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Language Therapy for Schizophrenic Patients with Persistent ‘Voices’

Published online by Cambridge University Press:  02 January 2018

Sally L. Satel
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, USA

Abstract

One of us has hypothesised that the ‘voices' of schizophrenic patients reflect altered preconscious planning of discourse that can produce involuntary ‘inner speech’ as well as incoherent overt speech. Some schizophrenic patients reporting voices do not, however, have disorganised speech. We hypothesise that these ‘counterexample’ patients compensate for impairments of discourse planning by reducing language complexity and relying on highly rehearsed topics. A ‘language therapy’ designed to challenge and enhance novel discourse planning was administered to four such patients; three had significant albeit temporary reductions in the severity of their voices. These clinical findings provide further evidence that alterations of discourse planning may underlie hallucinated voices.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Allen, H. (1986) A three-component analysis of Hoffman's model of verbal hallucinations. Behavioral and Brain Sciences, 9, 518519.CrossRefGoogle Scholar
Allen, H., Halperin, J. & Friend, R. (1985) Removal and diversion tactics and the control of auditory hallucinations. Behavioral Research and Therapy, 23, 601605.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1979) Thought, language and communication disorders: 1. Clinical assessment, definition of terms and evaluation of reliability. Archives of General Psychiatry, 36, 13151330.CrossRefGoogle Scholar
Chapey, R. (1981) Language Intervention Strategies in Adult Aphasia. Baltimore: Williams & Wilkins.Google Scholar
Dennett, D. C. (1991) Consciousness Explained. Boston: Little, Brown & Company.Google Scholar
Deese, J. (1978) Thought into speech. American Scientist, 66, 314321.Google ScholarPubMed
Faber, R. (1986) The diversity of the schizophrenias. Behavioral and Brain Sciences, 9, 522.CrossRefGoogle Scholar
Frith, C. D. & Done, D. J. (1988) Towards a neuropsychology of schizophrenia. British Journal of Psychiatry, 153, 437443.CrossRefGoogle ScholarPubMed
Harrow, M. & Miller, J. (1980) Schizophrenic thought disorders and impaired perspective. Journal of Abnormal Psychology, 89, 717727.CrossRefGoogle ScholarPubMed
Hoffman, R. E. (1986) Verbal hallucinations and language production processes in schizophrenia. Behavioral and Brain Sciences, 9, 503548.CrossRefGoogle Scholar
Hoffman, R. E. (1991) The Duphar lecture: on the etiology of alien, nonself attributes of schizophrenic ‘voices’. Psychopathology, 24, 335343.CrossRefGoogle ScholarPubMed
Hoffman, R. E., Kirstein, L., Stopek, S., et al (1982) Apprehending schizophrenic discourse: a structural analysis of the listener's task. Brain and Language, 15, 207233.CrossRefGoogle ScholarPubMed
Hoffman, R. E., Stopek, S. & Andreasen, N. (1986) A discourse analysis comparing manic versus schizophrenic speech disorganization. Archives of General Psychiatry, 43, 831838.CrossRefGoogle Scholar
Satel, S. L. & Sledge, W. H. (1989) Audiotape playback as a technique in the treatment of schizophrenic patients. American Journal of Psychiatry, 146, 10121016.Google ScholarPubMed
Schank, R. C. (1990) Tell Me a Story: A New Look at Real and Artificial Memory. New York: Charles Scribner's Sons.Google Scholar
Slade, P. (1993) Models of hallucinations: from theory to practice. In Neuropsychology and Schizophrenia (eds David, A. & Cutting, J.). New York: Erlbaum.Google Scholar
Vygotsky, L. S. (1978) Mind in Society: The Development of Higher Psychological Processes. Cambridge, MA: Harvard University Press.Google Scholar
Wechsler, D. (1945) A standardized memory scale for clinical use. Journal of Psychology, 19, 8795.CrossRefGoogle Scholar
Wood, F. B. & Flowers, D. L. (1990) Hypofrontal v. hypo-sylvian blood flow in schizophrenia. Schizophrenia Bulletin, 16, 413424.CrossRefGoogle Scholar
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