Medicine:Communication deviance

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Communication deviance (CD) occurs when a speaker fails to effectively communicate and convey meaning to their listeners with confusing speech patterns or illogical patterns.[1] These disturbances can range from vague linguistic references, contradictory statements to more encompassing non-verbal problems at the level of turn-taking. The term was originally introduced by Lyman Wynne and Margaret Singer in 1963 to describe a communication style found among parents who had children with schizophrenia.[2] According to Wynne, people are able to focus their attention and identify meaning from external stimuli beginning with their interactions, particularly with their parents, during their early years of life.[3] In family communication, deviance is present in the way members acknowledge or affirm one another as well as in task performance.[4]

A recent meta-analysis reported that communication deviance is highly prevalent in parents of patients diagnosed with schizophrenia [5] and adoption studies have reported significant associations between CD in the parent and thought disorder in the offspring.[6]

But, some research shows that CD may be more likely to be associated with specific cognitive disorganization rather than the criteria of schizophrenia, like DSM-III or DSM-II.[7] Also, findings of CD shows that CD may be associated with children's disorders too, rather than the behavior of preschizophrenic types.[8]

For application purposes: CD has been thought of as a measurement of disorder shown in speech in the subclinical aspect.[9]

However, the mechanisms by which CD impacts on the offspring's cognition are still unknown. Some researchers theorize that, in the case of a high degree of egocentric communication in parents where the sender and the receiver do not speak and listen according to each other's premises, the child develops uncertainty.[10]

The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of people with schizophrenia also became influential with systems-communications-oriented theorists and therapists.[11][12]

Signs and Symptoms

For individual

When talking to people with CD, it is difficult to follow and make consistent sharing of attention and meaning.[13] Also, the content which patients said may confuse the listener and inhibit to build of a shared focus of attention.[14] For the stability of CD, this will change followed by age. Some research shows that young people with CD were not correlated with the follow-up CD, but people at a mean age of 32 have a high correlation with follow-up CD.[15]

For parents

Research has shown that when communicating with patients who have CD, patients' parents will use similar odd terms and fail to express a sense of closure in their thought even when they talk to their parents.[16] To be more specific, for children with externalizing, “acting out” or “preschizophrenic” behaviors, the parental CD will be higher in maternal and paternal CD was found to be more significant only in which children with high externalizing behaviors[17].To be more specific, data analysis shows that a large magnitude(g = .97) is linked between maternal CD and offspring psychotic disorder.[18]

Cause

Genetic

CD is associated with genetics, which is a genetic vulnerability for schizophrenia. Studies show that CD is associated with schizophrenia spectrum disorders history in the family, among their parents and siblings.[19]

Children’s level of CD will link to the way of communication between parents. The parents who both have a pathologic affective style of communication will lead a high level of CD in their children. If the parents have a healthier style of communication, the levels of CD in their children will be lower.[20]

But studies of the high level of parental CD are mostly based on English-speaking countries and white subjects. So the findings lack generalisability.[21]

Environment

In the cultural aspect, CD was more common in intercultural encounters, especially when there were discrepancies in communication styles and norms, the misunderstanding can lead to CD.[22]

In the social aspect, children with self-isolation or lack of social support have more opportunities to get communication deviance, because they lack communication practice and have communication difficulties.[23] So, some researchers have suggested that more social support can help children reduce their communication difficulties and reduce the level of CD. But the reliability of result still need to be replicated.[24]

Diagnosis

There are two approaches to putting prevention of CD. The first is the 'clinical high risk' approach.[25] It puts a premium on early treatment, the ultimate goal of this approach is prevention. The second one is secondary and tertiary prevention, this approach can reflect the need for intervention focusing on the whole family.[26] Also, some studies point out that when considering the prevention of CD, the relationship between family and their children should be taken into account.[27]

Management

The psychology treatment

the psychology treatment can be divided into four main elements:[9]

  1. Holding seminars for parents which give them instructions on schizophrenia and how to treat a schizophrenic child.
  2. Problem-solving session.
  3. Milieu therapy: to create an 'emotional climate' environment by a depressed emotion for patients.
  4. Establishing a good social network for patients.

