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PubMed2003

Affective communication in normal and brain-damaged adults: an overview.

In the past few decades an increasing number of investigators have examined how emotions are communicated through facial expression, speech prosody, and language in nonclinical and brain-damaged populations. Disorders of emotional communication (often referred to as affective processing disorders) are commonly associated with brain damage. These disorders include difficulty with expressing and perceiving emotional information, regulating emotions in communicative interactions, and demonstrating sensitivity to the emotional expressions of communicative partners. The purposes of this article are to: (1) describe "normal" affective communication; (2) review disorders in affective expression, perception, and regulation; (3) discuss the modality of facial expression and disorders of affective facial expression; and (4) present some informal tools for assessing affective processing.

Affect↗
PubMed1992

Communication deficits in childhood schizotypal personality disorder.

This study examined the similarities and differences in the communication deficits of 13 schizotypal and 12 schizophrenic children matched by age and IQ. Like schizophrenic children, schizotypal children underutilize some discourse devices necessary for coherent speech and overutilize others. Schizotypal children, however, appear to display a more restricted range of discourse deficits than schizophrenic children. In addition, their discourse deficits do not appear to be associated with clinical measures of loose associations. The clinical implications and the potential use of discourse measures to differentiate schizophrenic and schizotypal children are discussed.

Child↗
PubMed1985

Life skill training: psychoeducational training as mental health treatment.

Fifty-four patients of a Veterans Administration Medical Center were assigned to either a life-skill training program that emphasized psychoeducational instruction and skill building or to a group counseling control condition. Subjects assigned to life-skill training were provided with 28 hours of instruction in interpersonal communication, purpose in life problem solving, and physical fitness/health maintenance. Control subjects received equal time engaged in psychiatric treatment that emphasized the analysis and exploration of personal problems, but with no direct coping skill training. Significant differences between the two groups were found on measures of interpersonal communication and meaningful purpose in life. Both groups received lower staff ratings on psychopathological behavior and demonstrated improvement on ratings of health and physical fitness upon completion of treatment. Twelve- and 24-month follow-up data that include rehospitalization rates are presented for each group.

Adaptation, Psychological↗
PubMed1982

[The evaluation of neuroses findings and treatment possibilities on 615 ambulatory psychotherapy patients].

For 615 neurotic and psychosomatic patients who visited two outpatient psychotherapeutic institutions for initial diagnostic interviews the diagnosis of neurosis was made according to the "Psychischer and Social-Kommunikativer Befundbogen" (PSKB; psychic and social-communicative findings sheet) and supplemented by evaluations based up on prognostic scales. This study presents an overview on the frequencies of symptom as well as personality characteristics in these patients. With regard to prognosis and indication of therapy, special emphasis is placed upon those characteristics which provide information concerning the interaction between patient and examiner.

Ambulatory Care↗
PubMed1987

Social perception and communication skills among schizophrenics and nonschizophrenics.

This study examined the performance of both schizophrenic (N = 13) and nonschizophrenic patients (N = 7), as well as that of a nonpatient contrast group (N = 18), on standardized measures of both social perception and social skill. Social judgment and self-perception also were examined. Schizophrenics were less skillful and less socially perceptive than members of both other groups. Members of the nonschizophrenic patient group also were significantly impaired on the dependent measures when compared to contrast subjects. Results point to the multi-component nature of skills deficits in schizophrenics. Implications for assessment and treatment programs on communication skills training with schizophrenics are discussed.

Adult↗
PubMed2004

Interaction of genetic risk and adoptive parent communication deviance: longitudinal prediction of adoptee psychiatric disorders.

