Alogia

For the progressive metal band, see Alogia (band).

In psychology, alogia (Greek ἀ-, “without”, and λόγος, “speech”[1]), or poverty of speech,[2] is a general lack of additional, unprompted content seen in normal speech. As a symptom, it is commonly seen in patients suffering from schizophrenia, and is considered as a negative symptom. It can complicate psychotherapy severely because of the considerable difficulty in holding a fluent conversation.

Alogia is often considered a form of aphasia, which is a general impairment in linguistic ability. It often occurs with intellectual disability and dementia as a result of damage to the left hemisphere of the brain. People can revert to alogia as a way of reverse psychology, or avoiding questions.

Characteristics

Alogia is characterized by a lack of speech, often caused by a disruption in the thought process. Usually, an injury to the left hemisphere of the brain will cause alogia to appear in an individual. In conversation, alogic patients will reply very sparsely and their answers to questions will lack spontaneous content; sometimes, they will even fail to answer at all.[3] Their responses will be brief, generally only appearing as a response to a question or prompt.[4]

Apart from the lack of content in a reply, the manner in which the person delivers the reply is affected as well. Patients affected by alogia will often slur their responses, and not pronounce the consonants as clearly as usual. The few words spoken usually trail off into a whisper, or are just ended by the second syllable. Studies have shown a correlation between alogic ratings in individuals and the amount and duration of pauses in their speech when responding to a series of questions posed by the researcher.[1][5]

The inability to speak stems from a deeper mental inability that causes alogic patients to have difficulty grasping the right words mentally, as well as formulating their thoughts. A study investigating alogiacs and their results on the category fluency task showed that people with schizophrenia who exhibit alogia display a more disorganized semantic memory than controls. While both groups produced the same number of words, the words produced by people with schizophrenia were much more disorderly and the results of cluster analysis revealed bizarre coherence in the alogiac group.[6]

Example

Alogia Normal speech

Q: Do you have any children?
A: Yes.
Q: How many?
A: Two.
Q: How old are they?
A: Six and sixteen.
Q: Are they boys or girls?
A: One of each.
Q: Who is the sixteen-year-old?
A: The boy.
Q: What is his name?
A: Edmond.
Q: And the girl's?
A: Alice.

Q: Do you have any children?
A: Yes, a boy and a girl.
Q: How old are they?
A: Edmond is sixteen and Alice is six.

Causes

Alogia can be brought on by frontostriatal dysfunction which causes degradation of the semantic store, the center located in the temporal lobe that processes meaning in language. A subgroup of chronic schizophrenia patients in a word generation experiment generated fewer words than the unaffected subjects and had limited lexicons, evidence of the weakening of the semantic store. Another study found that when given the task of naming items in a category, schizophrenia patients displayed a great struggle but improved significantly when experimenters employed a second stimulus to guide behavior unconsciously. This conclusion was similar to results produced from patients with Huntington's and Parkinson's disease, ailments which also involve frontostriatal dysfunction.[7]

Treatment

Medical studies conclude that certain adjunctive drugs effectively palliate the negative symptoms of schizophrenia, mainly alogia. In one study, Maprotiline produced the greatest reduction in alogia symptoms with a 50% decrease in severity.[8] Of the negative symptoms of schizophrenia, alogia had the second best responsiveness to the drugs, surpassed only by attention deficiency. D-amphetamine is another drug that has been tested on people with schizophrenia and found success in alleviating negative symptoms. This treatment, however, has not been developed greatly as it seems to have adverse effects on other aspects of schizophrenia such as increasing the severity of positive symptoms.[9]

Relation to schizophrenia

Although alogia is found as a symptom in a variety of health disorders, it is most commonly found as a negative symptom of schizophrenia.

The negative symptoms of schizophrenia have previously been considered to be related to a psychiatric form of the Dysexecutive Syndrome (also known as frontal lobe syndrome). Studies show that the symptoms of schizophrenia do indeed correlate with frontal lobe syndrome.[10]

Previous studies and analyses conclude that there are three factors that include both the positive and negative symptoms of schizophrenia. These three factors are: alogia, attention impairment, and inappropriate affect. Studies suggest that an inappropriate affect is strongly associated with bizarre behavior and positive formal thought disorder, attention impairment correlates significantly with psychotic, disorganization, and negative symptom factors. However, alogia is seen to contain both positive and negative symptoms, with the poverty of content of speech as the disorganization factor, and poverty of speech, latency, and blocking as the negative symptom factor. These results suggest that three dimensions are needed to categorize schizophrenia's negative and positive symptoms.[11]

See also

References

  1. 1 2 "MedTerms medical dictionary, Alogia definition". Archived from the original on 22 October 2006. Retrieved 2006-09-30.
  2. ↑ American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®. American Psychiatric Pub. p. 301. ISBN 978-0-89042-025-6. Retrieved 29 April 2012.
  3. ↑ "Alogia- Definition".
  4. ↑ Alpert, M., Kotsaftis, A. & Pouget, E.R. (1997). Speech fluency and schizophrenic negative signs. Schizophrenia Bulletin, 23, 171-177.
  5. ↑ Alpert, M. Clark, A. & Pouget, E.R. (1994). The syntactic role of pauses in the speech patients with schizophrenia and alogia. Journal of Abnormal Psychology, 103, 750-757
  6. ↑ Sumiyoshi, C.; Sumiyoshi, T.; Nohara, S.; Yamashita, I.; Matsui, M.; Kurachi, M.; Niwa, S. (Apr 2005). "Disorganization of semantic memory underlies alogia in schizophrenia: an analysis of verbal fluency performance in Japanese subjects.". Schizophr Res 74 (1): 91–100. doi:10.1016/j.schres.2004.05.011. PMID 15694758.
  7. ↑ Chen, R.Y., Chen, E.Y., Chan, C.K., Lam, L.C. & Lieh-Mak, E. (2000). Verbal fluency in schizophrenia: reduction in semantic store. Australian and New Zealand Journal of Psychiatry, 34, 43-48.
  8. ↑ Shafti, S.S., Rey, S., Abad, A. (2005). "Drug – Specific Responsiveness of Negative Symptoms.". International Journal of Psychosocial Rehabilitation. pp. 10 (1), 43–51.
  9. ↑ Desai, N., Gangadhar, B.N., Pradhan, N. & Channabasavanna, S.M. (1984). Treatment of negative schizophrenia with d-amphetamine. The American Journal of Psychiatry, 141, 723-724.
  10. ↑ Barch, D.M. & Berenbaum, H. (1996). Language production and thought disorder in schizophrenia. Journal of Abnormal Psychology, 105, 81-88.
  11. ↑ Miller, D., Arndt, S. & Andreasen, N. (2004). Alogia, attentional impairment, and inappropriate affect: Their status in the dimensions of schizophrenia. Comprehensive psychiatry, 34, 221-226.
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