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Measuring disorganized speech in schizophrenia: automated analysis explains variance in cognitive deficits beyond clinician-rated scales

Published online by Cambridge University Press:  25 April 2018

K. S. Minor ,
J. A. Willits ,
M. P. Marggraf ,
M. N. Jones  and
P. H. Lysaker
K. S. Minor*
Affiliation:
Department of Psychology, Indiana University- Purdue University Indianapolis, Indianapolis, IN, USA
J. A. Willits
Affiliation:
Department of Psychology, University of California-Riverside, Riverside, CA, USA
M. P. Marggraf
Affiliation:
Department of Psychology, Indiana University- Purdue University Indianapolis, Indianapolis, IN, USA
M. N. Jones
Affiliation:
Department of Psychology, Indiana University, Bloomington, IN, USA
P. H. Lysaker
Affiliation:
Roudebush VA Medical Center, Indianapolis, IN, USA Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
*
Author for correspondence: K. S. Minor, E-mail: ksminor@iupui.edu
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Abstract

Background

Conveying information cohesively is an essential element of communication that is disrupted in schizophrenia. These disruptions are typically expressed through disorganized symptoms, which have been linked to neurocognitive, social cognitive, and metacognitive deficits. Automated analysis can objectively assess disorganization within sentences, between sentences, and across paragraphs by comparing explicit communication to a large text corpus.

Method

Little work in schizophrenia has tested: (1) links between disorganized symptoms measured via automated analysis and neurocognition, social cognition, or metacognition; and (2) if automated analysis explains incremental variance in cognitive processes beyond clinician-rated scales. Disorganization was measured in schizophrenia (n = 81) with Coh-Metrix 3.0, an automated program that calculates basic and complex language indices. Trained staff also assessed neurocognition, social cognition, metacognition, and clinician-rated disorganization.

Results

Findings showed that all three cognitive processes were significantly associated with at least one automated index of disorganization. When automated analysis was compared with a clinician-rated scale, it accounted for significant variance in neurocognition and metacognition beyond the clinician-rated measure. When combined, these two methods explained 28–31% of the variance in neurocognition, social cognition, and metacognition.

Conclusions

This study illustrated how automated analysis can highlight the specific role of disorganization in neurocognition, social cognition, and metacognition. Generally, those with poor cognition also displayed more disorganization in their speech—making it difficult for listeners to process essential information needed to tie the speaker's ideas together. Our findings showcase how implementing a mixed-methods approach in schizophrenia can explain substantial variance in cognitive processes.

Keywords

Automated analysiscognitiondisorganized symptomsschizophreniaspeech
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 3 , February 2019 , pp. 440 - 448
Copyright
Copyright © Cambridge University Press 2018 

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