BACKGROUND: In the Finnish Adoptive Family Study of Schizophrenia, adoptee thinking disorders have been shown to be a joint effect of genetic liability for schizophrenia spectrum disorders and adoptive rearing-parent communication patterns. However, longitudinal predictions of clinical psychiatric disorders of the adoptees have not been reported. METHOD: Adoptees (n = 109) who had no DSM-III-R disorder at initial assessment (median age 18 years) were selected from the total sample of the Finnish Adoption Study of Schizophrenia. They were defined as at high versus low genetic risk based upon the lifetime diagnoses of their biological, adopting-away mothers - schizophrenia spectrum disorder versus no spectrum disorder. At initial assessment, adoptive rearing parents were independently evaluated from tape-recorded Rorschach protocols scored as manifesting either high or low Communication Deviance (CD), a composite index of communication patterns that distract and befuddle listeners. Adoptees were independently re-diagnosed after a median interval of 14 years and followed-up from national registers for an additional 7 years. RESULTS: The main effects of genetic liability (G) and CD of the adoptive parents (E), each taken separately, predicted significantly for psychiatric disorders of the adoptees as adults. However, when G, E, and their joint interaction effect were entered into the same logistic model, only the interaction effect was significant. The sample included seven adoptees with schizophrenia spectrum disorders, but a separate analysis to predict them was non-significant. CONCLUSION: Genetic liability for schizophrenia spectrum disorder and an adoptive family rearing variable interact, predicting longitudinally and significantly to broadly defined adoptee psychiatric disorder.

Adoption↗
PubMed1993

Nonverbal expression in autism of Asperger type.

Short unstructured social interactions between a volunteer interviewer, an adult with autism of Asperger type, and a control subject with a schizoid personality disorder were video-recorded. Asperger subjects tended to look less at the other person, to make more self-stimulatory gestures, and to look at the interviewer significantly less than normal subjects, and substantially less than schizoid subjects, during the periods when the interviewer was vocalizing although there were no such differences when the interviewer was listening. We suggest that the gaze avoidance of autism may in actuality be a lack of expected gaze (e.g., gaze when the other person is talking) rather than an absolute avoidance, and suggest that a lifelong absence of gaze response to social cues including speech could explain a number of the developmental features of autism including lack of joint attention with others, lack of understanding and affective response to others, and poor discrimination of facial expressions.

Adult↗
PubMedDate not supplied

Psychoeducation for the families of patients with eating disorders and changes in expressed emotion: A preliminary study.

Psychosocial variables such as expressed emotion (EE) have prognostic significance, and family psychoeducation has been developed to aid in the treatment of various psychiatric disorders. This study reports relationships among EE, family factors, and symptoms observed while conducting multifamily psychoeducation for eating disorders. Group sessions were held once a month for the relatives of patients with DSM-IV eating disorders, and the group met for five sessions that included both education and problem-solving. Thirty-seven relatives volunteered to participate in our program, and of these, 28 completed the program. EE (as measured by the Five-Minute Speech Sample [FMSS]), family function (as measured by the Family Adaptability and Cohesion Evaluation Scales [FACES]), the family's mental state (as measured by the Profile of Mood States [POMS]), and patient's symptoms (as measured by the Eating Disorder Evaluation Scales [EDES] and Global Assessment of Functioning [GAF] on clinician evaluations, and by the Anorexic Behavior Observation Scale [ABOS] assessment of the family) were administered at both the first and final sessions. The rates of high-EE relatives tended to decrease (especially high emotional overinvolvement [EOI]), and families' assessment of symptoms was also significantly improved. Twice-repeated multivariate analysis of variance (MANCOVA) showed that EOI, ABOS, and POMS scores were changed significantly during the sessions. Psychoeducation for the family members of patients with eating disorders might help lower distress and encourage positive interactions within the family. EE is an important measure in evaluations of psychoeducation. However, a randomized, controlled trial is needed to clarify the efficacy of this treatment.

Adaptation, Psychological↗
PubMed1998

Cognitive-linguistic subgroups in closed-head injury.

This study examined variability in the interrelationship between language skill and neuropsychological function within a group of 25 severe closed head injury (CHI) subjects and 23 matched controls. All subjects underwent a battery of standardized language and neuropsychological tests. Cluster analyses were conducted to determine whether the CHI sample was universally or differentially impaired. Further subgroup analysis using a Q-type factor analysis outlined the differences in performance profiles within the group of CHI subjects. Results support the hypothesis that while some deficits were common to all CHI subjects, impairments delineated by whole group analysis do not necessarily represent universal impairments. In particular, ability to perform tasks involving auditory comprehension, naming, verbal memory, visual memory and visuospatial skills appeared to be important components in group differentiation. The cognitive-linguistic impairments which were common to all CHI subjects and considered to be the 'cardinal' cognitive-linguistic deficits following severe CHI were deficits in lexical-semantic and sentential semantic skills, verbal fluency, complex auditory comprehension, and attentional operations. Profile analysis revealed the existence of a double dissociation between performances on naming and verbal memory tasks and performances on visually related cognitive tasks. Results are discussed with reference to findings on previous studies of subgroups in the CHI population.

