Biomedical subjects

Nancy M Docherty

Publications and source records attributed to Nancy M Docherty.

At least 19 recordsLinked to original sources

PubMed2006

Schizophrenic patients' perceptions of stress, expressed emotion, and sensitivity to criticism.

This study was designed to get an "insider's view" of expressed emotion (EE) from the perspective of schizophrenic patients. Thirty-two patient and "influential other" pairs participated in the study. Patients' perceptions of EE attitudes in influential others were examined to determine whether they corresponded with actual EE ratings. Patients also rated how "stressed" they felt when interacting with their influential others, and patients' general sensitivity to criticism (STC) was assessed. As predicted, patients' perceptions of critical attitudes were related to actual EE ratings of criticism, although patients' perceptions of emotional overinvolvement (EOI) were not related to EOI ratings. Patients reported feeling more stressed when interacting with high-EE influential others, supporting an "EE as stressor" hypothesis. Finally, patients' STC influenced the level of stress they reported.

Adult↗

PubMed2006

Psychosis proneness, coping, and perceptions of social support.

The current study examined coping styles and perceived levels of social support in hypothetically psychosis-prone individuals. Results suggest that psychosis-prone individuals did not differ from a comparison group on levels of adaptive coping or positive social support but that they did endorse higher rates of nonadaptive coping and negative social support compared with the comparison group.

Adaptation, Psychological↗

PubMed2006

Attentional dysfunction, social perception, and social competence: what is the nature of the relationship?

The aim of this study was to examine the nature of the relationship between attentional dysfunction and social competence deficits in patients with schizophrenia. Attentional functioning, social perception, and social competence were assessed in 56 inpatients. Measures of vigilance and span of apprehension were administered to assess attentional functioning. Social perception was assessed with an audiovisual measure of affect recognition. Social competence was rated from a role-play task. Span of apprehension and auditory vigilance emerged as specific predictors of social competence. Affect recognition was tested as a mediator and a moderator of the relationship between attentional dysfunction and social competence. Affect recognition was found to moderate the relationship between span of apprehension and social competence.

Adult↗

PubMed2006

The cognitive origins of specific types of schizophrenic speech disturbances.

OBJECTIVE: Cognitive impairments associated with schizophrenia might be expected to have a marked impact on the ability to produce coherent speech, yet associations between cognitive performance and speech disorder have typically been weak. Findings on this question may have been limited by measurement methods and by the heterogeneity of speech disorder. This study examined the contributions of impairments in sustained attention and sequencing abilities to schizophrenic speech disorder, measured in terms of communication failures and divided into different types of disorder. METHOD: Samples of natural speech were collected from severely ill inpatients with schizophrenia and nonpsychiatric comparison subjects and rated for frequencies of six types of communication failures: four structural and two nonstructural types. Subjects also completed a battery of cognitive tests assessing several facets of attention and sequencing ability. Hierarchical regression was used to identify cognitive contributors to communication failures. RESULTS: Impaired sustained attention was associated with more frequent structural and nonstructural communication failures. As predicted, impaired sequencing, and in particular conceptual sequencing, also made a substantial contribution to the structural communication failures, but not to the nonstructural ones. These findings held when global level of impairment was controlled statistically. Performance on the tests of attention and sequencing explained 56% of the variance in structural speech disorder. CONCLUSIONS: Schizophrenic speech disorder is heterogeneous in form and in cognitive underpinnings. Impairments in attention and sequencing abilities are highly predictive of communication failures related to language structure.

Adult↗

PubMed2005

Internal source monitoring and communication disturbance in patients with schizophrenia.

