Madness Explained

by Richard P. Bental

  20. A. Shimkunas (1972) ‘Demand for intimate self-disclosure and pathological verbalizations in schizophrenia’, Journal of Abnormal Psychology, 80: 197–205.

  21. G. Haddock, M. Wolfenden, I. Lowens, N. Tarrier and R. P. Bentall (1995) ‘The effect of emotional salience on the thought disorder of patients with a diagnosis of schizophrenia’, British Journal of Psychiatry, 167: 618–20.

  22. N. M. Docherty, I. M. Evans, W. H. Sledge, J. P. Seibyl and J. H. Krystal (1994) ‘Affective reactivity of language in schizophrenia’, Journal of Nervous and Mental Disease, 182: 98–102; N. M. Docherty and A. S. Hebert (1997) ‘Comparative affective reactivity of different types of communication disturbances in schizophrenia’, Journal of Abnormal Psychology, 106: 325–30.

  23. S. Tai, G. Haddock and R. P. Bentall (in submission) ‘The effects of emotional salience on thought disorder in patients with bipolar affective disorder’.

  24. W. M. Grove and N. C. Andreasen (1985) ‘Language and thinking in psychosis’, Archives of General Psychiatry, 42: 26–32.

  25. M. Harrow and J. G. Miller (1980) ‘Schizophrenic thought disorders and impaired perspective’, Journal of Abnormal Psychology, 89: 717–27.

  26. Rochester and Martin, Crazy Talk, op. cit.

  27. B. A. Maher, K. O. McKean and B. McLaughlin (1966) ‘Studies in psychotic language’, in P. J. Stone, R. F. Bales, Z. Namenworth and D. M. Ogilvie (eds.), The General Inquirer: A Computer Approach to Content Analysis. Cambridge, MA: MIT Press.

  28. Quoted in Rochester and Martin, Crazy Talk, op. cit.

  29. P. D. Harvey and J. M. Neale (1983) ‘The specificity of thought disorder to schizophrenia: research methods in their historical perspective’, in B. A. Maher and W. B. Maher (eds.), Progress in Experimental Personality Research. New York: Academic Press.

  30. T. Wykes and J. Leff (1982) ‘Disordered speech: differences between manics and schizophrenics’, Brain and Language, 15: 117–24.

  31. P. D. Harvey (1983) ‘Speech competence in manic and schizophrenic psychosis: the association between clinically rated thought disorder and cohesion and reference performance’, Journal of Abnormal Psychology, 92: 368–77. For similar findings, see: A. B. Ragin and T. F. Oltmanns (1986) ‘Lexical cohesion and formal thought disorder during and after psychotic episodes’, Journal of Abnormal Psychology, 95: 181–3.

  32. Elaine Chaika of Providence College in Rhode Island (Understanding Psychotic Speech: Beyond Freud and Chomsky. Springfield, IL: Charles C. Thomas, 1990; see also ‘On analysing psychotic speech: what model should we use?’, in A. Sims (ed.) (1995) Speech and Language Disorders in Psychiatry. London: Gaskell) has questioned aspects of Halliday and Hasan’s theory of cohesion, arguing that some speech can have ample cohesive ties but still remain incoherent. An example of such speech from a schizophrenia patient she studied was as follows:

  Her parents that she’s so proud of she goes out, leaves the ice cream and eats it and on the way and we don’t know what happens the fact. You can interpolate and say that she ate the ice cream and brought it home.

  In her own research, Chaika asked schizophrenia patients and ordinary people to watch and then talk about a short film, ‘The Ice Cream Stories’, concerning a young girl who is refused cash for ice cream from her mother but who manages to persuade her father to supply the necessary money. Using an analysis similar to that employed by Rochester and Martin, she found no evidence of abnormal cohesive ties, although there was evidence of excessive exophoria.

  Chaika’s findings certainly did not imply that the speech of thought-disordered patients is normal. They often had difficulty constructing narratives that followed the temporal ordering of the events in the story. When the normal participants misperceived some aspect of the story, their misperception generally fitted in with the story line (for example, they mistook the flavour of the ice cream bought by the girl) whereas the misperceptions of the schizophrenia patients sometimes deviated from the story line significantly (for example, one patient reported that the girl in the story moved a shop counter rather than leaned against it). Sometimes the schizophrenia patients veered off the story line and never returned to it.

  33. N. M. Docherty, M. DeRosa and N. C. Andreasen (1996) ‘Communication disturbances in schizophrenia and mania’, Archives of General Psychiatry, 53: 358–64.

  34. Docherty and Hebert, ‘Comparative affective reactivity’, op. cit.

  35. R. E. Hoffman, L. Kirstein, S. Stopek and D. V. Cicchetti (1982) ‘Apprehending schizophrenic discourse: a structural analysis of the listener’s task’, Brain and Language, 15: 207–33.

