Allé M C, Gandolphe M-C, Doba K, Köber C, Potheegadoo J, Coutelle R, Habermas T, Nandrino J-L, Danion J-M, Berna F
INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, France.
Université de Lille, UMR CNRS 9193 SCALab, Lille, France.
Compr Psychiatry. 2016 Aug;69:20-9. doi: 10.1016/j.comppsych.2016.04.015. Epub 2016 Apr 30.
Life narratives of patients with schizophrenia are characterized by impaired coherence so that the listener has often difficulties to grasp the life trajectory of the patients. In order to better understand what causes this reduced temporal coherence, we investigated the temporal structure of patients' life narratives through different temporal narrative elements (elaboration of beginnings and endings, local temporal indicators and temporal deviations from a linear order), across two complementary studies.
Life narratives were collected by means of two different methods; a free recall in study 1 and a more structured protocol, aiming at reducing the cognitive task demands in study 2. All narratives from the two studies were analyzed using the same validated method.
Both studies showed that global temporal coherence is significantly reduced in patients with schizophrenia (ps.02). This is mainly due to their stronger tendency to temporally deviate from a linear temporal order without marking the deviation as such. We also observed significant correlations in the patient groups between global temporal coherence and executive dysfunction (p=.008) or their higher tendency to temporally deviate from a linear temporal order in their life narratives (p<.001).
These results shed light on narrative correlates of temporal narrative incoherence in schizophrenia and highlight the central role of executive dysfunction in this incoherence.
精神分裂症患者的生活叙事具有连贯性受损的特点，以至于听众常常难以理解患者的生活轨迹。为了更好地理解导致这种时间连贯性降低的原因，我们通过两项互补研究，从不同的时间叙事元素（开头和结尾的阐述、局部时间指标以及与线性顺序的时间偏差）来研究患者生活叙事的时间结构。
通过两种不同方法收集生活叙事；研究1采用自由回忆法，研究2采用更结构化的方案，旨在降低认知任务要求。两项研究的所有叙事均使用相同的经过验证的方法进行分析。
两项研究均表明，精神分裂症患者的整体时间连贯性显著降低（p<0.02）。这主要是因为他们更倾向于在时间上偏离线性时间顺序，且不对此类偏差进行标记。我们还在患者组中观察到整体时间连贯性与执行功能障碍之间存在显著相关性（p = 0.008），或者他们在生活叙事中更倾向于在时间上偏离线性时间顺序（p<0.001）。
这些结果揭示了精神分裂症中时间叙事不连贯的叙事相关因素，并突出了执行功能障碍在这种不连贯中的核心作用。