BACKGROUND: This study examined the relationship between internal source monitoring and disordered speech in patients with schizophrenia or schizoaffective disorder. It was predicted that internal source monitoring would relate specifically to one type of communication disturbance, the missing information reference. METHOD: Immediate, working, and internal source memory were assessed in 47 out-patients diagnosed with schizophrenia or schizoaffective disorder. Speech samples were also collected from this sample and coded for six types of communication disturbance. RESULTS: Of the six types of communication disturbance coded in this study, internal source monitoring indices were uniquely related to the frequency of the missing information reference. Furthermore, internal source monitoring was the only type of short-term memory process assessed in this study that was related to the missing information reference. Neither immediate nor working-memory capacity was related significantly to the frequency of this type of communication disturbance. CONCLUSIONS: This study adds to our knowledge of the neurocognitive processes that underlie communication disturbance in the speech of patients with schizophrenia.

Adolescent↗

PubMed2005

Cognitive impairments and disordered speech in schizophrenia: thought disorder, disorganization, and communication failure perspectives.

This article posits that basic cognitive impairments in schizophrenia are more highly related to speech disorder measured as communication failures than speech disorder measured as thought disorder or disorganization. The author tested 47 schizophrenia patients and 36 control participants for sustained attention, sequencing, and conceptual sequencing ability. Their speech was also rated for communication failures, thought disorder, and conceptual disorganization. Attention and sequencing impairments, examined hierarchically, explained a substantial 38% of the variance in the communication measure of speech disorder but little of the variance in formal thought disorder or conceptual disorganization. The author concludes that (a) impairments in attention and sequencing abilities contribute substantially to schizophrenic communication failures, and (b) it is important to consider lower level cognitive "3rd variables" when examining higher level cognitive associates of speech disorder.

Attention↗

PubMed2005

Effects of positive affect on speech disorder in schizophrenia.

Speech disorder exacerbates when negative affect is aroused in patients with schizophrenia. However, little is known about the effects of positive affect on speech disorder. A well-validated laboratory procedure was used to determine whether arousal of positive affect would modulate speech disorder in 57 stable outpatients with schizophrenia and 48 community controls. Overall, the level of speech disorder modulation was negligible for both groups, although there was considerable variability in whether patients' speech disorder exacerbated or ameliorated. Results suggest that arousal of positive affect has an ameliorative effect on speech disorder for certain patients who have relatively severe symptomatology.

Adult↗

PubMed2005

Diminished emotionality and social functioning in schizophrenia.

There is indirect evidence to suggest that a subgroup of patients with schizophrenia exhibit a diminished capacity to experience both positive and negative emotions. To date however, no studies have focused specifically on this diminished emotionality (DE). The main objective of the present project was to determine whether patients with self-reported DE differed from other patients in level of social functioning, physical and social anhedonia, and negative/deficit symptoms. Seventy-three state hospital patients with DSM-IV diagnosed schizophrenia and 22 nonpsychiatric controls were examined. Results provided mixed support for the present hypotheses. Patients with self-reported DE (N = 10) versus those without (N = 63) had poorer social functioning, similar levels of physical and social anhedonia, and significantly less severe negative/deficit symptoms. Moreover, there was a substantial amount of discrepancy between patients' self-reported levels of emotionality and the ratings of their emotionality as made by trained observers. Implications of these results are discussed.

Adult↗

PubMed2005

Symptom-oriented versus syndrome approaches to resolving heterogeneity of neuropsychological functioning in schizophrenia.

Schizophrenia is a heterogeneous disorder. The syndrome and the symptom-oriented approaches are two methods that have been used to examine differences in psychopathological processes across different patients with schizophrenia. The authors indirectly compared these two approaches in their examination of associations between positive symptoms and neuropsychological performance. Positive syndrome and delusion and hallucination severity scores were compared in respective associations to functioning on 12 neuropsychological variables in 73 stable outpatients with schizophrenia. The individual symptoms of the positive syndrome were associated with relatively distinct patterns of neuropsychological performance, suggesting that the symptom-oriented approach was more sensitive.

Adolescent↗

PubMed2004

Language reactivity and work functioning in schizophrenia.

