Conceptual sequencing and disordered speech in schizophrenia.

This study examined associations between impairments of attention, memory, and conceptual sequencing ability, and specific schizophrenia thought and language symptoms. Speech samples of stable schizophrenia outpatients were assessed for frequencies of six different types of communication failures. The classification of types of failures was based on hypothesized differences in underlying cognitive process. Frequencies of the four types of communication failures believed to involve language structural weaknesses all were significantly and fairly strongly related to conceptual sequencing ability. In addition, regression analyses indicated that each of these four types of communication failures was associated with a unique configuration of attentional, memorial, and conceptual sequencing processes. In contrast, the two types of communication disturbances not suggestive of language structural problems were not positively associated with any of the cognitive weaknesses assessed.

Schizophrenia outpatients' perceptions of their parents: is expressed emotion a factor?

The factors that mediate the association between expressed emotion (EE) and relapse in schizophrenia patients are still unknown. Many researchers hypothesize that interactions with high-EE individuals are stressful for patients, leaving them vulnerable to relapse. It would be useful to investigate whether patients perceive interactions with high-EE parents as stressful. In this study, associations were examined between levels of EE in parents and the types of personal memories patients had about these parents. EE ratings were obtained for both parents of 27 schizophrenia outpatients, and patients were asked to describe "happy, nonstressful" memories and "unhappy, stressful" memories during 2 interviews. Patients recounted fewer nonstressful memories and more stressful memories about high-versus low-EE parents. Implications of these results are discussed.

Communication disturbances in relatives beyond the age of risk for schizophrenia and their associations with symptoms in patients.

This article provides a detailed examination of subclinical disturbances in the natural speech of healthy relatives beyond the age of risk for schizophrenia. Speech samples from 43 stable schizophrenia outpatients, 42 nonschizophrenia parents of patients (pairs only), and 23 control subjects matched to the parents were analyzed for frequencies of six specific types of communication failures. The parents had higher overall communication disturbance ratings than the control subjects. The specific types of failures that occurred more frequently were unclarities caused by (1) language structural breakdown, (2) use of vague, overinclusive words, and (3) use of words with ambiguous meanings. In intrafamilial analyses, higher levels of communication disturbance in parents were associated with greater severity of illness in their patient offspring. These results support the idea that communication disturbances may be one manifestation of a stable genetic vulnerability to schizophrenia. The nature of the failures identified suggests the possible involvement of weaknesses in specific areas of cognitive functioning.

Expressed emotion and differentiation of self in the relatives of stable schizophrenia outpatients.

This study examined "trait" variables associated with high and low levels of expressed emotion in the parents of long-term stable schizophrenia outpatients. Self-descriptions collected from patients, their parents, and control participants matched to the parents were rated for levels of differentiation and integration, substantiality, relatedness, and self-criticism using established methods. The parents as a group did not differ from controls on any of the self-description variables. When parents were classified based on their expressed emotion status, those with low expressed emotion showed higher levels of differentiation and integration than those with high expressed emotion. Low expressed emotion parents were also lower on self-criticism. There was no difference between expressed emotion groups on substantiality or relatedness. These findings support the idea that high expressed emotion in parents of long-term stable outpatients may be a manifestation in part of relatively low levels of differentiation and integration of self in the parents. Furthermore, though patients as a group scored lower than parents on differentiation and integration and substantiality, patients' ratings on these two variables also correlated with those of their parents, suggesting that these variables are to some extent familially determined.