Communication disturbances in schizophrenia: a two-process formulation.

We hypothesized that communication disturbances in the form of unclear linguistic references in schizophrenia are associated with excess-related pathophysiologic processes in some individuals and deficit-related processes in others. We divided a sample of 28 acutely ill schizophrenic inpatients into two groups: those with negative symptoms and those without. We analyzed audiotaped speech samples from each subject, and found that the two groups did not differ significantly on overall level of communication disturbance. In patients without negative symptoms, level of communication disturbance was associated with severity of positive symptoms (r = .62, P < .02) and with neuroleptic responsiveness (r = .52, P < .06 [trend]). In those with negative symptoms, level of communication disturbance did not correlate with severity of positive symptoms (r = .09, NS), and correlated negatively with medication responsiveness (r = -.66, P < .01). These findings support a two-process hypothesis of schizophrenic communication disturbance.