Understanding the communicative impairments in schizophrenia: A preliminary study

The aim of the present study was to evaluate the pragmatic abilities of patients with schizophrenia in a variety of pragmatic phenomena expressed through different communicative means (language, gestures, and paralinguistic modality). For this purpose we used the Assessment Battery of Communication (ABaCo; Sacco et al., 2008). The ABaCo is a validated clinical tool for assessing pragmatic skills, which comprises five evaluation scales—linguistic, extralinguistic, paralinguistic, context, and conversational—investigating both comprehension and production of the main pragmatic phenomena involved in a communicative exchange, such as direct and indirect speech acts, irony, deceit, the violation of Grice's maxims, topic management, and turn-taking. The battery was administered to a group of seventeen patients with schizophrenia, and matched healthy controls. We expected the clinical group to perform widely worse than the control group in the different pragmatic dimensions investigated. Results showed that patients with schizophrenia performed significantly worse than controls on all the five scales of the battery, both in comprehension and production tasks. Moreover, the results within each scale showed a differentiated performance in the clinical group among the pragmatic phenomena, with irony assessed as the most difficult task. The implications of these results for research and treatment in schizophrenia are discussed.Learning outcomes: After reading this article, the reader will be able to: (1) summarize thepreliminary assessment of pragmatic impairments in patients with schizophrenia; (2) describea variegated communicative profile regarding different pragmatic phenomena; and (3) discuss the planning and evaluating specific rehabilitation programs.

► We assessed different communicative modalities in patients with schizophrenia.
► We tested several pragmatic phenomena in patients with schizophrenia.
► Patients with schizophrenia performed worse than controls in all dimensions.
► Pragmatic impairment in schizophrenia is pervasive and not only linguistic.
► A detailed assessment of pragmatic is crucial for rehabilitation programs.