Some studies have found that the speech of certain schizophrenia patients becomes more disordered in stressful laboratory situations. It is unknown, however, whether affective reactivity of speech is associated with stress responsiveness of symptoms in the real world. This study examines whether language-reactive patients report more stress-related impairments in work functioning than language-nonreactive patients. Forty-six patients provided speech samples and completed a work history interview. It was found that the language-reactive patients were more likely than the language-nonreactive patients to endorse items pertaining to social anxiety and difficulty relating to others as reasons for their work difficulties. This suggests that language-reactive patients are more sensitive to social stressors than language-nonreactive patients.

Adult↗

PubMed2004

Stress and arousability in schizophrenia.

This paper examines trait arousability (TA), a temperament characteristic, in 47 stable outpatients with schizophrenia and 50 non-psychiatric controls. Self-reported levels of stress were obtained during a negative and positive memory speech task. Levels of TA, and the association of TA scores with reported stress during the speech tasks, were examined both between and within groups. In addition, TA scores were examined in relation to symptom presentation in the patient group. Patients reported higher levels of trait arousability and higher levels of stress than controls. Trait arousability scores were significantly associated with reported stress in one of the speech condition in patients, and with the severity of positive and affective symptoms. These results suggest that temperament characteristics of an individual with schizophrenia may be related to stress responsiveness and symptom presentation.

Adult↗

PubMed2004

Affective reactivity of speech and emotional experience in patients with schizophrenia.

Communication disturbances are exacerbated by stress in patients with schizophrenia, a phenomenon known as affective reactivity of speech. However, a subset of these patients, those with the deficit syndrome, is characterized by a diminished capacity to experience emotion. We examined affective reactivity in the natural speech of schizophrenia patients with and without the deficit syndrome, with the expectation that deficit syndrome patients would evidence lower levels of affective reactivity. Two 10-min conversational speech samples were collected from each of 13 deficit syndrome patients, 22 nondeficit patients and 26 healthy control subjects. One speech sample from each participant was on the topic of emotionally negative, stressful memories, and the other was on emotionally positive, nonstressful memories. The audiotaped speech samples were analyzed blindly for frequencies of referential communication failure. All three groups showed significantly higher frequencies of communication disturbances in the emotionally negative speech sample than the positive speech sample. Nondeficit patients showed greater affective reactivity of speech than either deficit patients or controls. Conversely, deficit patients' speech was not more reactive to emotion than the speech of the control group. These results suggest that emotion-related variables mediate the relationship between stress and language symptom exacerbations in at least some patients with schizophrenia.

Adult↗

PubMed2004

Referential communication disturbances in the speech of nonschizophrenic siblings of schizophrenia patients.

Several different types of communication disturbances have been identified in the speech of schizophrenia patients. This study assessed 6 types of referential communication disturbances in the speech of 32 stable outpatients, 23 of their nonschizophrenic siblings, and 27 control subjects. The siblings made more frequent reference failures of all types than control subjects and did not differ from the patients on most types of disturbance. Only on the arguably most "schizophrenic" type of disturbance, the missing information reference, did patients show more deviance than siblings. On the vague reference, siblings showed more deviance than patients. These results, which are very similar to those previously reported on parents of patients, support the idea that referential disturbances reflect vulnerability to schizophrenia.

Adult↗

PubMed2004

Deficit versus negative syndrome in schizophrenia: prediction of attentional impairment.

Findings on neuropsychological associates of the negative syndrome of schizophrenia have been inconsistent. The "deficit syndrome," a reconceptualization of the negative syndrome, was developed in part to address this inconsistency. The purpose of this study was (1) to replicate previous findings relating the deficit syndrome to impairment of certain kinds of attentional abilities, and (2) to compare the negative and deficit syndromes in their associations with performance on tests of attention. Data from 40 individuals with schizophrenia were analyzed. Results provide evidence to suggest that impairment of certain attentional processes is associated with severity of deficit symptomatology, while impairment of other attentional processes is not. Moreover, the negative and deficit syndromes differed in their respective associations with attentional task performance at a trend level or above for five of seven tasks, suggesting that the negative and deficit syndromes do indeed have different underlying neuropsychological correlates.

