Psychopathology

Original Paper

Negative Symptoms and Avoidance of Social Interaction: A Study of Non-Verbal Behaviour

Worswick E. · Dimic S. · Wildgrube C. · Priebe S.

Author affiliations

Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK

Keywords: SchizophreniaNon-verbal behaviourCommunicationSocialNegative symptoms

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Psychopathology 2018;51:1–9
https://doi.org/10.1159/000484414

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 18, 2017
Accepted: October 15, 2017
Published online: December 09, 2017
Issue release date: March 2018

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

Abstract

Background: Non-verbal behaviour is fundamental to social interaction. Patients with schizophrenia display an expressivity deficit of non-verbal behaviour, exhibiting behaviour that differs from both healthy subjects and patients with different psychiatric diagnoses. The present study aimed to explore the association between non-verbal behaviour and symptom domains, overcoming methodological shortcomings of previous studies. Sampling and Methods: Standardised interviews with 63 outpatients diagnosed with schizophrenia were videotaped. Symptoms were assessed using the Clinical Assessment Interview for Negative Symptoms (CAINS), the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale. Independent raters later analysed the videos for non-verbal behaviour, using a modified version of the Ethological Coding System for Interviews (ECSI). Results: Patients with a higher level of negative symptoms displayed significantly fewer prosocial (e.g., nodding and smiling), gesture, and displacement behaviours (e.g., fumbling), but significantly more flight behaviours (e.g., looking away, freezing). No gender differences were found, and these associations held true when adjusted for antipsychotic medication dosage. Conclusions: Negative symptoms are associated with both a lower level of actively engaging non-verbal behaviour and an increased active avoidance of social contact. Future research should aim to identify the mechanisms behind flight behaviour, with implications for the development of treatments to improve social functioning.

