Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Schizophr Res. 2021 Dec;238:1-9. doi: 10.1016/j.schres.2021.09.005. Epub 2021 Sep 22.
thinking is a cognitive process that involves the assimilation of concepts reduced from diffuse sensory input, organized, and interpreted in a manner beyond the obvious. There are multiple facets by which abstraction is measured that include semantic, visual-spatial and social comprehension. This study examined the prevalence and course of abstract and concrete responses to semantic proverbs and aberrant abstraction (composite score of semantic, visual-spatial, and social comprehension) over 20 years in 352 participants diagnosed with schizophrenia, affective psychosis, and unipolar non-psychotic depression. We utilized linear models, two-way ANOVA and contrasts to compare groups and change over time. Linear models with Generalized Estimation Equation (GEE) to determine association. Our findings show that regardless of diagnosis, semantic proverb interpretation improves over time. Participants with schizophrenia give more concrete responses to proverbs when compared to affective psychosis and unipolar depressed without psychosis. We also show that the underlying structure of concretism encompasses increased conceptual overinclusion at index hospitalization and idiosyncratic associations at follow-up; whereas, abstract thinking overtime encompasses increased visual-spatial abstraction at index and rich associations with increased social comprehension scores at follow-up. Regardless of diagnosis, premorbid functioning, descriptive characteristics, and IQ were not associated with aberrant abstraction. Delusions are highly and positively related to aberrant abstraction scores, while hallucinations are mildly and positively related to this score. Lastly, our data point to the importance of examining the underlying interconnected structures of 'established' constructs vis-à-vis mixed methods to provide a description of the rich interior world that may not always map onto current quantitative measures.
思维是一种认知过程，它涉及将从分散的感官输入中简化的概念同化，以超越明显的方式进行组织和解释。有多种衡量抽象的方面，包括语义、视觉空间和社会理解。本研究在 352 名被诊断为精神分裂症、情感性精神病和单相非精神病性抑郁症的参与者中，在 20 多年的时间里，检查了对语义谚语的抽象和具体反应以及异常抽象（语义、视觉空间和社会理解的综合得分）的流行率和过程。我们使用线性模型、双向 ANOVA 和对比来比较组和随时间的变化。使用广义估计方程 (GEE) 的线性模型来确定关联。我们的研究结果表明，无论诊断如何，语义谚语的解释都会随着时间的推移而提高。与情感性精神病和单相无精神病性抑郁症相比，精神分裂症患者对谚语的反应更具体。我们还表明，具体化的基础结构包括在索引住院时增加概念过度包容和在随访时增加特质性关联；而抽象思维则在索引时涵盖了增加的视觉空间抽象，并且在随访时与增加的社会理解得分相关联。无论诊断如何，发病前的功能、描述性特征和智商都与异常抽象无关。妄想与异常抽象得分高度正相关，而幻觉则与该得分轻度正相关。最后，我们的数据表明，检查“既定”结构的潜在相互关联结构非常重要，需要采用混合方法，以便对可能并不总是映射到当前定量测量的丰富内部世界进行描述。