  36. R. E. Hoffman, S. Stopek and N. C. Andreasen (1986) ‘A comparative study of manic vsschizophrenic speech disorganization’, Archives of General Psychiatry, 43: 831–5.

  37. A. W. Beveridge and K. Brown (1985) ‘A critique of Hoffman’s analysis of schizophrenic speech’, Brain and Language, 24: 174–81.

  38. D. M. Barch and H. Berenbaum (1996) ‘Language production and thought disorder in schizophrenia’, Journal of Abnormal Psychology, 105: 81–8.

  39. Chaika, ‘On analysing psychotic speech’, op. cit.

  40. P. D. Harvey (1985) ‘Reality monitoring in mania and schizophrenia: the association between thought disorder and performance’, Journal of Abnormal Psychology, 92: 368–77; P. D. Harvey (1988) ‘Cognitive deficits and thought disorder: a retest study’, Schizophrenia Bulletin, 14: 57–66; P. D. Harvey and M. Serper (1990) ‘Linguistic and cognitive failures in schizophrenia: a multivariate analysis’, Journal of Nervous and Mental Disease, 178: 487–94.

  41. Y. Sarfati, M. C. Hardy-Bayle, C. Besche and D. Widlocher (1997) ‘Attributions of intentions to others in people with schizophrenia: a nonverbal exploration with comic strips’, Schizophrenia Research, 25: 199–209; Y. Sarfati and M. C. Hardy-Bayle (1999) ‘How do people with schizophrenia explain the behaviour of others? A study of theory of mind and its relationship to thought and speech disorganization inschizophrenia’, Psychological Medicine, 29: 613–20;Y. Sarfati, M. C. Hardy-Bayle, E. Brunet and D. Widlocher (1999) ‘Investigating theory of mind in schizophrenia: influence of verbalization in disorganized and non-disorganized patients’, Schizophrenia Research, 37: 183–90; Y. Sarfati, C. Passerieux and M. C. Hardy-Bayle (2000) ‘Can verbalization remedy the theory of mind deficit in schizophrenia?’ Psychopathology, 33: 246–51; Y. H. B. Sarfati, J. Nadel, J. F. Chevalier and D. Widlocher (1997) ‘Attribution of mental states to others by schizophrenic patients,’ Cognitive Neuropsychiatry, 2: 1–17.

  42. T. F. Oltmanns and J. M. Neale (1978) ‘Distractability in relation to other aspects of schizophrenic disorder’, in S. Schwartz (ed.), Language and Cognition in Schizophrenia. Hillsdale, NJ. Erlbaum.

  43. See, for example, P. D. Harvey, E. A. Earle-Boyer and J. C. Levinson (1986) ‘Distractability and discourse failure: their association in mania and schizophrenia’, Journal of Nervous and Mental Disease, 174: 274–9.

  44. D. Barch and H. Berenbaum (1994) ‘The relationship between information processing and language production’, Journal of Abnormal Psychology, 103: 241–50.

  45. C. M. Adler, T. E. Goldberg, A. K. Malhotra, D. Pickar and A. Breier (1998) ‘Effects of ketamine on thought disorder, working memory, and semantic memory in healthy volunteers’, Biological Psychiatry, 43: 811–16.

  46. T. E. Goldberg and D. R. Weinberger (2000) ‘Thought disorder in schizophrenia: a reappraisal of older formulations and an overview of some recent studies’, Cognitive Neuropsychiatry, 5: 1–19.

  47. For a discussion of these effects and their relevance to psychiatric disorders, see: E. Chen, P. McKenna and A. Wilkins (1995) ‘Semantic processing and categorisation in schizophrenia’, in A. Sims (ed.), Speech and Language Disorders in Psychiatry. London: Gaskell; and M. Spitzer (1997) ‘A cognitive neuroscience view of schizophrenic thought disorder’, Schizophrenia Bulletin, 23: 29–50.

  48. See, for example: L. Clare, P. J. McKenna, A. M. Mortimer and A. D. Baddeley (1993) ‘Memory in schizophrenia: what is
impaired and what is preserved?’ Neuropsychologia, 31: 1225–41; and P. J. McKenna, A. M. Mortimer and J. R. Hodges (1994) ‘Semantic memory and schizophrenia’, in A. S. David and J. C. Cutting (eds.), The Neuropsychology of Schizophrenia. Hove: Erlbaum.

  49. Spitzer, ‘A cognitive neuroscience view’, op. cit.

  50. T. E. Goldberg, M. Aloia, M. L. Gourovitch, D. Missar, D. Pickar and D. R. Weinberger (1998) ‘Cognitive substrates of thought disorder, I: The semantic system’, American Journal of Psychiatry, 155: 1671–6.

