Cognitive bases of schizophrenic language symptoms

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DESCRIPTION (provided by applicant): This revised proposal is for continuation of an R01 project on schizophrenic disordered speech. Aims of the proposed project are to (1) confirm that impairments in basic neurocognitive processes are more highly associated with disordered speech when the speech disorder is measured from a communication perspective than when it is measured from a formal thought disorder or linguistic structural perspective; (2) replicate, extend, and refine findings on the unique and combined contributions of specific neurocognitive impairments to specific types of communication failures; (3) test the additional contributions of two social cognitive variables, relatedness and "theory of mind", to the communicative efficacy of patients' speech; (4) assess the degree to which each specific type of speech disorder is associated with deficits in social and vocational functioning; and (5) test for diagnostic specificity of the associations between the cognitive, social cognitive, and speech variables. We would assess multiple specified areas of cognitive, social cognitive, and social/ vocational functioning in 120 schizophrenia patients and 30 manic controls. We would collect speech samples from the same subjects, and analyze them for disorder of several different types. We would determine which types of speech disorder were most highly related to social/vocational dysfunction. We would examine the relationships between the neurocognitive and social cognitive measures, and assess their independent and shared contributions to the different types of speech disorder, controlling carefully for generalized deficit effects. This project could help to (a) identify which types of speech disorder are most disabling socially, and (b) further specify the abnormal processes underlying different forms of speech disorder. This would provide more specific, focused targets for imaging studies of speech symptoms. It also would have more immediate practical benefits: Disordered speech creates a substantial barrier to successful social and vocational functioning. A better understanding of its cognitive and social cognitive underpinnings could lead to the identification of specific, workable targets for pharmacological and psychosocial interventions designed to improve patients' communicative abilities and thereby improve their lives. Consideration would be given to ways of translating the findings of this study into workable interventions to improve patients' ability to communicate, which could be tested in future studies.