Adult↗

PubMed2004

Internal source monitoring and thought disorder in schizophrenia.

A new task was developed to examine source monitoring in 52 patients with schizophrenia. Patients and nonpsychiatric controls were not found to differ on recognition memory, source discrimination, or attribution bias when the between group difference in IQ was controlled. However, among patients, source discrimination was significantly related to severity of thought disorder. After controlling for IQ and verbal working memory, thought-disordered patients were significantly poorer than nonthought-disordered patients at discriminating the source of previously presented information. Results suggest that internal source monitoring is specifically related to thought disorder in patients with schizophrenia.

Adult↗

PubMed2004

Expressed emotion, attribution, and control in parents of schizophrenic patients.

Expressed emotion is a measure of an individual's critical and/or emotionally overinvolved attitudes toward another person. The characteristics of parents who are high in expressed emotion are not fully understood. This study examined some variables potentially associated with expressed emotion, as measured by the Camberwell Family Interview, in 54 parents of schizophrenic young adults. Statements of (1) self-blame for the patient's illness, (2) controlling behaviors toward the patient, and (3) controlling behaviors toward others were assessed. As predicted, parents who blamed themselves for the patient's illness had higher emotional overinvolvement ratings than non-self-blaming parents. Measures of controlling behavior revealed that highly critical parents were not more controlling than less critical parents; however, parents high in emotional overinvolvement reported higher levels of patient- and other-controlling behaviors than parents low in emotional overinvolvement. These results suggest that the emotional overinvolvement component of high expressed emotion is associated with self-blaming attributions and controlling behaviors in parents, but that the criticism component is not.

Adult↗

PubMed2003

Stability of formal thought disorder and referential communication disturbances in schizophrenia.

This study examined the degree to which different types of communication disturbances in the speech of 48 schizophrenia patients and 28 controls were variable and state related versus stable and traitlike. Clinically rated formal thought disorder and 5 types of referential disturbance showed substantial stability within participants over time. The sixth type of referential disturbance, the vague reference, was not stable over time. Formal thought disorder was associated with the severity of core psychotic symptoms in patients. whereas referential disturbances showed little or no association with positive or negative symptom severity. Furthermore, changes in psychotic symptoms over time were accompanied by corresponding changes in formal thought disorder but not referential disturbances. These results support the idea that some types of referential disturbances are traitlike and may be reflective of vulnerability as well as manifest illness.

Adolescent↗

PubMed2003

Self-reported stress and the deficit syndrome of schizophrenia.

GENERALLY speaking, schizophrenia is not associated with diminished positive and negative emotions. Even patients with negative symptoms such as blunted affect have generally not differed in their levels of self-reported emotionality compared to patients without negative symptoms. However, there is evidence to suggest that a subgroup of patients with negative symptoms, those with the deficit syndrome, have a diminished capacity to experience positive and negative emotions. The present study examined whether ratings of the deficit and negative syndrome were associated with lower levels of self-reported stress during a laboratory-based, emotion-induction manipulation. Thirty-six participants with schizophrenia were asked to produce separate affectively positive and affectively negative narratives. Immediately following each narrative, participants were asked to report the level of stress they had experienced while recounting their memories. The deficit syndrome ratings, analyzed in a continuous and a categorical manner, were associated with lower levels of self-reported stress in the affectively negative condition. Moreover, the deficit and negative syndrome ratings significantly differed in their associations to levels of self-reported stress during both tasks, supporting the notion that there are appreciable differences between the two syndromes. Given that stress has been an essential component in conceptualizations of schizophrenia onset and relapse, the possibility of stress-resistant properties associated with the deficit syndrome should be tested in future research.

Adult↗