The family treatment

The family treatment mainly includes education, communication and problem-solving techniques. Study shows that family treatment will have a more effective improvement than individual treatment.[28]

Cost

In comparison to control subjects or patients with other non-psychotic disturbances, parents of schizophrenic patients have substantially higher CD levels. The maternal CD was found to be higher than Patrilineal CD. Also, Paternal CD was found to be a higher level in families whose children were with higher externalizing behaviors.[29]

Measurement of CD

CD levels can be measured by Thematic Apperception Test (TAT) and Rorschach test.[30]

See also

References

  1. ↑ Singer, MT; Wynne, LC (August 1966). "Principles for scoring communication defects and deviances in parents of schizophrenics: Rorschach and TAT scoring manuals.". Psychiatry 29 (3): 260–88. doi:10.1080/00332747.1966.11023470. PMID 5969538. 
  2. ↑ Andrés Martin; Fred R. Volkmar; Melvin Lewis (2007). Lewis's Child and Adolescent Psychiatry: A Comprehensive Textbook. Lippincott Williams & Wilkins. pp. 862. ISBN 978-0-7817-6214-4. https://books.google.com/books?id=ceD-3DbuRwgC&pg=PA862. 
  3. ↑ Vangelisti, Anita L. (2012-11-27). The Routledge Handbook of Family Communication. Oxon: Routledge. ISBN 978-1-136-94636-3. 
  4. ↑ Huser Liem, Joan (1979). "Family Studies of Schizophrenia: An Update and Commentary". Special Report: Schizophrenia, 1980. U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration. pp. 91. 
  5. ↑ de Sousa, P.; Varese, F.; Sellwood, W.; Bentall, R. P. (25 June 2013). "Parental Communication and Psychosis: A Meta-analysis". Schizophrenia Bulletin 40 (4): 756–768. doi:10.1093/schbul/sbt088. PMID 23800431. 
  6. ↑ Wahlberg, KE; Wynne, LC; Oja, H; Keskitalo, P; Anais-Tanner, H; Koistinen, P; Tarvainen, T; Hakko, H et al. (January 2000). "Thought disorder index of Finnish adoptees and communication deviance of their adoptive parents.". Psychological Medicine 30 (1): 127–36. doi:10.1017/s0033291799001415. PMID 10722183. 
  7. ↑ Sass, Louis A.; Gunderson, John G.; Singer, Margaret Thaler; Wynne, Lyman C. (September 1984). "Parental Communication Deviance and Forms of Thinking in Male Schizophrenic Offspring" (in en). The Journal of Nervous and Mental Disease 172 (9): 513–520. doi:10.1097/00005053-198409000-00001. ISSN 0022-3018. PMID 6470693. http://journals.lww.com/00005053-198409000-00001. 
  8. ↑ Velligan, Dawn; Christensen, Andrew; Goldstein, Michael J.; Margolin, Gayla (December 1988). "Parental communication deviance: Its relationship to parent, child, and family system variables" (in en). Psychiatry Research 26 (3): 313–325. doi:10.1016/0165-1781(88)90126-6. PMID 3222396. https://linkinghub.elsevier.com/retrieve/pii/0165178188901266. 
  9. ↑ 9.0 9.1 Subotnik, K. L.; Goldstein, M. J.; Nuechterlein, K. H.; Woo, S. M.; Mintz, J. (2002-01-01). "Are Communication Deviance and Expressed Emotion Related to Family History of Psychiatric Disorders in Schizophrenia?" (in en). Schizophrenia Bulletin 28 (4): 719–729. doi:10.1093/oxfordjournals.schbul.a006975. ISSN 0586-7614. PMID 12795501. https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/oxfordjournals.schbul.a006975. 
  10. ↑ L'Abate, Luciano (1998). Family Psychopathology: The Relational Roots of Dysfunctional Behavior. New York: Guilford Press. pp. 84. ISBN 1-57230-369-7. 