  51. Goldberg and Weinberger, ‘Thought disorder in schizophrenia’, op. cit.

  52. B. A. Maher, T. C. Manschreck, T. M. Hoover and C. C. Weisstein (1987) ‘Thought disorder and measured features of language production in schizophrenia’, in P. D. Harvey and E. Walker (eds.), Positive and Negative Symptoms in Psychosis: Description, Research and Future Directions. Hillsdale, NJ: Erlbaum; T. C. Manschreck, B. A. Maher, J. J. Milavetz, D. Ames, C. C. Weisstein and M. L. Schneyer (1988) ‘Semantic priming in thought disordered schizophrenic patients’, Schizophrenia Research, 1: 61–6.

  53. Spitzer, ‘A cognitive neuroscience view’, op. cit.

  54. M. Spitzer, U. Braun, L. Hermie and S. Maier (1993) ‘Associative semantic network dysfunction in thought disordered schizophrenic patients’, Biological Psychiatry, 34: 864–77.

  55. M. Aloia, M. L. Gourovitch, D. Missar, D. Pickar, D. R. Weinberger and T. E. Goldberg (1998) ‘Cognitive substrates of thought disorder, II: specifying a candidate cognitive mechanism’, American Journal of Psychiatry, 155: 1677–84. See also D. M. Barch, J. D. Cohen, D. Servan-Schreiber, S. Steingard, S. Steinhauer and D.P.van Kammen (1996) ‘Semantic priming in schizophrenia: anexamination of spreading activation using word pronounciation and multiple SOAs’, Journal of Abnormal Psychology, 105: 592–601.

  56. D. M. Barch and H. Berenbaum (1996) ‘Language production and thought disorder in schizophrenia’, Journal of Abnormal Psychology, 105: 81–8.

  57. Grossman and Harrow, ‘Thought disorder and cognitive processes in mania’, op. cit.

  Chapter 16 Things are Much More Complex than they Seem

  1. J. B. S. Haldane (1923) Daedalus, or Science and the Future. London: Kegan Paul.

  2. R. Mojtabai and R. O. Rieder (1998) ‘Limitations of the symptom-orientated approach to psychiatric research’, British Journal of Psychiatry, 173: 198–202.

  3. See, for example, his comments about delusions in G. E. Berrios (1991) ‘Delusions as “wrong beliefs”: a conceptual history’, British Journal of Psychiatry, 159: 6–13.

  4. T. Honderich (1993) How Free are You?: The Determinism Problem. Oxford: Oxford University Press.

  5. R. Warner (1985) Recovery from Schizophrenia: Psychiatry and Political Economy. New York: Routledge & Kegan Paul.

  6. P. Sturmey (1996) Functional Analysis in Clinical Psychology. Chichester: Wiley.

  7. B. A. Maher (1974) ‘Delusional thinking and perceptual disorder’, Journal of Individual Psychology, 30: 98–113.

  8. S. Escher, M. Romme, A. Buiks, P. Delespaul and J. van Os (2002) ‘Formation of delusional ideationinadolescents hearing voices: a prospective study’, American Journal of Medical Genetics (Neuropsychiatric Genetics), 114: 913–20.

  9. G. Haddock, P. D. Slade and R. P. Bentall (1995) ‘Auditory hallucinations and the verbal transformation effect: the role of suggestions’, Personality and Individual Differences, 19: 301–6; S. Mintz and M. Alpert (1972) ‘Imagery vividness, reality testing and schizophrenic hallucinations’, Journal of Abnormal and Social Psychology, 19: 310–16; H. F. Young, R. P. Bentall, P. D. Slade and M. E. Dewey (1987) ‘The role of brief instructions and suggestibility in the elicitation of hallucinations in normal and psychiatric subjects’, Journal of Nervous and Mental Disease, 175: 41–8.

  10. M. Birchwood, Z. Iqbal, P. Chadwick and P. Trower (2000) ‘Cognitive approach to depression and suicidal thinking in psychosis: 1. Ontogeny of post-psychotic depression’, British Journal of Psychiatry, 177: 516–21.

  11. Z. Iqbal, M. Birchwood, P. Chadwick and P. Trower (2000) ‘Cognitive approach to depression and suicidal thinking in psychosis: 2. Testing the validity of a social rank model’, British Journal of Psychiatry, 177: 522–8.

  12. D. H. Erickson, M. Beiser and W. G. Iacono (1998) ‘Social support predicts 5-year outcome in first-episode schizophrenia’, Journal of Abnormal Psychology, 107: 681–5.

  13. P. Meehl (1962) ‘Schizotaxia, schizotypia, schizophrenia’, American Psychologist, 17: 827–38. See Chapter 5 of this book for more details.

  14. G. S. Claridge (1990) ‘Can a disease model of schizophrenia survive?’, in R. P. Bentall (ed.), Reconstructing Schizophrenia. London: Routledge.

