Article

Nonverbal behavior during standardized interviews in patients with schizophrenia spectrum disorders

Centre for Psychiatry, Psychotherapy, Psychosomatics and Preventative Medicine, University of Bochum, Germany.
The Journal of nervous and mental disease (Impact Factor: 1.81). 05/2008; 196(4):282-8. DOI: 10.1097/NMD.0b013e31816a4922
Source: PubMed

ABSTRACT Several studies have consistently shown that patients with schizophrenia or schizophrenia spectrum disorders (SSD) can be distinguished from normal controls on the basis of their nonverbal behavior during standardized interviews, with considerable interactions between negative symptoms and poor facial expressivity. However, most studies have examined unmedicated patients, and gender of both interviewer and interviewee has not been taken into account. In this study we assessed the nonverbal behavior of male and female patients with SSD who were receiving second-generation antipsychotic medication (SGA) using the Ethological Coding System for Interviews (Troisi, 1998). In addition, we used a novel 5-factor model of the Positive and Negative Symptom Scale (PANSS, van der Gaag et al., 2006) to correlate nonverbal behavior with standard psychopathology ratings. Our findings strongly resembled results of previous studies into nonverbal behavior of patients with SSD, despite differences in cultural backgrounds and gender of the interviewer. Negative symptoms were inversely correlated with several of the nonverbal behavioral dimensions. Medication dose did not correlate with any one of the behavioral or psychopathological measures. Patients with SSD make less use of their nonverbal behavioral repertoire compared with controls, independent of antipsychotic treatment. Culture-specific nonverbal expressivity seems to play an additional (minor) role in distinguishing patients from healthy controls.

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    • "Findings on displacement behaviors, such as self-touching and grooming, which signal emotional arousal or tension, were also contradictory. Troisi et al. (1998) found that, compared with the controls, schizophrenia patients displayed fewer displacement behaviors, whereas Brüne et al. (2008) reported no difference. Compared with patients with affective disorders , such as depression, schizophrenia patients displayed more displacement behaviors (Annen et al., 2012; Jones et al., 1979). "
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    ABSTRACT: Patients with a diagnosis of schizophrenia display social cognitive deficits. However, little is known about patients' nonverbal communication during their social encounters with others. This review identified 17 studies investigating nonverbal communication in patients' unscripted face-to-face interactions, addressing a) nonverbal differences between patients and others, b) nonverbal behavior of the patients' partners, c) the association between nonverbal behavior and symptoms, and d) the association between nonverbal behavior and social outcomes. Patients displayed fewer nonverbal behaviors inviting interaction, with negative symptoms exacerbating this pattern. Positive symptoms were associated with heightened nonverbal behavior. Patients' partners changed their own nonverbal behavior in response to the patient. Reduced prosocial behaviors, inviting interaction, were associated with poorer social outcomes. The evidence suggests that patients' nonverbal behavior, during face-to-face interaction, is influenced by patients symptoms and impacts the success of their social interactions.
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    • "Findings on displacement behaviors, such as self-touching and grooming, which signal emotional arousal or tension, were also contradictory. Troisi et al. (1998) found that, compared with the controls, schizophrenia patients displayed fewer displacement behaviors, whereas Brüne et al. (2008) reported no difference. Compared with patients with affective disorders , such as depression, schizophrenia patients displayed more displacement behaviors (Annen et al., 2012; Jones et al., 1979). "
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    • "Nonverbal communication is problematic in schizophrenia (Brüne et al., 2008; Penn, Sanna, & Roberts, 2007) Early psychiatrists described feeling a difficulty building rapport with patients during interaction, which was based on patients' nonverbal behaviour and termed the 'Praecox feeling' (Rümke, 1941). A recent study revealed that patients with schizophrenia display atypical patterns of hand movement when speaking and have difficulty coordinating their nonverbal behaviours with others during social interaction. "
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