Multimodal assessment of communicative-pragmatic features in schizophrenia: a machine learning approach

Abstract

An impairment in pragmatic communication is a core feature of schizophrenia, often associated with difficulties in social interactions. The pragmatic deficits regard various pragmatic phenomena, e.g., direct and indirect communicative acts, deceit, irony, and include not only the use of language but also other expressive means such as non-verbal/extralinguistic modalities, e.g., gestures and body movements, and paralinguistic cues, e.g., prosody and tone of voice. The present paper focuses on the identification of those pragmatic features, i.e., communicative phenomena and expressive modalities, that more reliably discriminate between individuals with schizophrenia and healthy controls. We performed a multimodal assessment of communicative-pragmatic ability, and applied a machine learning approach, specifically a Decision Tree model, with the aim of identifying the pragmatic features that best separate the data into the two groups, i.e., individuals with schizophrenia and healthy controls, and represent their configuration. The results indicated good overall performance of the Decision Tree model, with mean Accuracy of 82%, Sensitivity of 76%, and Precision of 91%. Linguistic irony emerged as the most relevant pragmatic phenomenon in distinguishing between the two groups, followed by violation of the Gricean maxims, and then extralinguistic deceitful and sincere communicative acts. The results are discussed in light of the pragmatic theoretical literature, and their clinical relevance in terms of content and design of both assessment and rehabilitative training.

Efforts for the Correct Comprehension of Deceitful and Ironic Communicative Intentions in Schizophrenia: A Functional Magnetic Resonance Imaging Study on the Role of the Left Middle Temporal Gyrus

“…At a behavioral level, patients showed more difficulty than HC under all three experimental conditions, especially in irony understanding. This result is in accordance with previous pragmatic studies carried out on subjects with SZ ( Brüne and Bodenstein, 2005 ; Mazza et al, 2008 ; Colle et al, 2013 ; Bambini et al, 2016 ; Bosco et al, 2019 ; Parola et al, 2021b ). Moreover, we found that both patients and HC demonstrated greater difficulties in the correct comprehension of deceptive and ironic experimental conditions compared to the sincere one.…”

“…Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia (SZ) ( Fett et al, 2011 ; Javed and Charles, 2018 ; Green et al, 2019 ). In particular, patients suffering from SZ have shown a wide range of deficits in the communicative-pragmatic domain, characterized by a severe impairment of the comprehension of the speaker’s communicative intention in everyday conversational interactions ( Brüne and Bodenstein, 2005 ; Mazza et al, 2008 ; Colle et al, 2013 ; Bambini et al, 2016 ; Bosco and Parola, 2017 ; Bosco et al, 2019 ; Parola et al, 2018 , 2021a , 2021b ; Pawełczyk et al, 2018 ). Communicative-pragmatics, i.e., the ability to use language to convey meaning in a specific context ( Levinson, 1983 ), is linked to the Theory of Mind (ToM), i.e., the ability to attribute mental states to oneself and others, however, these two abilities do not completely overlap ( Bambini et al, 2016 ; Bosco et al, 2018 , 2019 ; Parola et al, 2018 ).…”

A cross-sectional study to assess pragmatic strengths and weaknesses in healthy ageing

“…The ABaCo is made up of five different evaluation scales-linguistic, extralinguistic, paralinguistic, context, and conversationalinvestigating participants' communicative-pragmatic ability. The ABaCo has shown in previous research to be a valid tool for investigating communicative-pragmatic ability in patients with traumatic brain injury [54][55][56][57][58][59], schizophrenia [60][61][62][63][64][65], left and right acquired brain lesions [66,67]. We expected to observe age-related differences on the pragmatic performance on the ABaCo in the three groups of participants, from the oldest (poorest performance) to the youngest group (best performance).…”

An eye-tracking investigation of the cognitive processes involved in the comprehension of simple and complex communicative acts

“…This definition is more encompassing than the previous distinction between direct and indirect speech acts proposed by the SPM (Searle, 1975). This distinction has proven particularly useful for studying how pragmatic performance can vary as a function of increasing inferential complexity in clinical populations, such as those with traumatic brain injury (Bosco, Parola & Sacco et al, 2017), schizophrenia (Bosco et al, 2019; Parola et al, 2018), right (Parola et al, 2016) and left (Gabbatore et al, 2014) hemisphere damage, and also for assessing the comprehension of different communicative phenomena and expressive modalities in these populations (Bosco, Gabbatore, et al, 2018; Bosco, Parola, et al, 2018; Parola, Brasso, et al, 2021; Parola et al, 2020; Parola, Gabbatore, et al, 2021). This study provides additional support for this distinction and its utility, for example, in the clinical assessment of communicative-pragmatic deficits (see Angeleri et al, 2008; Bosco, Parola et al, 2018).…”