Schizophrenia and the structure of language: The linguist's view☆
Received 10 December 2004; received in revised form 21 January 2005; accepted 26 January 2005.
Abstract
Patients with schizophrenia often display unusual language impairments. This is a wide ranging critical review of the literature on language in schizophrenia since the 19th century. We survey schizophrenic language level by level, from phonetics through phonology, morphology, syntax, semantics, and pragmatics.
There are at least two kinds of impairment (perhaps not fully distinct): thought disorder, or failure to maintain a discourse plan, and schizophasia, comprising various dysphasia-like impairments such as clanging, neologism, and unintelligible utterances.
Thought disorder appears to be primarily a disruption of executive function and pragmatics, perhaps with impairment of the syntax–semantics interface; schizophasia involves disruption at other levels. Phonetics is also often abnormal (manifesting as flat intonation or unusual voice quality), but phonological structure, morphology, and syntax are normal or nearly so (some syntactic impairments have been demonstrated). Access to the lexicon is clearly impaired, manifesting as stilted speech, word approximation, and neologism. Clanging (glossomania) is straightforwardly explainable as distraction by self-monitoring.
Recent research has begun to relate schizophrenia, which is partly genetic, to the genetic endowment that makes human language possible.
☆ This research was funded by GlaxoSmithKline Research & Development Ltd. as part of the project CASPR (Computer Analysis of Speech for Psychiatric Research), Michael A. Covington, principal investigator. We thank Willem J. Riedel of GlaxoSmithKline for helpful discussions.
1 Now at Department of Experimental Psychology, Cambridge University, Cambridge CB2 3EB, UK.
2 Now at Sandia National Laboratories, P.O. Box 5800, Albuquerque, NM 87185-1188, USA.