Clues from caregiver emotional language usage highlight the link between putative social environment and the psychosis-risk syndrome

Abstract

Familial emotional word usage has long been implicated in symptom progression in schizophrenia. However, few studies have examined caregiver emotional word usage prior to the onset of psychosis, among those with a clinical high-risk (CHR) syndrome. The current study examined emotional word usage in a sample of caregivers of CHR individuals (N = 37) and caregivers of healthy controls (N = 40) and links with clinical symptoms in CHR individuals. Caregivers completed a speech sample task in which they were asked to speak about the participant; speech samples were then transcribed and analyzed for general positive (e.g. good) and negative (e.g., worthless) emotional words as well as words expressing three specific negative emotions (i.e., anxiety, anger, and sadness) using Linguistic Inquiry and Word Count (LIWC). Findings indicated that (1) CHR caregivers used more negative and anxiety words compared to control caregivers; and (2) less positive word usage among CHR caregivers were related to more positive symptomatology among CHR individuals. These findings point toward the utility of automated language analysis in assessing the intersections between caregiver emotional language use and psychopathology.

Keywords: Clinical high-risk; Family environment; LIWC; Language; Schizophrenia.

Fig. 1.

Group differences in word use deduced from speech samples submitted into Linguistic Inquiry and Word Count in a sample of caregivers of individuals with a clinical high-risk syndrome (N = 37) compared to control caregivers (N = 40). Note. *p < 0.05; Anger, sadness, and anxiety are words also counted in the negative emotion category; Error bars represent standard error.

Fig. 2.

Relationships between caregivers’ positive emotion word usage and positive symptoms of those with a CHR syndrome (N = 37). Note. Positive symptoms are a sum scores of items obtained from the Structured Interview for Psychosis-Risk Syndromes.

Fig. 3.

Possible model of the bidirectional relationships between youth clinical state and their caregiver’s language use. Note. This model posits that the clinical state/symptom severity of a family member can influence their caregiver’s language use (e.g., more anxiety words). However, it is also possible that caregiver language use can influence a family member’s clinical state.