COGNITIVE BASES OF SCHIZOPHRENIC LANGUAGE SYMPTOMS

这个研究项目的长期目标是确定精神分裂症言语障碍的病理生理过程。思想和语言症状的异质性一直是这一领域研究人员面临的一个问题。最近开发了一种“自然语言”测量方法，用于评估精神分裂症患者语言中存在的六种不同类型的参考沟通失败（沟通障碍指数（CDI））。来自稳定门诊病人的初步数据表明，概念排序、工作记忆和持续注意力的缺陷是这些形式的干扰的基础，而不是其他形式。本研究有四个具体目的：(1)重复CDI在重度精神分裂症患者言语中测量的六种不同类型的参照沟通失败的频率升高的结果；(2)探讨重症患者特定结构相关类型的交流障碍在概念序列、工作记忆和持续注意方面的神经心理学相关性；(3)开始测试这些关联是精神分裂症特有的，还是跨诊断类别发生的；(4)评估其他非结构性交流障碍的一些可能的神经心理学关联。语言样本将从40名重度精神分裂症患者、40名重度躁狂症患者和40名匹配的非精神病对照受试者中收集，并使用CDI进行评分。受试者的认知功能也将通过一系列专门设计的神经心理学测试来评估，这些测试被假设涉及与结构相关的沟通障碍的产生，这些测试包括概念排序、工作记忆的各个方面、低负荷和高负荷持续注意力以及整体语言智力。此外，认知功能可能涉及非结构类型的沟通障碍将被评估。将比较各组之间每种交流障碍的水平。认知测试的表现将与组内和组间语言样本中不同类型的交流障碍的评分进行比较，控制受试者在整体语言智力和疾病严重程度上的差异，以测试有关认知障碍领域与特定语言症状之间联系的特定假设。

A long-term goal of this program of research is to identify pathophysiological processes underlying schizophrenic disordered speech. The heterogeneity of thought and language symptoms has been a problem to investigators in this area. A "natural language" measure has recently been developed that assesses six different types of referential communication failures present in the speech of schizophrenia patients (Communication Disturbances Index (CDI). Preliminary data from stable outpatients suggests that deficits in conceptual sequencing, working memory, and sustained attention underlie some of these forms of disturbance and not others. The proposed study has four specific aims: (1) To replicate findings of elevated frequencies of each of the six different types of referential communication failures measured by the CDI in the speech of severely ill schizophrenia patients; (2) To assess the neuropsychological correlates of specific structure-related types of communication disturbances in severely ill patients in the areas of conceptual sequencing, working memory, and sustained attention; (3) To begin to test whether these associations are specific to schizophrenia, or occur across diagnostic categories; (4) To assess some possible neuropsychological correlates of other, nonstructural types of communication disturbances. Speech samples would be collected from 40 severely ill schizophrenia patients, 40 severely ill mania patients, and 40 matched nonpsychiatric control subjects, and rated using the CDI. Subjects' cognitive functioning also would be assessed in areas hypothesized to be involved in the production of structure-related communication disturbances, with a series of neuropsychological tests specifically designed to measure conceptual sequencing, facets of working memory, low- and high-load sustained attention, and global verbal intelligence. In addition, cognitive functions potentially implicated in nonstructural types of communication disturbances would be assessed. Levels of each type of communication disturbance would be compared between groups. Performance on the cognitive tests would be compared with ratings of the different types of communication disturbances in the speech samples within and between groups, controlling for differences among subjects in global verbal intelligence and severity of illness, to test specific hypotheses about connections between areas of cognitive impairment and particular kinds of language symptoms.