Narrative qualities in schizophrenia: associations with impairments in neurocognition and negative symptoms

Schizophrenia spectrum disorders often involve a profound diminishment in people's ability to coherently narrate their lives. Unknown is whether narrative difficulties of persons with schizophrenia differ from those with other disabilities, and how they relate to clinical or neurocognitive aspects of schizophrenia. To address both issues, personal narratives were obtained for 25 participants with schizophrenia spectrum disorders and a comparison group of eight legally blind participants and four with major depressive disorders. Flexibility of abstract thought and positive, negative, and emotional discomfort symptoms were assessed among the schizophrenia group. ANCOVA comparing scores on our scale to assess narrative development, controlling for age, found the schizophrenia group narratives significantly more impoverished than the comparison group on multiple dimensions, including self-worth and agency. Neurocognitive impairment and negative symptoms were significant predictors of impoverishment in the schizophrenia group. Results may highlight deficits that could be addressed in psychotherapy or rehabilitation to promote recovery.