Send to

Choose Destination
Schizophr Res. 2017 Nov 16. pii: S0920-9964(17)30710-7. doi: 10.1016/j.schres.2017.11.014. [Epub ahead of print]

Evidence of disturbances of deep levels of semantic cohesion within personal narratives in schizophrenia.

Author information

Department of Psychology, University of California Riverside, United States.
Department of Psychological and Brain Science, Indiana University Bloomington, United States.
Indiana University Purdue University Indianapolis, Department of Psychology, United States.
Roudebush VA Medical Center, United States; Indiana University School of Medicine, Department of Psychiatry, United States. Electronic address:


Since initial conceptualizations, schizophrenia has been thought to involve core disturbances in the ability to form complex, integrated ideas. Although this has been studied in terms of formal thought disorder, the level of involvement of altered latent semantic structure is less clear. To explore this question, we compared the personal narratives of adults with schizophrenia (n=200) to those produced by an HIV+ sample (n=55) using selected indices from Coh-Metrix. Coh-Metrix is a software system designed to compute various language usage statistics from transcribed written and spoken language documents. It differs from many other frequency-based systems in that Coh-Metrix measures a wide range of language processes, ranging from basic descriptors (e.g., total words) to indices assessing more sophisticated processes within sentences, between sentences, and across paragraphs (e.g., deep cohesion). Consistent with predictions, the narratives in schizophrenia exhibited less cohesion even after controlling for age and education. Specifically, the schizophrenia group spoke fewer words, demonstrated less connection between ideas and clauses, provided fewer causal/intentional markers, and displayed lower levels of deep cohesion. A classification model using only Coh-Metrix indices found language markers correctly classified participants in nearly three-fourths of cases. These findings suggest a particular pattern of difficulties cohesively connecting thoughts about oneself and the world results in a perceived lack of coherence in schizophrenia. These results are consistent with Bleuler's model of schizophrenia and offer a novel way to understand and measure alterations in thought and speech over time.


Cohesion; Language; Narrative; Schizophrenia; Self; Thought disorder

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center