Mild vs. moderate: How behavioral speech measures predict metacognitive capacity across different levels of formal thought disorder.

Disorganized speech is a key component of formal thought disorder (FTD) in schizophrenia. Recent work has tied disorganized speech to deficits in metacognition, or one's ability to integrate experiences to form complex mental representations. The level of FTD at which differences in metacognitive capacity emerge remains unclear. Across two studies, using different cut scores to form FTD groups, we aimed to 1) explore the relationship between disorganized speech and metacognition and 2) compare trained rater and automated analysis methods. Clinical interviews were coded for disorganized speech and metacognition using the Communication Disturbances Index (CDI), Coh-Metrix multidimensional indices, and Metacognition Assessment Scale. In Study 1, we examined CDI and Coh-Metrix's ability to predict metacognition in FTD (n = 16) and non-FTD (n = 29) groups. We hypothesized the FTD group would have lower metacognition and that both CDI and Coh-Metrix would account for significant variance in metacognition. In Study 2, we conducted the same analyses with an independent sample using more stringent FTD cut scores (FTD: n = 23; non-FTD: n = 23). Analyses indicated that at a moderate but not mild cutoff: 1) automated methods differentiated FTD and non-FTD groups, 2) differences in metacognition emerged, and 3) behavioral measures accounted for significant variance (34%) in metacognition. Results emphasize the importance of setting the FTD cutoff at a moderate level and using samples that contain high levels of FTD. Findings extend research linking FTD and metacognition and demonstrate the benefit of pairing trained rater and automated speech measures.

Social functioning in schizotypy: How affect influences social behavior in daily life.

OBJECTIVE: Social deficits are already exhibited by people at risk for schizophrenia-spectrum disorders. Technological advances have made passive detection of social deficits possible at granular levels. METHOD: In this real-world study, we tested if schizotypy status (high/low) predicted two types of social behavior: (1) being around other people; and (2) actively socializing with others. We also examined if schizotypy influences relationships between social behavior and affect using subjective and objective instruments. RESULTS: Our findings revealed that socializing with others was significantly decreased in the high schizotypy group. Positive affect increased in social situations and predicted later social behavior in those low, but not high, in schizotypy. CONCLUSION: Decreased social behavior in schizotypy may be explained, in part, by these individuals being less incentivized than their peers to pursue social situations. Future studies should test this explanation in larger samples exhibiting elevated positive, negative, and disorganized schizotypy traits.

Speech production and disorganization in schizotypy: Investigating the role of cognitive and affective systems.

Diminished productivity and elevated disorganization have been detected in the speech of individuals with schizotypy. However, the underlying mechanisms for these disruptions are not well understood. Separate lines of research suggest potential contributions from cognitive and affective systems. In this study, disorganized speech and speech production were examined in speech samples generated by schizotypy (n = 47) and non-schizotypy (n = 51) groups by assessing "reactivity" (i.e., a change in experimental compared with baseline conditions) across baseline, affective, and dual-task (i.e., cognitive) conditions. Relationships with social functioning were also examined within each group. Three key findings emerged: 1) compared to the non-schizotypy group, those with schizotypy exhibited diminished speech production in the affective condition and affective reactivity was observed; 2) the schizotypy group displayed greater levels of disorganized speech in dual-task conditions and cognitive reactivity was observed; and 3) affective reactivity for disorganized speech was linked to worse social functioning within the schizotypy group. This study provides evidence that cognitive and affective systems are uniquely involved in separate characteristics of speech in schizotypy. At this stage, cognitive systems appear to have a specific role in the organization of speech, whereas affective systems are more heavily involved in speech production. Regarding the association between affective reactivity and social functioning, previous research has demonstrated individuals highly reactive to emotional stimuli carry additional risk for conversion to psychosis. Future research identifying a subset with schizotypy who demonstrate affective reactivity could lead to a better understanding of links between schizotypy and future psychosis symptoms.