Piecing together fragments: Linguistic cohesion mediates the relationship between executive function and metacognition in schizophrenia.

Schizophr Res

Department of Psychiatry, Richard L. Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, United States; Indiana University School of Medicine, department of Psychiatry Indianapolis IN. Electronic address:

Published: January 2020

AI Article Synopsis

  • Speech disturbances in psychosis may be linked to executive function impairments that affect cohesive discourse, but how this interacts with metacognition is still unclear.
  • A study with 94 individuals with schizophrenia investigated the relationship between executive function, linguistic cohesion, and metacognitive capacity, using a range of linguistic measures.
  • Results showed that better executive functioning may enhance metacognition by improving speech cohesion and diversity, suggesting that language-based therapies could aid insight and recovery in individuals with psychosis.

Article Abstract

Speech disturbances are prevalent in psychosis. These may arise in part from executive function impairment, as research suggests that inhibition and monitoring are associated with production of cohesive discourse. However, it is not yet understood how linguistic and executive function impairments in psychosis interact with disrupted metacognition, or deficits in the ability to integrate information to form a complex sense of oneself and others and use that synthesis to respond to psychosocial challenges. Whereas discourse studies have historically employed manual hand-coding techniques, automated computational tools can characterize deep semantic structures that may be closely linked with metacognition. In the present study, we examined whether higher executive functioning promotes metacognition by way of altering linguistic cohesion. Ninety-four individuals with schizophrenia-spectrum disorders provided illness narratives and completed an executive function task battery (Delis-Kaplan Executive Function System). We assessed the narratives for linguistic cohesion (Coh-Metrix 3.0) and metacognitive capacity (Metacognition Assessment Scale - Abbreviated). Selected linguistic indices measured the frequency of connections between causal and intentional content (deep cohesion), word and theme overlap (referential cohesion), and unique word usage (lexical diversity). In path analyses using bootstrapped confidence intervals, we found that deep cohesion and lexical diversity independently mediated the relationship between executive functioning and metacognitive capacity. Findings suggest that executive control abilities support integration of mental experiences by way of increasing causal, goal-driven speech and word expression in individuals with schizophrenia. Metacognitive-based therapeutic interventions for psychosis may promote insight and recovery in part by scaffolding use of language that links ideas together.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106973PMC
http://dx.doi.org/10.1016/j.schres.2019.11.032DOI Listing

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