand, and positive and affective on the other. References [1] Nieuwenstein, M.R., Aleman, A., & de Haan, E.H. (2001). Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting Test. Continuous Performance Test. J Psychiatr Res, 35(2), 119-125. [2] Kerns, J.G., & Berenbaum, H. (2002). Cognitive impairments associated with formal thought disorder in people with schizophrenia. J Abnorm Psychol, 111(2), 211-224. [3] Myin Germeys, I., Krabbendam, L., Jolles, J., Delespaul, P.A., & van Os, J. (2002). Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study. Am J Psychiatry, 159(3), 443-449.
183 – DOES ’AFFECTIVE’ THEORY OF MIND MEDIATE THE RELATIONSHIP BETWEN COGNITIVE AND SOCIAL FUNCTION IN SCHIZOPHRENIA Gary Donohoe Trinity College Dublin, Dublin, Ireland [email protected] Introduction: Theory of mind (ToM) deficits in schizophrenia have been parsed into ‘cognitive’ (mental state reasoning) and ‘affective’ (mental state decoding) components. Affective ToM deficits are suggested to be particularly relevant to social function, partly because of its conceptual and likely neural overlap with empathy. To test this hypothesis we compared ‘affective’ ToM performance as measured by performance on the “Eyes task” with ‘cognitive’ Methods: ToM performance as measured by the performance on the “Hinting task” in 73 stabilized outpatients with schizophrenia or schizoaffective disorder and 78 healthy comparison subjects. Neuropsychological performance was assessed using selected subtests from the Wechsler and CANTAB batteries, symptoms severity was assessed using the SAPS and SANS, and social functioning by the Independent living scale. Results: In a regression analysis, after the effects of age, educational experience, and symptom severity were accounted for, ‘affective’ ToM was observed to better predict social function than ‘cognitive’ ToM (F(1,63) change = 8.5; p=0.005). In a further regression analyses, ‘affective’ ToM was also observed to partly mediate the influence of basic neuropsychological functioning (as measured by verbal IQ) on social function (F(1,63) change = 7.3; p=0.009). Conclusions: We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia. References [1] Sprong M et al (2007) Theory of mind in schizophrenia: metaanalysis. British JournalofJouranl fo Psychiatry, 191, 5-13 [2] Shamay-Ysoory SG et al., (2007) Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Research, 14 9, 11-23. [3] Bora E et al., (2006) Social functioning, theory of mind and neurocognition in outpatients with schizophrenia. Psychiatry Research, 145, 95-103.
Abstracts / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279
181 – LANGUAGE IMPAIRMENTS AND PSYCHOPATHOLOGICAL DISORDERS Giancarlo Buoiano Centro di Salute Mentale Valle del Serchio, Lucca, Italy [email protected] Introduction: Scope of this paper is to show how Chomsky’s Government and Binding theory can be applied in psychopathology. We intend to draw the neurolinguistic bases for such application. By analyzing Sigma-role impaired functions in psychopathologies, it is possible to draw a neurolinguistic psychopathological scale. Theoretically, a sigma-role deficit is strictly linked to psychopathological disorders, along the depression and schizophrenia-bipolar disorders spectrum. Semantic Phrase verbal aspect component alterations might explain mood disorders, its modal component might explain paranoid delusions. Syntactic Phrase alterations, instead, might well be linked to hallucinations, i.e. in hallucinatory states deixis would not be properly established. Deeper tense alterations suggest dreamily-confusion states. Morphosyntactic progressive deficit may generate psychopathological breakdown series along a hierarchical severity scale. Methods: Applying this model, clinical case taxonomy sequence accords both with Ey’s organo-dynamism mental illness classification and symptomatic psychosis Conrad’s Mental Involution Stages. It is worth to note the strong relation existing between these nosological classifications. Results: Our preliminary research highlights that Further Mental Involution Stages are strongly linked to progressive language breakdown. Within this frame, neurolinguistic analysis is an instrument of study and research to deepen knowledge of mental illness, both for its cognitive aspects and their neuroanatomical-neurophysiological correlates. Conclusions: By applying neurolinguistics in psychopathology, new research frames can be individuated, so that we can name this method Psychiatric NeuroLinguistics. Given these methodological premises, we elaborated a series of assessment tasks in order to test language deficits in various psychotic frames, in particular in schizophrenia and bipolar disorders. References [1] Buoiano, G. and Betti, M. Situational role processing in schizophrenia spectrum and bipolar disorder patients: A development of previous studies. In Proceedings of the First PBLRS Workshop, in press.
