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Impaired Interpretation of Others’ Behavior is Associated with Difficulties in Recognizing Pragmatic Language in Patients with Schizophrenia

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Abstract

Much attention has been paid to the pragmatic language function in schizophrenia. This study of Japanese patients with schizophrenia examined the relationship between impaired interpretation of the behaviors of other people in social contexts and the ability to recognize metaphor and irony. We assessed 34 patients with schizophrenia and 34 normal subjects using first- and second-order theory of mind tasks, the Metaphor and Sarcasm Scenario Test, and the Dewey Story Test (which tests the ability to judge others’ social behaviors). We compared the performance between the groups and analyzed correlations between the tasks. All tasks revealed significant deficits in the patients compared with the controls. In the patient group, metaphor comprehension was correlated with the ability to judge normal behaviors, and irony comprehension was correlated with the ability to judge abnormal behaviors, suggesting that deficits of social cognition in schizophrenia include these two types of factors associated with pragmatic language.

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References

  • Arcara, G., & Bambini, V. (2016). A test for the assessment of pragmatic abilities and cognitive substrates (APACS): Normative data and psychometric properties. Frontiers in Psychology, 7, 70. doi:10.3389/fpsyg.2016.00070.

    Article  PubMed  PubMed Central  Google Scholar 

  • Adachi, T., Koeda, T., Hirabayashi, S., Maeoka, Y., Shiota, M., Wright, E. C., et al. (2004). The metaphor and sarcasm scenario test: A new instrument to help differentiate high functioning pervasive developmental disorder from attention deficit/hyperactivity disorder. Brain Development, 26, 301–306. doi:10.1016/S0387-7604(03)00170-0.

    Article  PubMed  Google Scholar 

  • Animated version of the Theory of Mind tasks (Version 2) (Computer software). Saitama: DIK, Inc. Retrieved from http://www.kokoro-cd.com/index.html

  • Bambini, V., Arcara, G., Bechi, M., Buonocore, M., Cavallaro, R., & Bosia, M. (2016). The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Comprehensive Psychiatry, 71, 106–120. doi:10.1016/j.comppsych.2016.08.012.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a theory of mind? Cognition, 21, 37–46. doi:10.1016/0010-0277(85)90022-8.

    Article  PubMed  Google Scholar 

  • Bora, E., Yucel, M., & Pantelis, C. (2009). Theory of mind impairment in schizophrenia: Meta-analysis. Schizophrenia Research, 109, 1–9. doi:10.1016/j.schres.2008.12.020.

    Article  PubMed  Google Scholar 

  • Brüne, M. (2003). Theory of mind and the role of IQ in chronic disorganized schizophrenia. Schizophrenia Research, 60, 57–64. doi:10.1016/S0920-9964(02)00162-7.

    Article  PubMed  Google Scholar 

  • Brüne, M. (2005). Theory of mind in schizophrenia: A review of the literature. Schizophrenia Bulletin, 31, 21–42. doi:10.1093/schbul/sbi002.

    Article  PubMed  Google Scholar 

  • Brüne, M., & Bodenstein, L. (2005). Proverb comprehension reconsidered—’Theory of mind’ and the pragmatic use of language in schizophrenia. Schizophrenia Research, 75, 233–239. doi:10.1016/j.schres.2004.11.006.

    Article  PubMed  Google Scholar 

  • Cassetta, B., & Goghari, V. (2014). Theory of mind reasoning in schizophrenia patients and non-psychotic relatives. Psychiatry Research, 218, 12–19. doi:10.1016/j.psychres.2014.03.043.

    Article  PubMed  Google Scholar 

  • Champagne-Lavau, M., & Stip, E. (2010). Pragmatic and executive dysfunction in schizophrenia. Journal of Neurolinguistics, 23, 286–296. doi:10.1016/j.jneuroling.2009.08.009.

