Schizophrenie, soziale Kognition, Embodiment (26.9.16/Tsch)
- Kupper Z, Ramseyer F, Hoffmann H, & Tschacher W (2015). Nonverbal synchrony in social interactions of patients with schizophrenia indicates socio-communicative deficits. PLoS ONE 10(12): e0145882.
- Walther S, Ramseyer F, Horn H, Strik W, & Tschacher W (2014). Less structured movement patterns predict severity of positive syndrome, excitement, and disorganization. Schizophrenia Bulletin, 40, 585-591.
- Kupper Z, Ramseyer F, Hoffmann H, Kalbermatten S & Tschacher W (2010). Video-based quantification of body movement during social interaction indicates the severity of negative symptoms in patients with schizophrenia. Schizophrenia Research, 121, 90-100.
Abstract: In schizophrenia, nonverbal behavior - which includes body movement in general - is of theoretical and clinical importance. Although reduced nonverbal expressiveness is a major component of the negative symptoms encountered in schizophrenia, few studies have objectively assessed body movement during social interaction. In the present study, 378 brief, videotaped role-play scenes involving 27 stabilized outpatients diagnosed with paranoid-type schizophrenia were analyzed using Motion Energy Analysis (MEA). This method enables the objective measuring of body movement in conjunction with ordinary video recordings. Correlations between movement parameters (percentage of time in movement, movement speed) and symptom ratings from independent PANSS interviews were calculated. Movement parameters proved to be highly reliable. In keeping with predictions, reduced movement and movement speed correlated with negative symptoms. Accordingly, in patients who exhibited noticeable movement for less than 20% of the observation time, prominent negative symptoms were highly probable. As a control measure, the percentage of movement exhibited by the patients during role-play scenes was compared to that of their normal interactants. Patients with negative symptoms differed from normal interactants by showing significantly reduced head and body movement. Two specific positive symptoms were possibly related to movement parameters: suspiciousness tended to correlate with reduced head movement, and the expression of unusual thought content tended to relate to increased movement. Overall, a close and theoretically meaningful association between the objective movement parameters and the symptom profiles was found. MEA appears to be an objective, reliable and valid method for quantifying nonverbal behavior, an aspect which may furnish new insights into the processes related to schizophrenia.
- Frith, CD and Corcoran, R (1996). Exploring 'theory of mind' in people with schizophrenia. Psychological Medicine 26, 521-530.
Abstract: Mentalizing ability was studied in 46 symptomatic schizophrenic patients and 44 non-symptomatic controls. Subjects heard six stories and simultaneously were shown simple cartoon pictures depicting the action sequencing occurring in the stories. All the stories involved false belief or deception, so that it was necessary to infer the mental states of the characters in order to understand their behaviour. After each story, subjects were asked one memory/reality question (concerning an event in the story) and one question that depended on the ability to infer the mental state of one of the characters. Patients with paranoid delusions were impaired on the questions concerning mental states. Patients with behavioural signs (i.e. negative features or incoherence) were also impaired on the mental state questions, but this difficulty was associated with memory impairments. Patients with symptoms of passivity (e.g. delusions of control) and patients in remission did not differ from normal controls. These results are consistent with the hypothesis that certain of the positive symptoms of schizophrenia reflect an impairment in the ability to infer the mental states of others.
- Brüne, M, Abdel-Hamid, M, Sonntag, C, Lehmkämper, C and Langdon, R (2009). Linking social cognition with social interaction: Non-verbal expressivity, social competence and "mentalising" in patients with schizophrenia spectrum disorders. Behav Brain Funct 5, 6
Abstract: Research has shown that patients with schizophrenia spectrum disorders (SSD) can be distinguished from controls on the basis of their non-verbal expression. For example, patients with SSD use facial expressions less than normals to invite and sustain social interaction. Here, we sought to examine whether non-verbal expressivity in patients corresponds with their impoverished social competence and neurocognition. METHOD: Fifty patients with SSD were videotaped during interviews. Non-verbal expressivity was evaluated using the Ethological Coding System for Interviews (ECSI). Social competence was measured using the Social Behaviour Scale and psychopathology was rated using the Positive and Negative Symptom Scale. Neurocognitive variables included measures of IQ, executive functioning, and two mentalising tasks, which tapped into the ability to appreciate mental states of story characters. RESULTS: Non-verbal expressivity was reduced in patients relative to controls. Lack of "prosocial" nonverbal signals was associated with poor social competence and, partially, with impaired understanding of others' minds, but not with non-social cognition or medication. CONCLUSION: This is the first study to link deficits in non-verbal expressivity to levels of social skills and awareness of others' thoughts and intentions in patients with SSD.
- Walther, S, Koschorke, P, Horn, H and Strik, W (2009). Objectively measured motor activity in schizophrenia challenges the validity of expert ratings. Psychiatry Res 169, 187-190
Abstract: Motor symptoms are frequent in schizophrenia and relevant to diagnosis. They are usually assessed by clinical observation and ratings based on psychometric scales. However, investigations with quantitative measurements are rare. To understand the relationship between the objective parameters of a quantitative motor activity measurement and the items related to motor symptoms of the Positive and Negative Syndrome Scale (PANSS), 55 schizophrenia patients were studied with 24-h continuous wrist actigraphy. Activity level, movement index, and mean duration of uninterrupted immobility periods were analyzed for wakeful periods. Actigraphic parameters were strongly inter-correlated. High PANSS negative syndrome subscale scores predicted low activity levels. Single PANSS items, such as suspiciousness, hallucinatory behavior, and emotional withdrawal, contributed largely to the variance in activity level and movement index. Age, gender, medication, and duration of illness had no significant impact on the actigraphic parameters. Interestingly, correlations between the specific motor symptoms of the PANSS and the actigraphic parameters were only found as a non-significant trend. We conclude that the objectively measured quantity of movement is related to the clinically assessed negative syndrome in schizophrenia. In contrast, PANSS items related to psychomotor behavior imprecisely reflect real quantitative motor activity.
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