Are schizophrenia patients’ response latencies in semi-structured diagnostic interviews merely a sign of pathology or are they context sensitive?

Abstract

Prolonged pause duration in speech is a typical phenomenon of schizophrenia. Despite this, however, studies have not previously focused on prolonged pause in clinical diagnostic interviews, nor has there been any consideration of whether silences occur within turns or in turn-transitions. The present study is based on videotaped semi-structured clinical diagnostic interviews with three persons with schizophrenia. We measured duration of silence or overlap in every turn-transition using Praat software. The participants differed considerably from each other. All of them seemed to display more delays in responding to manual-based questions taken from the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and to questions concerning supra-categories and proverbs. Qualitative analysis of the interview with the most dysfluent participant showed that topic-shifting and new-sequence-beginning questions caused more prolonged latencies than sequence-continuing questions. Moreover, questions that required more detailed description or reflection of psychotic experiences seemed to be problematic. We observed that the doctor adapted his tempo to the participant’s fluency. In addition, the doctor often produced expansions or tag questions when he noticed that the participant had difficulties in responding without a latency. Based on the measures and findings of the qualitative analyses, we presume that both individual psychopathology and contextual factors affect turn-transitional response patterns.