    Article  Google Scholar 

  • Chen, L., Phillips, G., Johnston, J., Kinon, B. J., Ascher-Svanum, H., Kollack-Walker, S., et al. (2011). The relationship, structure and profiles of schizophrenia measurements: A post-hoc analysis of the baseline measures from a randomized clinical trial BMC. Psychiatry, 11, 203. doi:10.1186/1471-244X-11-203.

    PubMed  PubMed Central  Google Scholar 

  • Corcoran, R., Mercer, G., & Frith, C. D. (1995). Schizophrenia, symptomatology and social inference: Investigating theory of mind in people with schizophrenia. Schizophrenia Research, 17, 5–13. doi:10.1016/0920-9964(95)00024-G.

    Article  PubMed  Google Scholar 

  • de Bonis, M., Epelbaum, C., Deffez, V., & Féline, A. (1997). The comprehension of metaphors in schizophrenia. Psychopathology, 30, 149–154. doi:10.1159/000285041.

    Article  PubMed  Google Scholar 

  • Dewey, M. (1991). Living with Asperger’s syndrome. In U. Frith (Ed.), Autism and Asperger Syndrome (pp. 184–206). Cambridge: Cambridge University Press. (Translated by M. Tomita, (1996). Autism and Asperger Syndrome (pp. 317–332). Tokyo: Tokyo-shoseki (in Japanese).)

  • Drury, V. M., Robinson, E. J., & Birchwood, M. (1998). ’Theory of mind’ skills during an acute episode of psychosis and following recovery. Psychological Medicine 28(5), 1101–1112. Retrieved from https://www.cambridge.org/core/journals/psychological-medicine.

  • Eda, M., Kado, S., & Okae, A. (2005). A case report of an adult with Asperger’s syndrome; Usefulness of Margaret Dewey’s social common sense test in diagnosis and treatment Jpn. Journal of Clinical Psychiatry, 34(9), 1117–1123.

    Google Scholar 

  • Elvevåg, B., Helsen, K., De Hert, M., Sweers, K., & Storms, G. (2011). Metaphor interpretation and use: a window into semantics in schizophrenia. Schizophrenia Research, 133, 205–211. doi:10.1016/j.schres.2011.07.009.

    Article  PubMed  Google Scholar 

  • Fett, A. K., Viechtbauer, W., Dominguez, M. D., Penn, D. L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neuroscience and Biobehavioral Reviews, 35, 573–588. doi:10.1016/j.neubiorev.2010.07.001.

    Article  PubMed  Google Scholar 

  • Gavilán Ibáñez, J. M., & García-Albea Ristol, J. E. (2011). Theory of mind and language comprehension in schizophrenia: Poor mindreading affects figurative language comprehension beyond intelligence deficits. Journal of Neurolinguistics, 24, 54–69. doi:10.1016/j.jneuroling.2010.07.006.

    Article  Google Scholar 

  • Gavilán Ibáñez, J. M., & García-Albea Ristol, J. E. (2013). Theory of mind and language comprehension in schizophrenia. Psicothema, 25, 440–445. doi:10.7334/psicothema2012.357.

    PubMed  Google Scholar 

  • Green, M. F., Bearden, C. E., Cannon, T. D., Fiske, A. P., Hellemann, G. S., Horan, W., et al. (2012). Social cognition in schizophrenia, Part 1: Performance across phase of illness. Schizophrenia Bulletin, 38, 854–864. doi:10.1093/schbul/sbq171.

    Article  PubMed  Google Scholar 

  • Green, M. F., Horan, W. P., & Lee, J. (2015). Social cognition in schizophrenia. Nature Reviews Neuroscience, 16, 620–631. doi:10.1038/nrn4005.

    Article  PubMed  Google Scholar 

  • Green, M. F., Penn, D. L., Bentall, R., Carpenter, W. T., Gaebel, W., Gur, R. C., et al. (2008). Social cognition in schizophrenia: An NIMH workshop on definitions, assessment, and research opportunities. Schizophrenia Bulletin, 34, 1211–1220. doi:10.1093/schbul/sbm145.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haas, M. H., Chance, S. A., Cram, D. F., Crow, T. J., Luc, A., & Hage, S. (2015). Evidence of pragmatic impairments in speech and proverb interpretation in schizophrenia. Journal of Psycholinguistic Research, 44, 469–483. doi:10.1007/s10936-014-9298-2.

