The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life

Valentina Bambini, Giorgio Arcara, Margherita Bechi, Mariachiara Buonocore, Roberto Cavallaro, Marta Bosia

Research output: Contribution to journalArticle

Abstract

Background Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. Methods Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. Results Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77% of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30% of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. Conclusions The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.

Original languageEnglish
Pages (from-to)106-120
Number of pages15
JournalComprehensive Psychiatry
Volume71
DOIs
Publication statusPublished - Nov 1 2016

Fingerprint

Aptitude
Cognition
Schizophrenia
Quality of Life
Accidental Falls
Psychopathology
Mental Competency
Language
Regression Analysis
Pathology

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

The communicative impairment as a core feature of schizophrenia : Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. / Bambini, Valentina; Arcara, Giorgio; Bechi, Margherita; Buonocore, Mariachiara; Cavallaro, Roberto; Bosia, Marta.

In: Comprehensive Psychiatry, Vol. 71, 01.11.2016, p. 106-120.

Research output: Contribution to journalArticle

Bambini, Valentina ; Arcara, Giorgio ; Bechi, Margherita ; Buonocore, Mariachiara ; Cavallaro, Roberto ; Bosia, Marta. / The communicative impairment as a core feature of schizophrenia : Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. In: Comprehensive Psychiatry. 2016 ; Vol. 71. pp. 106-120.
@article{42ebc5fbd52448a1aeb342ce727bd85d,
title = "The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life",
abstract = "Background Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. Methods Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. Results Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77{\%} of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30{\%} of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. Conclusions The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.",
author = "Valentina Bambini and Giorgio Arcara and Margherita Bechi and Mariachiara Buonocore and Roberto Cavallaro and Marta Bosia",
year = "2016",
month = "11",
day = "1",
doi = "10.1016/j.comppsych.2016.08.012",
language = "English",
volume = "71",
pages = "106--120",
journal = "Comprehensive Psychiatry",
issn = "0010-440X",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - The communicative impairment as a core feature of schizophrenia

T2 - Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life

AU - Bambini, Valentina

AU - Arcara, Giorgio

AU - Bechi, Margherita

AU - Buonocore, Mariachiara

AU - Cavallaro, Roberto

AU - Bosia, Marta

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. Methods Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. Results Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77% of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30% of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. Conclusions The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.

AB - Background Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. Methods Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. Results Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77% of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30% of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. Conclusions The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.

UR - http://www.scopus.com/inward/record.url?scp=84988353692&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988353692&partnerID=8YFLogxK

U2 - 10.1016/j.comppsych.2016.08.012

DO - 10.1016/j.comppsych.2016.08.012

M3 - Article

VL - 71

SP - 106

EP - 120

JO - Comprehensive Psychiatry

JF - Comprehensive Psychiatry

SN - 0010-440X

ER -