Bettis Robert J, Faith Laura A, Beard Ashlynn M, Whan Brailee A, Hegwood Ceouna M, Monette Mahogany A, Myers Evan J, Linton Imani S, Leonhardt Bethany L, Salyers Michelle P, Minor Kyle S
Department of Psychology, Indiana University-Indianapolis, Indianapolis, IN 46202, USA.
Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN 37240, USA.
Behav Sci (Basel). 2024 Mar 6;14(3):212. doi: 10.3390/bs14030212.
Disorganized speech is a critical barrier to recovery in schizophrenia, with profound negative impacts on one's ability to engage with the world. Despite the limited efficacy of existing treatments in addressing disorganization, a qualitative analysis of what leads to disorganization in patient narratives has been lacking. This study addresses this gap through inductive thematic analysis of 30 narrative interviews with individuals with schizophrenia, matched based on whether Formal Thought Disorder (FTD) is present. Through this analysis, we identified four core themes (alienation, interpersonal tension, personal benchmarks, and adverse experiences) and eight subthemes. Our findings suggest that disorganization may serve as a protective mechanism against psychological distress and highlight how the severity of FTD influences these themes. Alienation, particularly due to illness-related stigma, emerged more prominently in those with FTD. The themes of personal benchmarks and interpersonal tension pointed towards a heightened sensitivity to social interactions and self-perception among those with schizophrenia. Adverse experiences, encompassing past challenges, suggest a potential link between trauma and symptom exacerbation. Our qualitative analysis of what themes precede disorganized speech has implications for tailoring psychotherapy. By considering an individual's specific triggers and level of disorganization, therapy may be more effectively targeted to improve recovery-based outcomes. By identifying themes within patient narratives, this study advances our understanding of the qualitative aspects preceding disorganized speech in schizophrenia, paving the way for more personalized and effective recovery-focused interventions.
言语紊乱是精神分裂症康复的关键障碍，对患者与外界交流的能力产生深远负面影响。尽管现有治疗方法在解决言语紊乱方面效果有限，但对于患者叙述中导致言语紊乱的因素缺乏定性分析。本研究通过对30名精神分裂症患者的叙述性访谈进行归纳主题分析来填补这一空白，这些访谈对象根据是否存在形式思维障碍（FTD）进行匹配。通过该分析，我们确定了四个核心主题（疏离感、人际紧张、个人标准和不良经历）以及八个子主题。我们的研究结果表明，言语紊乱可能是一种抵御心理困扰的保护机制，并突出了FTD的严重程度如何影响这些主题。疏离感，尤其是由于与疾病相关的污名化，在患有FTD的患者中更为突出。个人标准和人际紧张的主题表明，精神分裂症患者对社交互动和自我认知的敏感度更高。不良经历，包括过去的挑战，表明创伤与症状加重之间可能存在联系。我们对言语紊乱之前出现的主题进行的定性分析对量身定制心理治疗具有启示意义。通过考虑个体的特定触发因素和言语紊乱程度，治疗可能更有效地针对改善基于康复的结果。通过识别患者叙述中的主题，本研究推进了我们对精神分裂症言语紊乱之前定性方面的理解，为更个性化和有效的以康复为重点的干预措施铺平了道路。