    Article  PubMed  Google Scholar 

  • Happé, F. G. (1993). Communicative competence and theory of mind in autism: A test of relevance theory. Cognition, 48, 101–119. doi:10.1016/0010-0277(93)90026-R.

    Article  PubMed  Google Scholar 

  • Herold, R., Tényi, T., Lénárd, K., & Trixler, M. (2002). Theory of mind deficit in people with schizophrenia during remission. Psychological Medicine, 32, 1125–1129. doi:10.1017/S0033291702005433.

    Article  PubMed  Google Scholar 

  • Ideno, Y., Takayama, M., Hayashi, K., Takagi, H., & Sugai, Y. (2012). Evaluation of a Japanese version of the Mini-Mental State Examination in elderly persons. Geriatrics and Gerontology International, 12, 310–316. doi:10.1111/j.1447-0594.2011.00772.x.

    Article  PubMed  Google Scholar 

  • Ikebuchi, E., Nakagome, K., Ikezawa, S., Miura, S., Yamasaki, S., Nemoto, T., et al. (2012). Social cognition of schizophrenia: Bridging gap between brain science and psychosocial intervention. Seishin Shinkeigaku Zasshi, 114(5), 489–507.

    PubMed  Google Scholar 

  • Joyal, M., Bonneau, A., & Fecteau, S. (2016). Speech and language therapies to improve pragmatics and discourse skills in patients with schizophrenia. Psychiatry Research, 240, 88–95. doi:10.1016/j.psychres.2016.04.010.

    Article  PubMed  Google Scholar 

  • Kanie, A., Hagiya, K., Ashida, S., Pu, S., Kaneko, K., Mogami, T., et al. (2014). New instrument for measuring multiple domains of social cognition: Construct validity of the Social Cognition Screening Questionnaire (Japanese version). Psychiatry and Clinical Neurosciences, 68, 701–711. doi:10.1111/pcn.12181.

    Article  PubMed  Google Scholar 

  • Kern, R. S., Green, M. F., Fiske, A. P., Kee, K. S., Lee, J., Sergi, M. J., et al. (2009). Theory of mind deficits for processing counterfactual information in persons with chronic schizophrenia. Psychological Medicine, 39, 645–654. doi:10.1017/S0033291708003966.

    Article  PubMed  Google Scholar 

  • Kircher, T. T., Leube, D. T., Erb, M., Grodd, W., & Rapp, A. M. (2007). Neural correlates of metaphor processing in schizophrenia. Neuroimage, 34, 281–289. doi:10.1016/j.neuroimage.2006.08.044.

    Article  PubMed  Google Scholar 

  • Langdon, R., Coltheart, M., Ward, P. B., & Catts, S. V. (2002a). Disturbed communication in schizophrenia: The role of poor pragmatics and poor mind-reading. Psychological Medicine, 32, 1273–1284. doi:10.1017/S0033291702006396.

    Article  PubMed  Google Scholar 

  • Langdon, R., Davies, M., & Coltheart, M. (2002b). Understanding minds and understanding communicated meanings in schizophrenia. Mind and Language, 17, 68–104. doi:10.1111/1468-0017.00189.

    Article  Google Scholar 

  • Mitchley, N. J., Barber, J., Gray, J. M., Brooks, N., & Livingston, M. G. (1998). Comprehension of irony in Schizophrenia Cogn. Neuropsychiatry, 3, 127–138. doi:10.1080/135468098396206.

    Google Scholar 

  • Mossaheb, N., Aschauer, H. N., Stoettner, S., Schmoeger, M., Pils, N., Raab, M., et al. (2014). Comprehension of metaphors in patients with schizophrenia-spectrum disorders. Comprehensive Psychiatry, 55, 928–937. doi:10.1016/j.comppsych.2013.12.021.