  11. ↑ Sholevar, G.P. (2003). Family Theory and Therapy. In Sholevar, G.P. & Schwoeri, L.D. Textbook of Family and Couples Therapy: Clinical Applications. Washington, DC: American Psychiatric Publishing Inc.
  12. ↑ Barker, P. (2007). Basic family therapy; 5th edition. Wiley-Blackwell.
  13. ↑ Szili, Ilona; Smohai, Máté; Tanyi, Zsuzsanna; Mészáros, Veronika; Kovács, Dóra; Jakubovits, Edit; Kövi, Zsuzsanna (2021). "Időskori depresszió és életminőség". Psychologia Hungarica Caroliensis 9 (1): 90–111. doi:10.52993/psyhung.9.2021.1.6. ISSN 2064-3101. http://dx.doi.org/10.52993/psyhung.9.2021.1.6. 
  14. ↑ Sousa, Paulo de; Sellwood, William; Fien, Kirsten; Sharp, Helen; Pickles, Andrew; Hill, Jonathan; Abbott, Kate; Fisher, Louise et al. (October 2019). "Mapping early environment using communication deviance: A longitudinal study of maternal sensitivity toward 6-month-old children" (in en). Development and Psychopathology 31 (4): 1501–1511. doi:10.1017/S0954579418001189. ISSN 0954-5794. PMID 30348239. https://www.cambridge.org/core/journals/development-and-psychopathology/article/mapping-early-environment-using-communication-deviance-a-longitudinal-study-of-maternal-sensitivity-toward-6monthold-children/74A40AEE8823A69698DCCAB9DCAAF3A8. 
  15. ↑ Wahlberg, Karl-Erik; Wynne, Lyman C.; Keskitalo, Pirjo; Nieminen, Pentti; Moring, Juha; Läksy, Kristian; Sorri, Anneli; Koistinen, Pekka et al. (August 2001). "Long-term stability of communication deviance." (in en). Journal of Abnormal Psychology 110 (3): 443–448. doi:10.1037/0021-843X.110.3.443. ISSN 1939-1846. PMID 11502087. http://doi.apa.org/getdoi.cfm?doi=10.1037/0021-843X.110.3.443. 
  16. ↑ Kymalainen, Jennifer A.; Weisman de Mamani, Amy G. (2008). "Expressed emotion, communication deviance, and culture in families of patients with schizophrenia: A review of the literature." (in en). Cultural Diversity and Ethnic Minority Psychology 14 (2): 85–91. doi:10.1037/1099-9809.14.2.85. ISSN 1939-0106. PMID 18426280. http://doi.apa.org/getdoi.cfm?doi=10.1037/1099-9809.14.2.85. 
  17. ↑ Velligan, Dawn; Christensen, Andrew; Goldstein, Michael J.; Margolin, Gayla (December 1988). "Parental communication deviance: Its relationship to parent, child, and family system variables" (in en). Psychiatry Research 26 (3): 313–325. doi:10.1016/0165-1781(88)90126-6. PMID 3222396. https://linkinghub.elsevier.com/retrieve/pii/0165178188901266. 
  18. ↑ de Sousa, Paulo; Varese, Filippo; Sellwood, William; Bentall, Richard P. (July 2014). "Parental Communication and Psychosis: A Meta-analysis" (in en). Schizophrenia Bulletin 40 (4): 756–768. doi:10.1093/schbul/sbt088. ISSN 1745-1701. PMID 23800431. PMC 4059429. https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/sbt088. 
  19. ↑ Subotnik, K. L.; Goldstein, M. J.; Nuechterlein, K. H.; Woo, S. M.; Mintz, J. (2002-01-01). "Are Communication Deviance and Expressed Emotion Related to Family History of Psychiatric Disorders in Schizophrenia?" (in en). Schizophrenia Bulletin 28 (4): 719–729. doi:10.1093/oxfordjournals.schbul.a006975. ISSN 0586-7614. PMID 12795501. https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/oxfordjournals.schbul.a006975. 
  20. ↑ Doane, Jeri A. (1981-06-01). "Parental Communication Deviance and Affective Style: Predictors of Subsequent Schizophrenia Spectrum Disorders in Vulnerable Adolescents" (in en). Archives of General Psychiatry 38 (6): 679–685. doi:10.1001/archpsyc.1981.01780310079008. ISSN 0003-990X. PMID 7247631. http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1981.01780310079008. 
