Narratives of Mandarin-speaking patients with schizophrenia

Schizophrenia is characterized by abnormalities in perception and expression. The traditional view of their disordered speech as a reflection of their disorganized thinking (Bleuler, 1950; Kraepelin, 1919/1992) has been questioned for the reason that language and thought are not in total isomorphic relationship. The disordered speech observed in individuals with schizophrenia could be more than a mere thought disorder or a mere language disorder (Harvey & Neale, 1983; McKenna & Oh, 2005). The present study investigated the narrative ability of Mandarin-speaking patients with schizophrenia. A group of 22 patients with schizophrenia as well as 20 normal controls participated in a story-telling task. Participants were asked to narrate three picture-books and their performance was evaluated by a Mandarin version of Narrative Assessment Profile (Tsou, Chang, & Cheung, 2009), which examines eight dimensions of a narrative: topic maintenance, event sequencing, reasonableness, referential skill, background information, evaluation, conjunctive cohesion, and the overall narrative pattern. Lexical choices of connectives (causal connectives and contrastive connectives) as well as verbal predicates (perceptual verbs, psychological verbs, and mental verbs) were also analyzed. Results showed that participants in the schizophrenic group preserved an intact ability to produce basic elements in narratives, performing comparatively well in dimensions of event sequencing and referential skill. However, their performance in the other six dimensions was significantly weaker than the controls. It is proposed that individuals with schizophrenia display an overall lack of structure in narratives, as reported in previous literature (Chaika & Alexander, 1986; Lysaker et al., 2005). They seemed to have difficulties in coping with the communication needs of their listeners, as revealed by lower scores in reasonableness, background information, and evaluation. Further evidence came from lexical analyses which also showed that the group with schizophrenia used fewer contrastive connectives and mental verbs when telling their stories. Discussions on the implications of these findings are considered.