Grant P M, Beck A T
Department of Psychiatry, University of Pennsylvania, USA.
Psychol Med. 2009 Jul;39(7):1211-9. doi: 10.1017/S0033291709005479. Epub 2009 Apr 20.
Communication disturbance (thought disorder) is a central feature of schizophrenia that predicts poor functioning. We investigated the hypothesis that memory and attention deficits interact with beliefs about the gravity of being rejected (i.e. evaluation sensitivity) to produce the symptoms of communication disorder.
Seventy-four individuals diagnosed with schizophrenia or schizo-affective disorder completed a battery of tests assessing neurocognition (attention, working and verbal memory, abstraction), symptomatology (positive, negative and affective), functioning, and dysfunctional beliefs.
Patients with communication deviance (n=33) performed more poorly on the neurocognitive tests and reported a greater degree of sensitivity to rejection than patients with no thought disorder (n=41). In a logistic regression analysis, evaluation sensitivity moderated the relationship between cognitive impairment and the presence of communication disorder. This finding was independent of hallucinations, delusions, negative symptoms, depression and anxiety.
We propose that negative appraisals about acceptance instigate communication anomalies in individuals with a pre-existing diathesis for imperfect speech production.
沟通障碍（思维紊乱）是精神分裂症的核心特征，预示着功能不良。我们研究了以下假设：记忆和注意力缺陷与对被拒绝严重性的信念（即评价敏感性）相互作用，从而产生沟通障碍症状。
74名被诊断为精神分裂症或分裂情感性障碍的个体完成了一系列测试，评估神经认知（注意力、工作记忆和言语记忆、抽象能力）、症状学（阳性、阴性和情感症状）、功能以及功能失调信念。
有沟通偏差的患者（n = 33）在神经认知测试中的表现比无思维紊乱的患者（n = 41）更差，并且报告对拒绝的敏感性更高。在逻辑回归分析中，评价敏感性调节了认知障碍与沟通障碍存在之间的关系。这一发现独立于幻觉、妄想、阴性症状、抑郁和焦虑。
我们提出，对被接纳的负面评价会促使已有言语产生缺陷素质的个体出现沟通异常。