  21. ↑ Kymalainen, Jennifer A.; Weisman de Mamani, Amy G. (2008). "Expressed emotion, communication deviance, and culture in families of patients with schizophrenia: A review of the literature." (in en). Cultural Diversity and Ethnic Minority Psychology 14 (2): 85–91. doi:10.1037/1099-9809.14.2.85. ISSN 1939-0106. PMID 18426280. http://doi.apa.org/getdoi.cfm?doi=10.1037/1099-9809.14.2.85. 
  22. ↑ Gudykunst, William B. (2004). Bridging differences : effective intergroup communication (4th ed.). Thousand Oaks, Calif.: Sage Publications. ISBN 978-1-4522-6299-4. OCLC 808344353. https://www.worldcat.org/oclc/808344353. 
  23. ↑ Kwan, Celia; Gitimoghaddam, Mojgan; Collet, Jean-Paul (2020-10-28). "Effects of Social Isolation and Loneliness in Children with Neurodevelopmental Disabilities: A Scoping Review" (in en). Brain Sciences 10 (11): 786. doi:10.3390/brainsci10110786. ISSN 2076-3425. PMID 33126519. 
  24. ↑ Eadie, Tanya; Kapsner‐Smith, Mara; Bolt, Susan; Sauder, Cara; Yorkston, Kathryn; Baylor, Carolyn (November 2018). "Relationship between perceived social support and patient‐reported communication outcomes across communication disorders: a systematic review" (in en). International Journal of Language & Communication Disorders 53 (6): 1059–1077. doi:10.1111/1460-6984.12417. ISSN 1368-2822. PMID 30039920. 
  25. ↑ Bearden, Carrie E.; Wu, Keng Nei; Caplan, Rochelle; Cannon, Tyrone D. (July 2011). "Thought Disorder and Communication Deviance as Predictors of Outcome in Youth at Clinical High Risk for Psychosis" (in en). Journal of the American Academy of Child & Adolescent Psychiatry 50 (7): 669–680. doi:10.1016/j.jaac.2011.03.021. PMID 21703494. 
  26. ↑ Kovács, Judit (2005-04-01). "Hatékonyság és méltányosság. Egy ultimátumjáték kísérletes tapasztalatai". Magyar Pszichológiai Szemle 60 (1–2): 225–247. doi:10.1556/mpszle.60.2005.1-2.12. ISSN 0025-0279. https://akjournals.com/doi/10.1556/mpszle.60.2005.1-2.12. 
  27. ↑ Ireland, Jane L.; Monaghan, Rachel (April 2006). "Behaviours indicative of bullying among young and juvenile male offenders: a study of perpetrator and victim characteristics" (in en). Aggressive Behavior 32 (2): 172–180. doi:10.1002/ab.20116. ISSN 0096-140X. https://onlinelibrary.wiley.com/doi/10.1002/ab.20116. 
  28. ↑ Nugter, M. A.; Dingemans, P. M. A. J.; Linszen, D. H.; Van der Does, A. J. W.; Gersons, B. P. R. (March 1997). "Parental communication deviance: its stability and the effect of family treatment in recent-onset schizophrenia" (in en). Acta Psychiatrica Scandinavica 95 (3): 199–204. doi:10.1111/j.1600-0447.1997.tb09620.x. ISSN 0001-690X. PMID 9111852. https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1997.tb09620.x. 
  29. ↑ Velligan, Dawn; Christensen, Andrew; Goldstein, Michael J.; Margolin, Gayla (December 1988). "Parental communication deviance: Its relationship to parent, child, and family system variables" (in en). Psychiatry Research 26 (3): 313–325. doi:10.1016/0165-1781(88)90126-6. PMID 3222396. https://linkinghub.elsevier.com/retrieve/pii/0165178188901266. 
  30. ↑ Velligan, Dawn I.; Goldstein, Michael J.; Nuechterlein, Keith H.; Miklowitz, David J.; Ranlett, Gregory (June 1990). "Can Communication Deviance Be Measured in a Family Problem-Solving Interaction?" (in en). Family Process 29 (2): 213–226. doi:10.1111/j.1545-5300.1990.00213.x. ISSN 0014-7370. PMID 2373216. https://onlinelibrary.wiley.com/doi/10.1111/j.1545-5300.1990.00213.x. 




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