Evaluation sensitivity as a moderator of communication disorder in schizophrenia

Department of Psychiatry, University of Pennsylvania, USA.
Psychological Medicine (Impact Factor: 5.94). 05/2009; 39(7):1211-9. DOI: 10.1017/S0033291709005479
Source: PubMed


Communication disturbance (thought disorder) is a central feature of schizophrenia that predicts poor functioning. We investigated the hypothesis that memory and attention deficits interact with beliefs about the gravity of being rejected (i.e. evaluation sensitivity) to produce the symptoms of communication disorder.
Seventy-four individuals diagnosed with schizophrenia or schizo-affective disorder completed a battery of tests assessing neurocognition (attention, working and verbal memory, abstraction), symptomatology (positive, negative and affective), functioning, and dysfunctional beliefs.
Patients with communication deviance (n=33) performed more poorly on the neurocognitive tests and reported a greater degree of sensitivity to rejection than patients with no thought disorder (n=41). In a logistic regression analysis, evaluation sensitivity moderated the relationship between cognitive impairment and the presence of communication disorder. This finding was independent of hallucinations, delusions, negative symptoms, depression and anxiety.
We propose that negative appraisals about acceptance instigate communication anomalies in individuals with a pre-existing diathesis for imperfect speech production.

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    • "In particular, rejection sensitivity (RS) is a type of social anxiety where the person believes he/she is being rejected in ambiguous interpersonal situations and overreacts to disengagement expressed by others (Downey & Feldman, 1996). The person then seeks reassurance, feels vulnerable about their relationships , and/or shows retaliation and aggression (Grant & Beck, 2009; Langens & Schuler, 2005; Lemay & Clark, 2008; Sinclair, Ladny, & Lyndon, 2011). Social anxiety can increase psychosis-like experiences (PLEs) in vulnerable populations (Bentall, Claridge, & Slade, 1989; Olin & Mednick, 1996; Raine et al., 1994) and exacerbate positive symptoms of psychosis, such as paranoia and delusions, via different pathways including avoidance (Achim et al., 2013; Lysaker et al., 2010). "
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