Interpretation of congruent and incongruent affective communications in paranoid schizophrenia

Emotional processing during speech communication and positive symptoms in schizophrenia

AIMS

The recognition of emotion is often impaired in patients with schizophrenia. The relationship of this deficit with symptoms of psychosis remains unclear. In the current study, we investigated the relationship between emotional processing and positive psychotic symptoms in schizophrenia.

METHODS

Twenty-eight patients with schizophrenia and 37 healthy participants were included in the study. They were instructed to listen to a set of sentences and judge whether the emotional valence expressed verbally and that expressed by affective prosody were congruous or incongruous.

RESULTS

Overall, the patients with schizophrenia had more inaccurate responses than the healthy participants and the poor performance was prominent when the patients processed affectively negative scenarios. The percentage of accurate responses negatively correlated with the severity of positive symptoms when the scenarios and/or the affective prosody had a negative valence.

CONCLUSION

Patients with schizophrenia appear to have impaired function in the processing of negative verbal information. Impaired processing of negative verbal and prosodic information seems to be associated with positive symptoms in schizophrenia.

A study of theory of mind in paranoid schizophrenia: a theory or many theories?

Social cognitive psychologists (Frith, 1992; Hardy-Baylé et al., 2003) sought to explain the social problems and clarify the clinical picture of schizophrenia by proposing a model that relates many of the symptoms to a problem of metarepresentation, i.e., theory of mind (ToM). Given the differences in clinical samples and results between studies, and considering the wide range of what is considered to constitute ToM, one must ask if there a core function, or is ToM multifaceted with dissociable facets? If, there are dissociable dimensions or facets, which are affected in patients with paranoid schizophrenia? To answer these questions, a group of 21 individuals diagnosed with paranoid schizophrenia and 29 non-clinical control subjects, were tested on a battery of five different measures of ToM. The results confirmed that there was little difference in specificity of three of the tests in distinguishing between the clinical and non-clinical group, but there were important differences in the shared variance between the tests. Further analyses hint at two dimensions although a single factor with the same variance and the same contributing weights in both groups could explain the results. The deficits related to the attribution of cognitive and affective states to others inferred from available verbal and non-verbal information. Further analyses revealed that incorrect attributions of mental states including the attribution of threatening intentions to others, non-interpretative responses and incomplete answers, depending on the test of ToM.

Paranoia

Both psychology and psychiatry are dominated by individualistic accounts of paranoia (and, indeed, other forms of distress). As a corrective to these, this paper provides a social account of paranoia grounded in a minimal notion of embodied subjectivity constituted from the interpenetration of feelings, perception and discourse. Paranoia is conceptualized as a mode or tendency within embodied subjectivity, co-constituted in the dialectical associations between subjectivity and relational, social and material influences. Relevant psychiatric and psychological literature is briefly reviewed; relational, social structural and material influences upon paranoia are described; and some implications of this account for research and intervention are highlighted.