Remediation of context-processing deficits in schizophrenia: preliminary data with ambiguous sentences

Abstract

Chrystel Besche-Richard,1,2 Sarah Terrien,1 Marion Lesgourgues,3,4 Célia Béchiri-Payet,5 Fabien Gierski,1,3 Frédéric Limosin6–8 1Laboratory Cognition, Santé, Socialisation, University of Reims Champagne-Ardenne, France; 2Institut Universitaire de France, Paris, France; 3Centre Hospitalier Universitaire, Pôle de Psychiatrie des Adultes, Reims, France; 4Service Universitaire de Médecine Préventive et de Promotion de la Santé, University of Reims Champagne-Ardenne, Reims, France; 5Etablissement Public de Santé mentale départemental de l’Aisne, Prémontré, France; 6Department of Adult and Geriatric Psychiatry, Hôpitaux Universitaires Paris, Ouest (Assistance publique-Hôpitaux de Paris), Hôpital Corentin-Celton, Issy-les-Moulineaux, France; 7Faculty of Medicine, University Paris Descartes, Sorbonne Paris Cité, Paris, France; 8Psychiatry and Neurosciences Center, French National Institute of Health and Medical Research, Institut National de la Santé et de la Recherche Médicale U894, Paris, France Background: Processing of contextual information is essential for the establishment of good interpersonal relations and communicational interactions. Nevertheless, it is known that schizophrenic patients present impairments in the processing of contextual information. The aim of this study is to explore the influence of the remediation of context processing in schizophrenic patients. Methods: Thirty-one schizophrenic patients and 28 matched healthy participants were included in this study. All participants were assessed on verbal knowledge (Mill-Hill test) and depression intensity (Beck Depression Scale 21 items). Schizophrenic patients were also assessed on thought, language, and communication disorders (Thought, Language and Communication scale). All participants completed a disambiguation task with two different levels of contextualization (high or low context) and a context-processing remediation task containing social scenarios that included ambiguous words and were presented with two different types of instruction: with or without context explanation. Results: For the disambiguation task, results showed no effect of group, but a main effect of context, with better performances in the high-context than the low-context condition. For the context-processing remediation task, results showed a main effect of group: The performance of schizophrenic patients who had received explanations differed from that both of healthy participants and of schizophrenic patients who had not received explanations. Conclusion: This study revealed that for all participants, the structuring of context had a positive effect on the contextual integration of ambiguous words. Concerning the remediation task, explanations about the strategies that could be used to take context into account improved the schizophrenic patients’ performances. This allows us to consider new methods of remediation that could improve social interaction in schizophrenia. Keywords: schizophrenia, context information, remediation, semantic, subordinate meaning