Why Schizophrenics Have Trouble Conversing
Many have no way of knowing whether the person they're talking to is pleased or annoyed
For the more than 2 million Americans who suffer from schizophrenia, the biggest hurdle that comes after their hallucinations, voices, and paranoia have been controlled with medication is the seemingly simple task of conversing. Many have no way of knowing whether the person they're talking to is pleased or annoyed, and a new study reveals why. The condition appears to cause disconnections between nerve cells in the auditory regions of the brain, which prevents the brain from discerning changes in pitch like the deepening of a voice expressing frustration.
In a new study in the American Journal of Psychiatry, researchers tested 19 patients who had been successfully treated for schizophrenia and 19 healthy volunteers on two fronts: first, to see how well they could detect a wrong note in popular tunes, and second, their success at perceiving emotions like anger, sadness, fear, and happiness in recorded voices. The researchers discovered that the schizophrenics were able to identify wrong notes 70 percent of the time and emotions in speech about 40 percent of the time. The control group spotted wrong notes 90 percent of the time; emotions, about 65 percent. MRI scans of both groups revealed that those with the worst abilities to discern tonal changes had the biggest deficit in connections between auditory nerve cells.
"Social interaction depends on being able to read other people's moods and tone of voice," says study coauthor Daniel Javitt, a professor of psychiatry and neuroscience at New York University School of Medicine, "and it's been linked to the ability of those with schizophrenia to live independently or hold a job." In a study published in 2005, he and his colleagues demonstrated that schizophrenics have trouble reading facial expressions because of abnormalities in their brain's visual cortex that prevent them from recognizing, say, the downward sag of a mouth in sadness or the lifting of a forehead in surprise. Other researchers are now conducting studies to see whether musical training can help these patients better distinguish emotional nuances in speech. For now, caregivers can help manage the problem with better communication. "Tell them explicitly how you're feeling rather then having them rely on your tone of voice," advises Javitt. Also, he adds, don't use sarcasm. "That, they completely don't understand."