© 2017 S. Karger AG, Basel



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References

  1. Burgoon J, Guerrero L, Floyd K: Nonverbal Communication. Boston, Allyn & Bacon, 2009.
  2. Tremeau F, Malaspina D, Duval F, Correa H, Hager-Budny M, Coin-Bariou L, et al: Facial expressiveness in patients with schizophrenia compared to depressed patients and nonpatient comparison subjects. Am J Psychiatry 2005;162:92-101.
  3. Troisi A, Spalletta G, Pasini A: Non-verbal behaviour deficits in schizophrenia: an ethological study of drug-free patients. Acta Psychiatr Scand 1998;97:109-115.
  4. Brüne M, Sonntag C, Abdel-Hamid M, Lehmkämper C, Juckel G, Troisi A: Nonverbal behavior during standardized interviews in patients with schizophrenia spectrum disorders. J Nerv Ment Dis 2008;196:282-288.
  5. Steimer-Krause E, Krause R, Wagner G: Interaction regulations used by schizophrenic and psychosomatic patients: studies on facial behavior in dyadic interactions. Psychiatry 1990;53:209-228.
  6. Jones IH, Pansa M: Some nonverbal aspects of depression and schizophrenia occurring during the interview. J Nerv Ment Dis 1979;167:402-409.
  7. Del-Monte J, Raffard S, Salesse RN, Marin L, Schmidt RC, Varlet M, et al: Nonverbal expressive behaviour in schizophrenia and social phobia. Psychiatry Res 2013;210:29-35.
  8. Troisi A, Pompili E, Binello L, Sterpone A: Facial expressivity during the clinical interview as a predictor functional disability in schizophrenia. A pilot study. Prog Neuropsychopharmacology Biol Psychiatry 2007;31:475-481.
  9. Annen S, Roser P, Brüne M: Nonverbal behavior during clinical interviews. J Nerv Ment Dis 2012;200:26-32.
  10. Brüne M, Abdel-Hamid M, Sonntag C, Lehmkämper C, Langdon R: Linking social cognition with social interaction: non-verbal expressivity, social competence and “mentalising” in patients with schizophrenia spectrum disorders. Behav Brain Funct 2009;5:6.
  11. Dimic S, Wildgrube C, McCabe R, Hassan I, Barnes TR, Priebe S: Non-verbal behaviour of patients with schizophrenia in medical consultations - a comparison with depressed patients and association with symptom levels. Psychopathology 2010;43:216-222.
  12. Davison PS, Frith CD, Harrison-Read PE, Johnstone EC: Facial and other non-verbal communicative behaviour in chronic schizophrenia. Psychol Med 1996;26:707-713.
  13. Lavelle M, Healey PGT, McCabe R: Is nonverbal communication disrupted in interactions involving patients with schizophrenia? Schizophr Bull 2013;39:1150-1158.
  14. Troisi A, Pasini A, Bersani G, Di Mauro M, Ciani N: Negative symptoms and visual behavior in DSM-III-R prognostic subtypes of schizophreniform disorder. Acta Psychiatr Scand 1991;83:391-394.
  15. Garcia-Portilla MP, Garcia-Alvarez L, Saiz PA, Al-Halabi S, Bobes-Bascaran MT, Bascaran MT, et al: Psychometric evaluation of the negative syndrome of schizophrenia. Eur Arch Psychiatry Clin Neurosci 2015;265:559-566.
  16. Blanchard JJ, Kring AM, Horan WP, Gur R: Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. Schizophr Bull 2011;37:291-299.
  17. Kirkpatrick B, Fenton WS, Carpenter WT, Marder SR: The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull 2006;32:214-219.
  18. Kring AM, Gur RE, Blanchard JJ, Horan WP, Reise SP: The Clinical Assessment Interview for Negative Symptoms (CAINS): final development and validation. Am J Psychiatry 2013;170:165-172.
  19. Lavelle M, Healey PGT, McCabe R: Nonverbal behavior during face-to-face social interaction in schizophrenia: a review. J Nerv Ment Dis 2014;202:47-54.
  20. Priebe S, Savill M, Reininghaus U, Wykes T, Bentall R, Lauber C, et al: Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia - a multi-centre randomised controlled trial. BMC Psychiatry 2013;13:26.
  21. Priebe S, Savill M, Wykes T, Bentall R, Lauber C, Reininghaus U, et al: Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial. Heal Technol Assess 2016;20:1-100.
  22. Priebe S, Savill M, Wykes T, Bentall RP, Reininghaus U, Lauber C, et al: Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial. Br J Psychiatry 2016;209:54-61.
  23. Troisi A: Ethological research in clinical psychiatry: the study of nonverbal behavior during interviews. Neurosci Biobehav Rev 1999;23:905-913.
  24. Chisholm D, Knapp MR, Knudsen HC, Amaddeo F, Gaite L, van Wijngaarden B: Client Socio-Demographic and Service Receipt Inventory - European Version: development of an instrument for international research. EPSILON Study 5. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. Br J Psychiatry Suppl 2000;39: s28-s33.
  25. Woods S: Chlorpromazine equivalent doses for newer atypical antipsychotics. J Clin Psychiatry 2003;64:663-667.
  26. Patel MX, Arista IA, Taylor M, Barnes TR: How to compare doses of different antipsychotics: a systematic review of methods. Schizophr Res 2013;149:141-148.
  27. Andreasen NC, Pressler M, Nopoulos P, Miller D, Ho B: Antipsychotic dose equivalents and dose-years: a standardized method for comparing exposure to different drugs. Biol Psychiatry 2010;67:255-262.
  28. Lavelle M, Dimic S, Wildgrube C, Mccabe R, Priebe S: Non-verbal communication in meetings of psychiatrists and patients with schizophrenia. Acta Psychiatr Scand 2014;131:197-205.
  29. Kay SR, Fiszbein A OL: The Positive and Negative Syndrome Scale for schizophrenia. Schizophr Bull 1987;13:261-276.
  30. Addington D, Addington J, Maticka-Tyndale E: Assessing depression in schizophrenia: the Calgary Depression Scale. Br J Psychiatry Suppl 1993;163:39-44.
  31. Walther S, Stegmayer K, Sulzbacher J, Vanbellingen T, Müri R, Strik W, et al: Nonverbal social communication and gesture control in schizophrenia. Schizophr Bull 2015;41:338-345.
  32. Kupper Z, Ramseyer F, Hoffmann H, Kalbermatten S, Tschacher W: Video-based quantification of body movement during social interaction indicates the severity of negative symptoms in patients with schizophrenia. Schizophr Res 2010;121:90-100.
  33. Troisi A, Moles A: Gender differences in depression: an ethological study of nonverbal behavior during interviews. J Psychiatr Res 1999;33:243-250.
  34. Trémeau F, Goggin M, Antonius D, Czobor P, Hill V, Citrome L: A new rating scale for negative symptoms: the Motor-Affective-Social Scale. Psychiatry Res 2008;160:346-355.
  35. Kupper Z, Ramseyer F, Hoffmann H, Tschacher W: Nonverbal synchrony in social interactions of patients with schizophrenia indicates socio-communicative deficits. PLoS One 2015;10:e0145882.
  36. Kring AM, Moran EK: Emotional response deficits in schizophrenia: insights from affective science. Schizophr Bull 2008;34:819-834.
  37. Gur RE, Kohler CG, Ragland JD, Siegel SJ, Lesko K, Bilker WB, et al: Flat affect in schizophrenia: relation to emotion processing and neurocognitive measures. Schizophr Bull 2006;32:279-287.
  38. Blanchard JJ, Sayers SL, Collins LM, Bellack AS: Affectivity in the problem-solving interactions of schizophrenia patients and their family members. Schizophr Res 2004;69:105-117.
  39. Mandal MK, Pandey R, Prasad AB: Facial expressions of emotions and schizophrenia: a review. Schizophr Bull 1998;24:399-412.
  40. Kring AM, Alpert M, Neale JM, Harvey PD: A multimethod, multichannel assessment of affective flattening in schizophrenia. Psychiatry Res 1994;54:211-222.
  41. Trémeau F: A review of emotion deficits in schizophrenia. Dialogues Clin Neurosci 2006;8:59-70.
  42. Ciompi L: The key role of emotions in the schizophrenia puzzle. Schizophr Bull 2015;41:318-322.
  43. Pinkham A, Brensinger C, Kohler C, Gur R, Gur R: Actively paranoid patients with schizophrenia over attribute anger to neutral faces. Schizophr Res 2011;125:174-178.
  44. Green MJ, Phillips ML: Social threat perception and the evolution of paranoia. Neurosci Biobehav Rev 2004;28:333-342.
  45. Dixon AK: Ethological strategies for defence in animals and humans: their role in some psychiatric disorders. Br J Med Psychol 1998;71:417-445.
  46. Rohricht F, Papadopoulos N, Suzuki I, Priebe S: Ego-pathology, body experience, and body psychotherapy in chronic schizophrenia. Psychol Psychother 2009;82:19-30.
  47. Jansen LMC, Kahn RS, Gispen-De Wied CC: Selective impairments in the stress response in schizophrenic patients. Psychopharmacology 2000;149:319-325.
  48. Lee SY, Kim KR, Park JY, Park JS, Kim B, Kang JI, et al: Coping strategies and their relationship to psychopathologies in people at ultra high risk for psychosis and with schizophrenia. J Nerv Ment Dis 2011;199:106-110.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 18, 2017
Accepted: October 15, 2017
Published online: December 09, 2017
Issue release date: March 2018

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

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