Narrative skills and time sense in the discourse of psychotic inpatients: diagnostic differences
Tolomiczenko, George S.
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The current study devised two instruments for rating autobiographical free speech samples with the aim of assessing narrative construction skills. 38 inpatients assigned to schizophrenic, schizoaffective and affective diagnostic groups were also subdivided for comparisons based on level and type of formal thought disorder. Covariate analyses designed to control for differences in verbal productivity, intelligence, thought disorder and educational level were used to contrast diagnostic groups and thought disorder subtypes. In addition, an attempt was made to assess links between these findings and subjective time sense as reflected in the subjects' use of verbs. One narrative measure used was "transformational capacity." Raters used this instrument to score subjects' level of predicate elaboration. A menu of such transformations (Todorov, 1977) was implemented to determine an overall score. The second narrative measure assessed subjects' use of spoken language to perform operations upon the listener. Inspired by "speech act theory" (Austin, 1962; Searle, 1969), this instrument was used to categorize action qualities of discourse as contextually accurate/appropriate or inaccurate/inappropriate. Finally, time, aspect and voice of predicates were evaluated and used as well to contrast groups defined by thought disorder subtypes. Thought disorder subtyping was done by dividing the sample along two separate dimensions severe/non-severe and positive/negative formal thought disorder. Results were consistent with the hypothesis that schizophrenic subjects would show impaired narrative skills. Subjects with higher narrative skills in one comparison and subjects with a positive formal thought disorder in another showed a trend toward greater flexibility in subjective time sense. Unexpectedly, subjects who were rated as severely thought disordered displayed more accurate speech acts in addition to a predicted excess of inaccurate speech acts. These results demonstrate the potential utility of narrative level language assessment. The concluding discussion considers how narrative skills reflect a combination of socialization and neurodevelopmental effects and offers suggestions for further research.
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