    Article  PubMed  Google Scholar 

  • Mo, S., Su, Y., Chan, R. C., & Liu, J. (2008). Comprehension of metaphor and irony in schizophrenia during remission: The role of theory of mind and IQ. Psychiatry Research, 157, 21–29. doi:10.1016/j.psychres.2006.04.002.

    Article  PubMed  Google Scholar 

  • Perner, J., & Wimmer, H. (1985). John thinks that Mary thinks that.. attribution of second-order beliefs by 5- to 10-year-old children. Journal of Experimental Child Psychology, 39, 437–471. doi:10.1016/0022-0965(85)90051-7.

    Article  Google Scholar 

  • Rapp, A. M., Langohr, K., Mutschler, D. E., Klingberg, S., Wild, B., & Erb, M. (2013). Isn’t it ironic? Neural correlates of irony comprehension in schizophrenia. PLoS ONE, 8(9), e74224. doi:10.1371/journal.pone.0074224.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rapp, A. M., Langohr, K., Mutschler, D. E., & Wild, B. (2014). Irony and proverb comprehension in schizophrenia: Do female patients dislike ironic remarks? Schizophrenia Research and Treatment, 2014, 841086. doi:10.1155/2014/841086.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sparks, A., McDonald, S., Lino, B., O’Donnell, M., & Green, M. J. (2010). Social cognition, empathy and functional outcome in schizophrenia. Schizophrenia Research, 122, 172–178. doi:10.1016/j.schres.2010.06.011.

    Article  PubMed  Google Scholar 

  • Tavano, A., Sponda, S., Fabbro, F., Perlini, C., Rambaldelli, G., Ferro, A., et al. (2008). Specific linguistic and pragmatic deficits in Italian patients with schizophrenia. Schizophrenia Research, 102, 53–62. doi:10.1016/j.schres.2008.02.008.

    Article  PubMed  Google Scholar 

  • Varga, E., Simon, M., Tényi, T., Schnell, Z., Hajnal, A., Orsi, G., et al. (2013). Irony comprehension and context processing in schizophrenia during remission—A functional MRI study. Brain and Language, 126, 231–242. doi:10.1016/j.bandl.2013.05.017.

    Article  PubMed  Google Scholar 

  • Ziv, I., Leiser, D., & Levine, J. (2011). Social cognition in schizophrenia: Cognitive and affective factors. Cognitive Neuropsychiatry, 16, 71–91. doi:10.1080/13546805.2010.492693.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Dr. Yutaka Sawa (Hokutokai Sawa Hospital), Mr. Goro Nishio (Work Box Daito) and the many medical staff members of Mikiwakai Orange Hospital for their help. This study was supported by a Grant-in-Aid for Scientific Research [(c) 22500470] from the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, 3-7-30 Habikino, Habikino-City, Osaka, 5838555, Japan

    Keita Fukuhara, Yasuhiro Ogawa, Hiroyuki Tanaka, Yuma Nagata, Saiji Nishida, Daisuke Haga & Takashi Nishikawa

  2. Department of Psychiatric Day Care, Mikiwakai Orange Hospital, Osaka, Japan

    Keita Fukuhara

  3. Day Care Center, Hokutokai Sawa Hospital, Osaka, Japan

    Yasuhiro Ogawa & Daisuke Haga

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  1. Keita Fukuhara
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  2. Yasuhiro Ogawa
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  3. Hiroyuki Tanaka
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Correspondence to Takashi Nishikawa.

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All participants have provided their written informed consent. This study was approved by the Ethics Committee of the Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University.

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Fukuhara, K., Ogawa, Y., Tanaka, H. et al. Impaired Interpretation of Others’ Behavior is Associated with Difficulties in Recognizing Pragmatic Language in Patients with Schizophrenia. J Psycholinguist Res 46, 1309–1318 (2017). https://doi.org/10.1007/s10936-017-9497-8

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