Adolescent↗
PubMedDate not supplied

Gaze and the turn: a nonverbal solution to an interactive problem.

This paper examines the use of gaze as one of a number of connected compensatory adaptations to linguistic impairment by a patient with Broca's aphasia. The examination of the import of gaze withdrawal and return of gaze in the context of self cuing by the patient shows how the patient exploits the complex multifaceted nature of meaning making. Consonant with the concept of emergentist pragmatics (Perkins), meaning making is shown to be a distributed process with sufficient "plasticity" to allow the aphasic patient to compensate for their linguistic impairments yet still be sensitive to the interactive needs of their interlocutor. Furthermore, the analysis of the use of gaze during self cuing is also shown to have implications for our conceptualization of the construction of the turn in interaction.

Adaptation, Psychological↗
PubMedDate not supplied

Developing communication in adults with profound and multiple learning difficulties using objects of reference.

Objects of reference were used to develop communication in adults with profound and multiple learning difficulties (PMLD). The use of objects specific to individuals is recommended, but it makes heavy demands on care staff who implement such programmes. This study investigated the effectiveness of using a standard set of objects with a group of 13 adults with PMLD. Progress was monitored over a 20-week training period using an assessment based upon the cues provided by staff to promote the use of the objects. Results indicated that the group as a whole made significant gains, although a plateau effect was reached after the first 10 weeks of training. Some individuals within the group were near to ceiling performance after training, while others, though progressing, still made limited use of the objects. There was evidence, as suggested in the literature, that greater and more sustained progress was made with objects at the index level of representation. The views of the care staff who implemented the training programme were sought through semistructured interviews. Although the use of a standard set of objects presents a number of difficulties, it is concluded that it is desirable in situations where the use of individual objects with each client is unfeasible. It has the additional advantages that it instructs and motivates care staff and provides a means by which the use of objects of reference by individual clients may be assessed and planning for the development of their communication may be informed.

Adult↗
PubMed2006

Long-term neuropsychological outcome in preterm twins.

Few long-term studies have yet described neuropsychological outcome in preterm twins. Our aim was to assess, by long-term evaluation, neuropsychological outcome in preterm twins in order to define a correct follow-up program. Our study was a cohort one, with an index and a comparison group. Neonatal medical records of all preterm newborns admitted to our centre between 1991 and 1997 were reviewed and selected patients were recalled. The sample population included two matched groups of children aged 6-12 years, 86 twins and 86 singletons, submitted to paediatric, neurological, psychological, and ophthalmological examinations. Inclusion criteria were twin pregnancy and gestational age 27-36 weeks for index group; same gestational age, but single pregnancy, for the comparison group. All children underwent paediatric and neuropsychiatric examinations, cognitive assessment, and psychological evaluation by standardized tests for screening of learning specific disorders and language difficulties, and finally, ophthalmological examination. In order to study their role in predicting neuropsychological outcome, we examined some perinatal prognostic factors by statistical analysis. Unfavourable neuropsychological outcome was observed in 55/172 (32%) children, with different prevalence in the two groups, 42/172 (24%) in twins and 13/172 (8%) in singletons. Statistical analysis performed for examined prognostic factors showed significant differences in neuropsychological outcome with regard only to gestational age < 32 weeks, low birth weight, intraventricular haemorrhage, and periventricular leukomalacia. The incidence of neuropsychological diseases in the two groups showed significant difference about language and learning difficulties. Our data suggest that preterm twins represent a particular high-risk category of premature babies, mostly regarding the risk of so-called "minimal brain dysfunction", so a careful follow-up is recommended.

Attention Deficit Disorder with Hyperactivity↗