Introduction:
Our interdisciplinary research, conducted collaboratively (with Dr Ivan Nenchev, Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin) across Psychiatry, Psychology, Linguistics, Computational Linguistics, and Philosophy, challenges the conventional understanding of language comprehension in schizophrenia. In particular, we scrutinize the Proverbs Test, a prominent assessment tool utilized in schizophrenia research since the early 20th century to date.
Background:
The Proverbs Test evaluates patients' comprehension of figurative language, including proverbs, metaphors, idioms, and irony. It commonly employs a paraphrase task where patients are asked to provide equivalent expressions for given figurative utterances. Schizophrenia patients often struggle to adequately paraphrase figurative expressions, a phenomenon termed concretism, which is considered a key symptom of the disorder. For instance, when asked to paraphrase the proverb 'The apple doesn't fall far from the tree', individual with schizophrenia often provide responses such as 'The apple comes to rest near its original tree' or 'The apple is right under the tree'.
Critique:
We question the validity of Proverbs Test results by examining underlying linguistic and philosophical assumptions. Contrary to the prevailing notion, we argue that failure in paraphrase tasks does not necessarily indicate a lack of figurative speech comprehension. Instead, we challenge the notion that comprehension of figurative speech can be adequately assessed through paraphrase tasks. Drawing on recent research in child language development, we contend that paraphrase tasks primarily measure metalinguistic rather than linguistic abilities. Furthermore, metalinguistic abilities are inherently more complex than linguistic ones.
Proposal:
To improve the assessment of figurative speech comprehension in schizophrenia, we advocate for abandoning the paraphrase paradigm within the Proverbs Test. Instead, we propose alternative experimental tasks that directly evaluate linguistic rather than metalinguistic abilities in patients with schizophrenia.
Conclusion:
Our interdisciplinary critique calls for a reevaluation of conventional methods used in schizophrenia research. By rethinking the assessment of figurative speech comprehension, we aim to advance the understanding of linguistic impairments in schizophrenia and refine diagnostic tools accordingly.
Keywords:
Schizophrenia, Concretism, Proverbs, Figurative Language Comprehension, Paraphrase, Linguistic vs. Metalinguistic Testing
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