The Comprehension of Familiar and Novel Metaphoric Meanings in Schizophrenia: A Pilot Study

Abstract

Miscomprehension of nonliteral (“figurative”) language like metaphors, proverbs, idioms, and ironic expressions by patients with schizophrenia is a phenomenon mentioned already in historical psychiatric descriptions. However, it was only recently that studies did differentiate between novel and conventional metaphors, a factor that is known to influence the difficulty of comprehension in healthy subjects. Further, familiarity with stimuli is an important factor for comprehension, which was not recommended in utmost previous studies. In this study, 23 patients with DSM IV schizophrenia and 19 healthy control subjects performed a newly-developed German metaphor comprehension test with three types of stimuli: novel metaphors, conventional German metaphors, and meaningless statements. During the test procedure, participants indicated familiarity with the stimulus and then matched the meaning with one out of four given alternatives. Familiarity rankings did not significantly differ between patients and control subjects. However, on descriptive level, there was a tendency for healthy controls to be more familiar with conventional metaphors than schizophrenic patients. Further, comprehension of conventional and novel metaphors differed significantly between the groups, with higher performance in healthy controls. Considering only those metaphors that had been ranked as familiar, patients only revealed significant lower performance opposed to controls regarding novel metaphors, while they did not differ in conventional metaphors. Taken together, the results indicate that patients with schizophrenia might show an altered way of comprehension in novel metaphors, leading to more misunderstandings. However, their previously reported impairments in conventional metaphors might rather be due to a lack of familiarity with the stimuli—making conventional metaphors to novel metaphors in the individual case.

A systematic review and meta-analysis of studies on metaphor comprehension in individuals with autism spectrum disorder: Do task properties matter?

“…Of note, the different tasks may each have advantages, but at the same time they can impede comprehension if inappropriately used with individuals with ASD. For instance, multiple-choice tasks can be desirable from the psychometric perspective due to an easy and precise scoring (Rapp et al, 2018) and high reliability (see, for instance, the different reliability values of figurative language tasks-multiple choice vs. verbal explanation in Carotenuto et al, 2018). In contrast, multiple-choice tasks are more susceptible for measurement error due to the possibility of guessing the responses (Kline, 2009), as well as due to tapping more executive functions because of the need to inhibit the incorrect alternatives and select the correct one.…”

“…By contrast, multiple-choice tasks do not rely on expressive language or meta-linguistic skills and require minimal social interaction with the examiner. However, multiple-choice tasks might be more costly in terms of need for inhibiting the false alternative(s) and selecting the correct one, as suggested by evidence from patients with brain lesions (Rapp, Felsenheimer, Langohr, & Klupp, 2018). The important role of the response format in metaphor comprehension is also supported by studies explicitly comparing different tasks.…”

“…For instance, a metaphor like "The sky's scarf is colored" (Melogno, D'Ardia, Pinto, & Levi, 2012) is considered novel, while "There is a flood outside the museum" (Rundblad & Annaz, 2010a), where flood refers to "lots of people," is considered a lexicalized/conventional metaphor. Both behavioral and neuroimaging evidence from different populations suggests different processing patterns for metaphor familiarity modulation, and, in particular, a facilitation for conventional compared to novel metaphors (Bambini, Gentili, Ricciardi, Bertinetto, & Pietrini, 2011;Blasko & Connine, 1993;Gluksberg, Gildea, & Bookin, 1982;Lee & Dapretto, 2006;Mashal, Faust, Hendler, & Jung-Beeman, 2009;Rapp et al, 2018;Rossetti et al, 2018;Varga et al, 2014). This might be because at least highly conventional metaphors are to be retrieved from the long-term memory where they are stored as learned lexical units, whereas novel metaphors might to a greater degree depend on the pragmatic ability to make context-relevant inferences (see Pouscoulous, 2011Pouscoulous, , 2014Wilson & Carston, 2006, for discussions).…”

Konkretistische Denkstörungen als Indikator der Akuität bei Schizophrenieerkrankungen

“…Auch wenn hier gezielt ein Screeningverfahren gewählt wurde, müsste zwecks Optimierung der Reliabilität allenfalls die Sprichwortliste von Barth und Küfferle [28] herangezogen werden; umfasst diese doch 14 Items. Zudem müsste kontrolliert werden, ob die präsentierten Sprichwörter für den Patienten als solche neuartig sind und dadurch einen kognitiven Prozess des Abstrahierens respektive Inhibierens verlangen oder bekannt sind und somit lediglich die Decodierung von erworbenem expliziten Wissen erfordern [29,30].…”

Metaphor Processing Dysfunctions in Schizophrenia Patients With and Without Substance Use Disorders

“…SZ patients have more difficulty understanding conventional metaphors than do healthy individuals (1,(12)(13)(14); they exhibit difficulty giving verbal explanations of metaphors and make a significantly higher number of literal incorrect (giving the literal meaning of words) and abstract incorrect (giving an answer that is abstract, but not in line with the meaning of the metaphor) errors than individuals without SZ (15). A study by Mossaheb et al (16) showed that processing metaphors may be related to processing speed, cognitive flexibility, and a range of intelligence quotient (IQ) subtests.…”