182 – ARE PSYCHOTIC PSYCHOPATHOLOGY AND NEUROCOGNITION ORTHOGONAL? A SYSTEMATIC REVIEW OF THEIR ASSOCIATIONS Maria de Gracia Dominguez, Wolfgang Viechtbauer, Claudia J.P. Simons, Jim van Os, Lydia Krabbendam Dept. Psychiatry And Neuropsychology, University Maastricht, Maastricht, The Netherlands [email protected] Introduction: To conduct a systematic review of associations between psychopathological dimensions of psychosis and measures of neurocognitive impairment. Methods: A meta-analysis was conducted of 56 studies (3682 patients) that evaluated the relationship between psychosis dimensions and neuropsychological performance in subjects with a lifetime history of non-affective psychosis, using standardized neuropsychological instruments. Results: Negative and disorganized dimensions were significantly but modestly associated with cognitive deficits (average correlations in the order of -0.31 to -0.12). In contrast, positive and depressive dimensions of psychopathology were not associated with neurocognitive measures. The pattern of association for the four psychosis dimensions was stable across neurocognitive domains and independent of age, gender and chronicity of illness (all p values>0.06). There were higher order contrasts in the pattern of association with neurocognition across the four psychopathological domains. Thus, correlations of the
disorganized and the depressive dimension with cognitive performance were negatively associated with each other (r = –0.49). In contrast, the correlations of the positive and the depressive dimension with cognitive performance were positively correlated with each other (r= 0.29). The correlation between the negative dimension and cognitive performance was weakly and to the same extent shared with the three other dimensions of disorganized (r = 0.15), positive (r = 0.14) and depressive symptoms (r = 0.14). Conclusions: Psychotic psychopathology and neurocognition are not entirely orthogonal, as heterogeneity in non-affective psychosis is weakly but meaningfully associated with measures of neurocognition, suggesting partly shared and partly mutually exclusive latent cerebral mechanisms underlying the cluster of disorganized and negative symptoms on the one hand, and positive and affective on the other. References [1] Nieuwenstein, M.R., Aleman, A., & de Haan, E.H. (2001). Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting Test. Continuous Performance Test. J Psychiatr Res, 35(2), 119-125. [2] Kerns, J.G., & Berenbaum, H. (2002). Cognitive impairments associated with formal thought disorder in people with schizophrenia. J Abnorm Psychol, 111(2), 211-224. [3] Myin Germeys, I., Krabbendam, L., Jolles, J., Delespaul, P.A., & van Os, J. (2002). Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study. Am J Psychiatry, 159(3), 443-449.
183 – DOES ’AFFECTIVE’ THEORY OF MIND MEDIATE THE RELATIONSHIP BETWEN COGNITIVE AND SOCIAL FUNCTION IN SCHIZOPHRENIA Gary Donohoe Trinity College Dublin, Dublin, Ireland [email protected] Introduction: Theory of mind (ToM) deficits in schizophrenia have been parsed into ‘cognitive’ (mental state reasoning) and ‘affective’ (mental state decoding) components. Affective ToM deficits are suggested to be particularly relevant to social function, partly because of its conceptual and likely neural overlap with empathy. To test this hypothesis we compared ‘affective’ ToM performance as measured by performance on the “Eyes task” with ‘cognitive’ Methods: ToM performance as measured by the performance on the “Hinting task” in 73 stabilized outpatients with schizophrenia or schizoaffective disorder and 78 healthy comparison subjects. Neuropsychological performance was assessed using selected subtests from the Wechsler and CANTAB batteries, symptoms severity was assessed using the SAPS and SANS, and social functioning by the Independent living scale. Results: In a regression analysis, after the effects of age, educational experience, and symptom severity were accounted for, ‘affective’ ToM was observed to better predict social function than ‘cognitive’ ToM (F(1,63) change = 8.5; p=0.005). In a further regression analyses, ‘affective’ ToM was also observed to partly mediate the influence of basic neuropsychological functioning (as measured by verbal IQ) on social function (F(1,63) change = 7.3; p=0.009). Conclusions: We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia. References [1] Sprong M et al (2007) Theory of mind in schizophrenia: metaanalysis. British JournalofJouranl fo Psychiatry, 191, 5-13 [2] Shamay-Ysoory SG et al., (2007) Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Research, 14 9, 11-23. [3] Bora E et al., (2006) Social functioning, theory of mind and neurocognition in outpatients with schizophrenia. Psychiatry Research, 145, 95-103.