نقص های مهارت های اجتماعی در اختلال شخصیت
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|38320||2000||10 صفحه PDF||سفارش دهید||5023 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Psychiatry Research, Volume 93, Issue 3, 10 April 2000, Pages 237–246
Abstract Evidence of long-standing social difficulties has been well documented in persons with schizophrenia. These deficits are often so rudimentary that a person with schizophrenia may never have developed the skills necessary to present as socially competent. Given the cognitive, biological, and neuroanatomical links between schizophrenia and schizotypal personality disorder (SPD), a study of social skills in persons with SPD may reveal a behavioral link. This study examined persons with SPD and their ability to label emotions in a recognition task, to display socially competent behaviors in a social role-play task, and to select appropriate behaviors from a multiple choice measure of social behavior. Results indicated that the performance of persons with SPD was similar to previously published findings in persons with schizophrenia. In terms of emotion recognition, the SPD group’s ability to label positive emotions was significantly worse than their ability to label other emotions. Persons with SPD performed significantly worse than matched control participants on a social role-play task. However, the groups were equivalent in their ability to select socially appropriate behavior from a multiple choice measure. These results suggest that persons with SPD display social skills which mirror those previously reported in persons with schizophrenia.
1. Introduction There is an emerging hypothesis that schizophrenia spectrum disorders are neuroanatomically, biochemically, and cognitively related and it is hypothesized that these disorders may represent different but related points along a continuum of which schizophrenia is the final and most severe endpoint. This spectrum of disorders includes those individuals who are biologically/genetically at risk for psychosis or schizotaxia (as termed by Meehl, 1962 and Meehl, 1989), persons with schizotypal personality disorder (SPD), and persons with schizophrenia. Multiple areas of research have suggested that persons with SPD show a range of deficits that have been previously identified in schizophrenia. Similarities have been reported in cognitive functioning with both groups demonstrating information-processing deficits (Braff, 1981) and attentional deficits (Trestman et al., 1995). An additional similarity reported is that both persons with schizophrenia and persons with SPD have been shown to exhibit eye-tracking deficits (Siever et al., 1994). In terms of biological links between SPD and schizophrenia, research has shown that persons with SPD demonstrated elevations in CSF homovanillic acid (Siever et al., 1993) and similar levels of platelet MAO in blood samples (Rogeness et al., 1985) to persons with schizophrenia. Even similar brain structural abnormalities have been suggested, including lateral ventricular enlargement (Siever et al., 1995) and, most recently, temporal lobe gray matter reduction (Dickey et al., 1999). These consistent findings of cognitive, neuroanatomical, and biological links, together with the suggestion of a genetic link as SPD tends to run in families and is more prevalent among first degree relatives of persons with schizophrenia (Lowing et al., 1983, Kendler and Gruenberg, 1984, Baron et al., 1985, Gershon et al., 1988, Schulz et al., 1989 and Kendler et al., 1993), support research examining possible areas of overlap. This study focuses on an additional area of overlap, namely a behavioral relationship in terms of social skills. Research in the area of schizophrenia and social skills has proliferated in the last several decades. Areas of focus have been the difficulties experienced by patients with schizophrenia in behaving appropriately in social situations (Bellack et al., 1992, Bellack et al., 1994 and Corrigan and Holmes, 1994); their inability to recognize behavior as appropriate or inappropriate (Monti and Fingeret, 1987 and Carini and Nevid, 1992); their inability to determine the emotional content of social situations (Morrison and Bellack, 1987 and Morrison et al., 1988a); their inability to decode social cues in their environment (Schwartz-Place and Gilmore, 1980 and Frith et al., 1983); their inability to recognize expressions of facial affect (Cutting, 1981, Novic et al., 1984 and Burch, 1995), particularly positive emotions (Walker et al., 1980); and their ability to recognize inappropriate behavior in others, but not in themselves (Carini and Nevid, 1992). The general consensus of this research has been that persons with schizophrenia, as compared to normal control subjects, are impaired on most measures of social competence. Limited research has been conducted with persons with SPD; however a recent study conducted by Mikhailova et al. (1996) found that persons with SPD exhibited mild deficits in the recognition of facial expressions as compared to healthy control subjects. They suggested that a similar pattern of social skills deficits as seen in persons with schizophrenia might be observed in persons with SPD. Given the suggestion of Mikhailova et al. (1996) and previous research demonstrating cognitive, biological, and neuroanatomical similarities, this study examined social skills in persons with SPD to determine if a similar pattern of social performance to that observed in persons with schizophrenia could be seen in persons with SPD. We examined persons with SPD on three measures, namely, a social role-play task (Goldsmith and McFall, 1975), an emotion-recognition task (Izard, 1971), and a measure of social appropriateness (Curran, 1982). Tests of social behavior and emotion recognition were selected as these areas have received a great deal of attention in the literature studying the social skills of persons with schizophrenia and it was thought that these areas should be tapped in persons with SPD. Given the hypothesized relationship between SPD and schizophrenia (Braff, 1981, Lowing et al., 1983, Kendler and Gruenberg, 1984, Baron et al., 1985, Rogeness et al., 1985, Gershon et al., 1988, Schulz et al., 1989, Kendler et al., 1993, Siever et al., 1993, Siever et al., 1994, Siever et al., 1995, Trestman et al., 1995 and Dickey et al., 1999) and based upon the work of previous researchers in the area of social skills (Schwartz-Place and Gilmore, 1980, Walker et al., 1980, Cutting, 1981, Frith et al., 1983, Novic et al., 1984, Monti and Fingeret, 1987, Morrison and Bellack, 1987, Morrison et al., 1988a, Bellack et al., 1992, Bellack et al., 1994, Corrigan and Holmes, 1994 and Burch, 1995), it was hypothesized that persons with SPD would perform significantly worse than control participants on measures of social skills in much the same manner as reported in persons with schizophrenia. Specifically, participants with SPD were hypothesized to demonstrate poorer performance on the social role-play task as compared to normal control participants and were hypothesized to perform significantly worse than normal control participants on the emotion-recognition task, displaying particular deficits decoding positive emotional expressions. This hypothesis is based largely on the work of Walker et al. (1980) who demonstrated this pattern in persons with schizophrenia. Finally, previous research has demonstrated that persons with schizophrenia retain the ability to appropriately label the behavior of others despite an inability to assess the appropriateness of their own behavior (Carini and Nevid, 1992). As such, it was predicted that both the SPD group and the control group would perform comparably on a measure of selecting appropriate social behavior. Given a choice, as the selected behavior is unrelated to the participants’ own behavior, there was predicted to be no difference in the participants’ abilities to accurately assess the appropriateness of the behavior.
