Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, 1101 E. 10th Street, Bloomington, IN 47405, United States.
Department of Psychiatry, Richard L. Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, United States.
Schizophr Res. 2020 Jan;215:54-60. doi: 10.1016/j.schres.2019.11.032. Epub 2019 Nov 26.
Speech disturbances are prevalent in psychosis. These may arise in part from executive function impairment, as research suggests that inhibition and monitoring are associated with production of cohesive discourse. However, it is not yet understood how linguistic and executive function impairments in psychosis interact with disrupted metacognition, or deficits in the ability to integrate information to form a complex sense of oneself and others and use that synthesis to respond to psychosocial challenges. Whereas discourse studies have historically employed manual hand-coding techniques, automated computational tools can characterize deep semantic structures that may be closely linked with metacognition. In the present study, we examined whether higher executive functioning promotes metacognition by way of altering linguistic cohesion. Ninety-four individuals with schizophrenia-spectrum disorders provided illness narratives and completed an executive function task battery (Delis-Kaplan Executive Function System). We assessed the narratives for linguistic cohesion (Coh-Metrix 3.0) and metacognitive capacity (Metacognition Assessment Scale - Abbreviated). Selected linguistic indices measured the frequency of connections between causal and intentional content (deep cohesion), word and theme overlap (referential cohesion), and unique word usage (lexical diversity). In path analyses using bootstrapped confidence intervals, we found that deep cohesion and lexical diversity independently mediated the relationship between executive functioning and metacognitive capacity. Findings suggest that executive control abilities support integration of mental experiences by way of increasing causal, goal-driven speech and word expression in individuals with schizophrenia. Metacognitive-based therapeutic interventions for psychosis may promote insight and recovery in part by scaffolding use of language that links ideas together.
言语障碍在精神疾病中很常见。这些可能部分源于执行功能障碍，因为研究表明，抑制和监控与连贯话语的产生有关。然而，目前尚不清楚精神疾病中的语言和执行功能障碍如何与认知失调相互作用，或者与整合信息以形成对自己和他人的复杂认识并利用这种综合来应对心理社会挑战的能力缺陷相互作用。虽然话语研究历来采用手动手工编码技术，但自动化计算工具可以描述与元认知密切相关的深层语义结构。在本研究中，我们通过改变语言连贯性来检验较高的执行功能是否通过改变语言连贯性来促进元认知。94 名精神分裂症谱系障碍患者提供了疾病叙述，并完成了执行功能任务组（Delis-Kaplan 执行功能系统）。我们使用 Coh-Metrix 3.0 评估了叙述的语言连贯性，并使用元认知评估量表 - 缩写版（Metacognition Assessment Scale - Abbreviated）评估了元认知能力。选择的语言指标衡量了因果内容和意向内容之间的连接频率（深层连贯性）、单词和主题重叠（参照连贯性）以及独特单词用法（词汇多样性）。在使用 bootstrap 置信区间的路径分析中，我们发现深层连贯性和词汇多样性独立地介导了执行功能和元认知能力之间的关系。研究结果表明，执行控制能力通过增加精神分裂症患者的因果、目标驱动的言语和单词表达，支持心理体验的整合。基于元认知的精神病治疗干预措施可能会通过构建将想法联系在一起的语言来促进洞察力和康复。
