White T P, Borgan F, Ralley O, Shergill S S
Institute of Psychiatry, Psychology and Neuroscience,De Crespigny Park,London,UK.
Psychol Med. 2016 Jan;46(1):149-60. doi: 10.1017/S0033291715001622. Epub 2015 Sep 4.
Deficits in the perception of social cues are common in schizophrenia and predict functional outcome. While effective communication depends on deciphering both verbal and non-verbal features, work on non-verbal communication in the disorder is scarce.
This behavioural study of 29 individuals with schizophrenia and 25 demographically matched controls used silent video-clips to examine gestural identification, its contextual modulation and related metacognitive representations.
In accord with our principal hypothesis, we observed that individuals with schizophrenia exhibited a preserved ability to identify archetypal gestures and did not differentially infer communicative intent from incidental movements. However, patients were more likely than controls to perceive gestures as self-referential when confirmatory evidence was ambiguous. Furthermore, the severity of their current hallucinatory experience inversely predicted their confidence ratings associated with these self-referential judgements.
These findings suggest a deficit in the contextual refinement of social-cue processing in schizophrenia that is potentially attributable to impaired monitoring of a mirror mechanism underlying intentional judgements, or to an incomplete semantic representation of gestural actions. Non-verbal communication may be improved in patients through psychotherapeutic interventions that include performance and perception of gestures in group interactions.
社会线索感知缺陷在精神分裂症中很常见，并可预测功能结局。虽然有效的沟通依赖于对言语和非言语特征的解读，但针对该疾病中非言语沟通的研究却很少。
这项行为研究对29名精神分裂症患者和25名人口统计学匹配的对照组进行，使用无声视频片段来检查手势识别、其情境调节及相关元认知表征。
与我们的主要假设一致，我们观察到精神分裂症患者识别典型手势的能力保留，且不会从偶然动作中差异推断交际意图。然而，当确证证据不明确时，患者比对照组更有可能将手势视为自我指涉。此外，他们当前幻觉体验的严重程度与这些自我指涉判断相关的信心评级呈负相关。
这些发现表明精神分裂症患者在社会线索加工的情境细化方面存在缺陷，这可能归因于对有意判断背后的镜像机制监测受损，或手势动作的语义表征不完整。通过包括在团体互动中表演和感知手势的心理治疗干预，患者的非言语沟通可能会得到改善。