  15. K. H. Nuechterlein and K. L. Subotnik (1998) ‘The cognitive origins of schizophrenia and prospects for intervention’, in T. Wykes, N. Tarrier and S. Lewis (eds.), Outcome and Innovation in Psychological Treatment of Schizophrenia. Chichester: Wiley.

  16. L. Y. Abramson, G. I. Metalsky and L. B. Alloy (1989) ‘Hopelessness depression: a theory-based subtype of depression’, Psychological Review, 96: 358–72; L. Y. Abramson, M. E. P. Seligman and J. D. Teasdale (1978) ‘Learned helplessness in humans: critique and reformulation’, Journal of Abnormal Psychology, 78: 40–74.

  17. M. H. Kernis (1993) ‘The role of stability and level of self-esteem in psychological functioning’, in R. F. Baumeister (ed.), Self-Esteem: The Puzzle of Low Self-Regard. New York: Plenum, pp. 167–82; M. H. Kernis, D. P. Cornell, C. R. Sun, A. Berry and T. Harlow (1993) ‘There’s more to self-esteem than whether it is high or low: the importance of stability of self-esteem’, Journal of Personality and Social Psychology, 65: 1190–204.

  18. K. D. Greenier, M. H. Kernis, C. W. McNamara, S. B. Waschull, A. J. Berry, C. E. Herlocker and T. A. Abend (1999) ‘Individual differences in reactivity to events: re-examining the roles of stability and level of self-esteem’, Journal of Personality, 67: 185–208.

  19. A. Gottschalk, M. S. Bauer and P. C. Whybrow (1995) ‘Evidence of chaotic mood variation in bipolar disorder’, Archives of General Psychiatry, 52: 947–59.

  20. J. Gleick (1988) Chaos: Making a New Science. London: Heinemann.

  21. I. Myin-Germeys, J. van Os, J. E. Schwartz, A. Stone and P. Delespaul (2001) ‘Emotional reactivity to daily stress in psychosis’, Archives of General Psychiatry, 58: 1137–44.

  22. I. Myin-Germeys, L. Krabbendam, J. Jolles, P. A. E. G. Delespaul and J. van Os (2002) ‘Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study’, American Journal of Psychiatry, 159: 443–9.

  23. W. Tschacher (1996) ‘The dynamics of psychosocial crises: time courses and causal models’, Journal of Nervous and Mental Disease, 184: 172–9. See also W. Tschacher, C. Scheier and Y. Hashimoto (1997) ‘Dynamical analysis of schizophrenia courses’, Biological Psychiatry, 41: 428–37.

  24. A. Gumley, C. A. White and K. Power (1999) ‘An interacting cognitive subsystems model of relapse and the course of psychosis’, Clinical Psychology and Psychotherapy, 6: 261–78.

  25. J. A. Smith and N. Tarrier (1992) ‘Prodromal symptoms in manic depressive psychosis’, Social Psychiatry and Psychiatric Epidemiology, 27: 245–8.

  26. M. Birchwood (1996) ‘Early intervention in psychotic relapse: cognitive approaches to detection and management’, in G. Haddock and P. D. Slade (eds.), Cognitive-Behavioural Interventions with Psychotic Disorders. London: Rout-ledge, pp. 171–211.

  27. G. W. Brown (1984) ‘The discovery of expressed emotion: induction or deduction?’, in J. Leff and C. Vaughn (eds.) Expressed Emotion in Families: Its Significance for Mental Health. New York: Guilford, pp. 7–25.

  28. G. W. Brown, M. Carstairs and G. Topping (1958) ‘Post-hospital adjustment of chronic mental patients’, Lancet, ii: 685–9.

  29. G. W. Brown, E. M. Monck, G. M. Carstairs and J. K. Wing (1962) ‘Influence of family life on the course of schizophrenia disorders’, British Journal of Preventative and Social Medicine, 16: 55�
��68.

  30. G. W. Brown and M. Rutter (1966) ‘The measurement of family activities and relationships: a methodological study’, Human Relations, 19: 241–63.

  31. The only widely used alternative to the Camberwell Family Interview is the Five Minute Speech Sample, which (as the name suggests) is based on the analysis of five minutes of speech in which the relative talks about the patient. See A. B. Magana, M. J. Goldstein, M. Karno, D. J. Miklowitz, J. Jenkins and I. R. H. Falloon (1986) ‘A brief method of assessing expressed emotion in relatives of psychiatric patients’, Psychiatry Research, 17: 203–12.

  32. P. E. Bebbington and E. Kuipers (1994) ‘The predictive utility of expressed emotion in schizophrenia’, Psychological Medicine, 24: 707–18. For a more recent meta-analysis that reached essentially the same conclusions, see R. L. Butzlaff and J. M. Hooley (1998) ‘Expressed emotion and psychiatric relapse’, Archives of General Psychiatry, 55: 547–52.