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An Examination of Speech Characteristics Under Conditions Of Louisiana State University LSU Digital Commons LSU Doctoral Dissertations Graduate School 2013 An examination of speech characteristics under conditions of affective reactivity and variable cognitive load as distinguishing feigned and genuine schizophrenia Gina M. Najolia Louisiana State University and Agricultural and Mechanical College, [email protected] Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_dissertations Part of the Psychology Commons Recommended Citation Najolia, Gina M., "An examination of speech characteristics under conditions of affective reactivity and variable cognitive load as distinguishing feigned and genuine schizophrenia" (2013). LSU Doctoral Dissertations. 1551. https://digitalcommons.lsu.edu/gradschool_dissertations/1551 This Dissertation is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Doctoral Dissertations by an authorized graduate school editor of LSU Digital Commons. For more information, please [email protected]. AN EXAMINATION OF SPEECH CHARACTERISTICS UNDER CONDITIONS OF AFFECTIVE REACTIVITY AND VARIABLE COGNITIVE LOAD AS DISTINGUISHING FEIGNED AND GENUINE SCHIZOPHRENIA A Dissertation Submitted to the Graduate Faculty of Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Doctor of Philosophy in The Department of Psychology by Gina M. Najolia B.A., New York University, 1999 J.D., Harvard Law School, 2002 M.A., Louisiana State University, 2010 December 2013 TABLE OF CONTENTS ABSTRACT .......................................................................................................................iv INTRODUCTION ............................................................................................................1 Schizophrenia .............................................................................................................1 Malingering of Schizophrenia....................................................................................3 Current methods of assessment of malingering of schizophrenia .................4 Currently utilized assessment tools ....................................................8 Examining Behaviorally-Based Speech Characteristics Under Controlled Conditions of Variable Affective and Cognitive Load to Identify Feigning of Schizophrenia .............................................................................................................10 Communication Disturbances Index ..............................................................12 Communication disturbances under conditions of variable affective load ......................................................................................14 Communication disturbances under conditions of variable cognitive load .....................................................................................16 Flat affect and alogia as measured using the CANS procedure .....................22 Flat affect and alogia under conditions of variable affective load .....................................................................................................22 Flat affect and alogia under conditions of variable cognitive load .....................................................................................................23 Study Design ..............................................................................................................23 Hypotheses .................................................................................................................25 METHODS .........................................................................................................................29 Participants .................................................................................................................29 Schizophrenia group ......................................................................................29 Honest control group......................................................................................30 Feigning group ...............................................................................................30 Speech Tasks ..............................................................................................................32 Cognitive load speech task.............................................................................32 Medium-load cognitive task ..............................................................33 High-load cognitive task ....................................................................33 Affective reactivity speech task .....................................................................34 Post-test Assessment ..................................................................................................34 Dependent Variables ..................................................................................................35 Speech variables.............................................................................................35 CDI .....................................................................................................35 CANS .................................................................................................36 Cognitive task performance ...........................................................................39 Analyses .....................................................................................................................39 Data distribution.............................................................................................39 Demographic variables ..................................................................................39 Primary analyses ............................................................................................40 Feigning group post-task questionnaire .........................................................40 ii Power Analysis ..........................................................................................................41 RESULTS ...........................................................................................................................43 Data Distribution ........................................................................................................43 Demographic Variables .............................................................................................43 Primary Analyses .......................................................................................................48 Affective reactivity speech task .....................................................................48 CDI .....................................................................................................49 Alogia .................................................................................................51 Blunt Affect .......................................................................................55 Formant variables...............................................................................58 Cognitive load speech task.............................................................................62 CDI .....................................................................................................62 Alogia .................................................................................................65 Blunt Affect .......................................................................................71 Formant variables...............................................................................75 Cognitive task performance ...............................................................79 Feigning group post-task questionnaire .........................................................81 DISCUSSION ....................................................................................................................85 REFERENCES ..................................................................................................................102 APPENDIX A SCHIZOPHRENIA SUMMARY EXCERPTED FROM THE NATIONAL INSTITUTE OF MENTAL HEALTH (2009) .......................109 APPENDIX B NEUTRAL SPEECH TASK INSTRUCTIONS ..........................111 APPENDIX C INSTRUCTIONS FOR AFFECTIVE LOAD SPEECH TASK ...................................................................................................................................112 APPENDIX D POST-TASK QUESTIONNAIRE FOR THE FEIGNING GROUP ................................................................................................................................113 APPENDIX E COPY OF THE LOUISIANA STATE UNIVERSITY INTERNAL REVIEW BOARD’S PROJECT APPROVAL FORM ............... 114 THE VITA ........................................................................................................ 123 iii ABSTRACT Proper assessment of schizophrenia is complicated by the need for clinicians to be cognizant of the possibility of malingering, i.e., the intentional production of false or grossly exaggerated symptoms, motivated by external incentives. Current standardized schizophrenia malingering detection methods rely on endorsement of improbable or exaggerated, mainly positive, symptoms. However, these detection methods may be vulnerable to successful manipulation by sophisticated malingerers, particularly if coached regarding response style assessment strategies. This paper explored the utility of supplementalvariables to examine in schizophrenia malingering
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