The Impact of Poor Nonverbal Social Perception on Functional Capacity in Schizophrenia

Pragmatic features in patients with schizophrenia

Schizophrenia is a heterogeneous disorder. Despite the fact that communication and language skills may be impaired in schizophrenia, only a few studies have examined specific aspects of pragmatic competence in these patients. Therefore, this study aimed to compare the pragmatic skills of schizophrenic patients and a control group. Forty-three schizophrenic patients with a Mean ± SD age of 40 ± 1.21 years old and a control group were assessed using the Adult Pragmatics Profile (APP), which is a validated tool consisting of three scales: verbal, nonverbal and paralinguistic. The participants in the schizophrenia group demonstrated significant impairments in pragmatic abilities compared to the participants in those the control group. The most remarkable difference was in the nonverbal scale (5.00 ± 1.09), while the lowest difference was seen in the verbal scale (18.30 ± 3.91). Within the nonverbal subscales, eye contact was the most impaired. Schizophrenic patients presented with impairments in their pragmatic skills (verbal, nonverbal and paralinguistic). As pragmatic skills play a paramount role in social communication, it is of great significance to address these impairments to enhance patients' quality of life.

Using virtual reality to assess gesture performance deficits in schizophrenia patients

Introduction

Gesture performance deficits are prevalent in schizophrenia patients and are strongly associated with poor social communication skills and community functioning, affecting their overall quality of life. Currently, video-recording technology is widely used in clinical settings to assess gesture production deficits in schizophrenia patients. Nevertheless, the subjective evaluation of video-recordings can encumber task assessment. The present study will aim to use virtual reality to examine its potential use as an alternative tool to objectively measure gesture performance accuracy in schizophrenia patients and healthy controls.

Methods

Gesture performance in the virtual reality setting will be based on the well-established Test of Upper Limb Apraxia. Participants will be immersed in a virtual environment where they will experience themselves being embodied in a collocated virtual body seen from a first-person perspective. Motion trackers will be placed on participants' hands and elbows to track upper body movements in real-time, and to record gesture movement for later analysis. Participants will see a virtual agent sitting across from them, with a virtual table in between. The agent will perform various types of gestures and the participants' task will be to imitate those gestures as accurately as possible. Measurements from the tracking devices will be stored and analyzed to address gesture performance accuracy across groups.

Discussion

This study aims to provide objective measurements of gesture performance accuracy in schizophrenia patients. If successful, the results will provide new knowledge to the gesture literature and offer the potential for novel therapeutic interventions using virtual reality technologies. Such interventions can improve gesturing and thus advance social communication skills in schizophrenia patients.

PECULIARITIES OF PERCEPTION OF NON-VERBAL STIMULI BY PATIENTS WITH SCHIZOPHRENIA: SUBJECTIVE UNDERSTANDING, INTEREST AND EMOTIONS

OBJECTIVE

The aim: The main purpose of this article was to investigate the subjective understanding, interest, and emotional perception of non-verbal stimuli by schizophrenic patients.

PATIENTS AND METHODS

Materials and methods: For this study, the clinical interview method was used, in which all questions were presented in Ukrainian. The questionnaire form was divided into three main blocks: socio-demographic, mental anamnesis, and non-verbal stimulus assessment. 50 respondents took part in the study. The experimental group, i.e., respondents with schizophrenia spectrum disorders, made up 58% (n = 29) of the total number of respondents, and the control group, respondents with other diagnoses, made up 42% (n = 21).

RESULTS

Results: The results showed that in both groups the level of abstractness or objectivity of the drawings affected the understanding of what was depicted. Patients with schizophrenia had a better understanding of images that didn't have a single semantic and compositional whole. The abstractness of the drawings and their detailing affected the appearance of interest in the image in people who have disorders on the schizophrenia spectrum. In addition, the more realistic the objects in the picture were, the less interesting it was for people with schizophrenia spectrum disorders.

CONCLUSION

Conclusions: In conclusion, schizophrenic patients found stereotypical signs of emotions much more easily than respondents with other diagnoses, and facial expressions were the most important factor in determining the emotional component of drawings.

Brain Stimulation and Group Therapy to Improve Gesture and Social Skills in Schizophrenia-The Study Protocol of a Randomized, Sham-Controlled, Three-Arm, Double-Blind Trial

An important component of nonverbal communication is gesture performance, which is strongly impaired in 2/3 of patients with schizophrenia. Gesture deficits in schizophrenia are linked to poor social functioning and reduced quality of life. Therefore, interventions that can help alleviate these deficits in schizophrenia are crucial. Here, we describe an ongoing randomized, double-blind 3-arm, sham-controlled trial that combines two interventions to reduce gesture deficits in schizophrenia patients. The combined interventions are continuous theta burst stimulation (cTBS) and social cognitive remediation therapy (SCRT). We will randomize 72 patients with schizophrenia spectrum disorders in three different groups of 24 patients. The first group will receive real cTBS and real SCRT, the second group will receive sham cTBS and real SCRT, and finally the third group will receive sham SCRT. Here, the sham treatments are, as per definition, inactive interventions that mimic as closely as possible the real treatments (similar to placebo). In addition, 24 age- and gender-matched controls with no interventions will be added for comparison. Measures of nonverbal communication, social cognition, and multimodal brain imaging will be applied at baseline and after intervention. The main research aim of this project will be to test whether the combination of cTBS and SCRT improves gesture performance and social functioning in schizophrenia patients more than standalone cTBS, SCRT or sham psychotherapy. We hypothesize that the patient group receiving the combined interventions will be superior in improving gesture performance.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [NCT04106427].