نتیجه گیری انگلیسی
3. Results The experimental (n=24) and control (n=24) groups did not significantly differ in age [t(46)=1.76, P=0.085], education [t(46)=1.60, P=0.117], or gender (both groups had 12 males and 12 females). The participants’ social skill scores from the role-play task and the facial recognition measure were analyzed using a multivariate analysis of variance (MANOVA). This analysis revealed a significant multivariate main effect of participant group (F1,46=3.23; P<0.05). Post hoc analysis (alpha corrected for family-wise error was P<0.025) revealed significant between-group differences for the role-play task, revealing the SPD group's performance to be significantly worse than that of the control group [t(46)=−3.07, P<0.01] ( Table 1). As hypothesized, the SPD group responded with fewer socially appropriate responses than did the control group. Table 1. Statistical analysis (t-test comparison) of schizotypal (n=24) and control (n=24) participants’ performance on social skill measures Schizotypal group Control group t(d.f.) P Mean S.D. Mean S.D. Goldsmith and McFall's Social Interaction Test 25.63 6.16 30.92 5.79 −3.07(46) 0.004 Izard's Emotion Recognition Test 18.67 5.02 20.54 3.80 −1.46(46) 0.151 Multiple Choice Version of Simulated Social Interaction Test 5.83 1.09 6.20 1.10 −1.18(46) 0.242 Table options To examine the interaction of group by the ability to identify positive and negative emotions, multivariate analysis was conducted. The results of this analysis revealed no interaction of group by positive versus negative emotion; however, it did reveal a significant effect for emotion (F1,46=6.58; P<0.01). Given this lack of interaction, but a significant effect for emotion recognition, exploratory within-group comparisons were conducted. These analyses revealed the SPD group to be significantly less accurate at identifying negative emotions (mean=0.49, S.D.=0.17) as compared to positive emotions (mean=0.73, S.D.=0.18) [t(23)=−8.51, P<0.001; Fig. 1) during the emotion-recognition task. No significant differences were noted within the control group in terms of the ability to recognize positive as compared to negative emotions. Comparison of mean positive and negative emotions performance with standard ... Fig. 1. Comparison of mean positive and negative emotions performance with standard deviation bars of schizotypal (n=24) and control (n=24) participants on the Izard Emotion Recognition Test. Figure options Post hoc analyses looked at the eight categories of emotions individually (Table 2). Although it was expected that the groups would be distinguished by emotional category, analyses revealed this was not the case with this sample. Significant differences were found only within the positive emotions of joy and surprise. In both these emotional categories, the SPD group performed significantly less accurately compared to the control group [joy t(46)=−2.75, P<0.01; surprise t(46)=−2.01, P<0.05]. Table 2. Statistical analysis (t-test comparison) of schizotypal (n=24) and control (n=24) participants' performance on emotion recognition task by emotional category a Schizotypal group Control group t(d.f.) P Mean S.D. Mean S.D. Positive emotions Interest 2.08 1.21 2.25 1.23 −0.47(46) 0.638 Joy 3.38 0.82 3.88 0.34 −2.75(46) 0.01* Surprise 3.33 0.87 3.75 0.53 −2.01(46) 0.05* Negative emotions Anger 2.88 0.99 3.25 0.90 −1.37(46) 0.273 Contempt 1.71 1.30 1.17 1.09 1.56(46) 0.125 Disgust 1.96 1.20 2.58 1.10 −1.88(46) 0.066 Fear 2.17 1.00 2.33 0.96 −0.59(46) 0.561 Shame 1.17 1.09 1.25 1.11 −0.26(46) 0.794 a Range for all variables is 1–4. *Denotes statistical significance. Table options In terms of the participants’ ability to select appropriate behavior given a choice (SSIT), as predicted, t-test analyses revealed no significant differences. As this test had the potential of eight correct answers, the SPD group identified the most socially appropriate behavior an average of 5.83 times (S.D.=1.0) and the control group an average of 6.21 times (S.D.=1.1) ( Table 1).