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Linguistic alignment and theory of mind impairments in schizophrenia patients' dialogic interactions

Published online by Cambridge University Press:  10 September 2019

Karen Dwyer ,
Anthony S. David ,
Rosaleen McCarthy ,
Peter McKenna  and
Emmanuelle Peters
Karen Dwyer*
Affiliation:
Department of English Language and Literature, University College London, London, UK Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
Anthony S. David
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK Institute of Mental Health, University College London, London, UK
Rosaleen McCarthy
Affiliation:
Department of Psychology, University of Southampton, Southampton, UK Wessex Neurological Centre, Southampton General Hospital, Southampton University Hospital Trust, Tremona Road, Southampton, UK
Peter McKenna
Affiliation:
FIDMAG Research Foundation, Germanes Hospitalàries, Barcelona, Spain CIBERSAM, Madrid , Spain
Emmanuelle Peters
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
*
Author for correspondence: Karen Dwyer, E-mail: k.dwyer@ucl.ac.uk
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Abstract

Background

Impairments of contextual processing and theory of mind (ToM) have both been offered as accounts of the deviant language characterising formal thought disorder (FTD) in schizophrenia. This study investigated these processes in patients' dialogue. We predicted that FTD patients would show a decrement in linguistic alignment, associated with impaired ToM in dialogue.

Methods

Speech samples were elicited via participation in an interactive computer-based task and a semi-structured interview to assess contextual processing abilities and ToM skills in dialogue, respectively, and from an interactive card-sorting task to measure syntactic alignment. Degree of alignment in dialogue and the syntactic task, and evidence of ToM in (i) dialogue and (ii) a traditional ToM task were compared across schizophrenia patients with FTD (n = 21), non-FTD patients (n = 22) and healthy controls (n = 21).

Results

FTD patients showed less alignment than the other two groups in dialogue, and than healthy controls on the syntactic task. FTD patients showed poorer performance on the ToM task than the other two groups, but only compared to the healthy controls in dialogue. The FTD group's degree of alignment in dialogue was correlated with ToM performance in dialogue but not with the traditional ToM task or with syntactic alignment.

Conclusions

In dialogue, FTD patients demonstrate an impairment in employing available contextual information to facilitate their own subsequent production, which is associated with a ToM deficit. These findings indicate that a contextual processing deficit impacts on exploiting representations via the production system impoverishing the ability to make predictions about upcoming utterances in dialogue.

Keywords

Alignmentcontextual processingformal thought disorderprimingtheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 13 , October 2020 , pp. 2194 - 2202
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Copyright
Copyright © Cambridge University Press 2019

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