Cohen Alex S, Alpert Murray, Nienow Tasha M, Dinzeo Thomas J, Docherty Nancy M
Department of Psychology, University of Maryland, College Park, MD, USA.
J Psychiatr Res. 2008 Aug;42(10):827-36. doi: 10.1016/j.jpsychires.2007.08.008. Epub 2007 Oct 24.
Accurate measurement of negative symptoms is crucial for understanding and treating schizophrenia. However, current measurement strategies are reliant on subjective symptom rating scales, which often have psychometric and practical limitations. Computerized analysis of patients' speech offers a sophisticated and objective means of evaluating negative symptoms. The present study examined the feasibility and validity of using widely-available acoustic and lexical-analytic software to measure flat affect, alogia and anhedonia (via positive emotion). These measures were examined in their relationships to clinically-rated negative symptoms and social functioning. Natural speech samples were collected and analyzed for 14 patients with clinically-rated flat affect, 46 patients without flat affect and 19 healthy controls. The computer-based inflection and speech rate measures significantly discriminated patients with flat affect from controls, and the computer-based measure of alogia and negative emotion significantly discriminated the flat and nonflat patients. Both the computer and clinical measures of positive emotion/anhedonia corresponded to functioning impairments. The computerized method of assessing negative symptoms offered a number of advantages over the symptom scale-based approach.
准确测量阴性症状对于理解和治疗精神分裂症至关重要。然而,目前的测量策略依赖于主观症状评定量表,这些量表往往存在心理测量和实际应用方面的局限性。对患者言语进行计算机化分析为评估阴性症状提供了一种精密且客观的方法。本研究考察了使用广泛可得的声学和词汇分析软件来测量情感平淡、言语贫乏和快感缺失(通过积极情绪)的可行性和有效性。研究了这些测量指标与临床评定的阴性症状及社会功能之间的关系。收集并分析了14例临床评定为情感平淡的患者、46例无情感平淡的患者以及19名健康对照者的自然言语样本。基于计算机的语调变化和语速测量指标能够显著区分情感平淡的患者与对照者,基于计算机的言语贫乏和消极情绪测量指标能够显著区分情感平淡和无情感平淡的患者。积极情绪/快感缺失的计算机测量指标和临床测量指标均与功能损害相关。与基于症状量表的方法相比,评估阴性症状的计算机化方法具有诸多优势。