Raluca Nicoleta TRIFU1, Bogdan NEMEȘ1*,
Carolina BODEA-HAȚEGAN2, Doina COZMAN1
*nemes.bogdan@umfcluj.ro
1Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
2Babes-Bolyai University, Cluj-Napoca, Romania
Abstract
Depression is a significant disorder, with more than 300 million people having this diagnosis. Mood, cognition and language are altered during depressive episodes. Language could act as a diagnostic and a therapeutic tool in psychotherapy. While the theoretical body of literature is increasing, studies on language indicators in depression are still challenging. This study aims to limit this gap, by bringing valid data on linguistic indicators used in the narrative language of persons with depression, and by testing the relation between these indicators and cognitive dysfunction in major depressive disorder. The study used a content analysis approach to rate the collected language sample. Results confirm the existence of linguistic indicators for depressive patients: use of the singular form pronoun, mainly 1st person pronouns use, tendency of self-focus, extensive past tense use for verb actions, inverted word order for topic, use of emphasis, presence of short, impersonal, truncated and arid sentences, presence of ellipsis, tautologies, repetition and lack of comparison. The changes in morphologic-syntactic-lexical language dimensions are associated with deficits in working memory, set shifting, strategic planning, attention and psychomotor speed, as assessed through the Cogtest neuropsychological measurements.
Keywords: depression, linguistic indicators, cognitive dysfunction, MDD, Cogtest
Published online: 2017/03/01
Published print: 2017/03/01
References
Abdullaev, Y., Kennedy, B. L., & Tasman, A. (2002). Changes in neural circuitry of language before and after treatment of major depression. Human Brain Mapping, 17(3), 156–67. https://doi.org/10.1002/hbm.10060
Abercrombie, D. (1967). Elements of general phonetics (1st ed.). Edinburgh U.P.
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). American Psychiatric Association.
Årdal, G., & Hammar, Å. (2011). Is impairment in cognitive inhibition in the acute phase of major depression irreversible? Results from a 10-year follow-up study. Psychology and Psychotherapy: Theory, Research and Practice, 84(2), 141–150. https://doi.org/10.1348/147608310X502328
Atkin, A. (2013). Peirce’s Theory of Signs. In The Stanford Encyclopedia of Philosophy (Summer 201). Metaphysics Research Lab, Stanford University. Retrieved from https://plato.stanford.edu/archives/sum2013/entries/peirce-semiotics/
Axelrod, B. N., & Henry, R. R. (1992). Age-related performance on the wisconsin card sorting, similarities, and controlled oral word association tests. The Clinical Neuropsychologist, 6(1), 16–26. https://doi.org/http://dx.doi.org/10.1080/13854049208404113
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. Cognitive therapy and the emotional disorders (Vol. 8). https://doi.org/10.1016/S0005-7894(77)80293-1
Beck, A. T. (1986). Cognitive models of depression. Journal of Cognitive Psychotherapy, 1(1), 5–37.
Bender, M., Carrera, M., & Alonso-Arbiol, I. (2015). The relationship between autobiographical self-focus and memory specificity/overgenerality: differences between individuals with and without a diagnosis of depression. Accion Psicologica, 12(2), 109–122. https://doi.org/10.5944/ap.12.2.15785
Bernard, J. D., Baddeley, J. L., Rodriguez, B. F., & Burke, P. A. (2016). Depression, Language, and Affect: An Examination of the Influence of Baseline Depression and Affect Induction on Language. Journal of Language and Social Psychology, 35(3), 317–326. https://doi.org/10.1177/0261927X15589186
Bodea-Hațegan, C. (2016). Validation Study of a Morphological Assessment Tool for the Romanian Speaking Population. Journal of Evidence-Based Psychotherapies, 16(2), 238–257.
Bolla-Wilson, K., & Bleecker, M. L. (1986). Influence of verbal intelligence, sex, age, and education on the Rey auditory verbal learning test. Developmental Neuropsychology, 2(3), 203–211. https://doi.org/10.1080/87565648609540342
Boone, K. . (1999). Neuropsychological assesment of executive function: impact of age, education, gender, intellectual level, and vascular status on executive test scores. In L. Cummings (Ed.), The human frontal lobes:Functions and disorders (pp. 247–260). New York: Guilford.
Brockmeyer, T., Zimmermann, J., Kulessa, D., Hautzinger, M., Bents, H., Friederich, H.-C., … Backenstrass, M. (2015). Me, myself, and I: self-referent word use as an indicator of self-focused attention in relation to depression and anxiety. Frontiers in Psychology, 6. https://doi.org/10.3389/fpsyg.2015.01564
Bucci, W., & Freedman, N. (1981). The language of depression. Bulletin of the Menninger Clinic, 45(4), 334–58.
Cacioppo, J. T., von Hippel, W., & Ernst, J. M. (1997). Mapping cognitive structures and processes through verbal content: the thought-listing technique. Journal of Consulting and Clinical Psychology, 65(6), 928–940. https://doi.org/10.1037/0022-006X.65.6.928
Clark, C., Paul, R., Williams, L., Arns, M., Fallahpour, K., Handmer, C., & Gordon, E. (2006). Standardized assessment of cognitive functioning during development and aging using an automated touchscreen battery. Archives of Clinical Neuropsychology, 21(5), 449–467. https://doi.org/10.1016/j.acn.2006.06.005
Ellis, A. (1977). Rational-Emotive Therapy: Research Data That Supports The Clinical and Personality Hypotheses of RET and Other Modes of Cognitive-Behavior Therapy. The Counseling Psychologist, 7(1), 2–42. https://doi.org/10.1177/001100007700700102
Ellis, A. (1994). Reason and emotion in psychotherapy. Carol Pub. Group.
Ellis, A. (2007). General Semantics and Rational-Emotive Therapy: 1991 Alfred Korzybski Memorial Lecture. ETC: A Review of General Semantics, 64(4), 301–319. Retrieved from www.generalsemantics.org/wp-content/uploads/2011/04/gsb-58-ellis.pdf
Ellis, H. C., Seibert, P. S., & Herbert, B. J. (1990). Mood state effects on thought listing. Bulletin of the Psychonomic Society, 28(2), 147–150. https://doi.org/10.3758/BF03333990
Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., … Koretz, D. (2013). Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLoS Medicine, 10(11), e1001547. https://doi.org/10.1371/journal.pmed.1001547
Fineberg, S. K., Leavitt, J., Deutsch-Link, S., Dealy, S., Landry, C. D., Pirruccio, K., … Corlett, P. R. (2016). Self-reference in psychosis and depression: a language marker of illness. Psychological Medicine, 46(12), 2605–2615. https://doi.org/10.1017/S0033291716001215
Gruber, O., Zilles, D., Kennel, J., Gruber, E., & Falkai, P. (2011). A systematic experimental neuropsychological investigation of the functional integrity of working memory circuits in major depression. European Archives of Psychiatry and Clinical Neuroscience, 261(3), 179–184. https://doi.org/10.1007/s00406-010-0165-3
Harciarek, M., & Cosentino, S. (2013). Language, executive function and social cognition in the diagnosis of frontotemporal dementia syndromes. International Review of Psychiatry (Abingdon, England), 25(2), 178–96. https://doi.org/10.3109/09540261.2013.763340
Hasselbalch, B. J., Knorr, U., Hasselbalch, S. G., Gade, A., & Kessing, L. V. (2013). The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder. European Psychiatry, 28(6), 349–355. https://doi.org/10.1016/j.eurpsy.2012.03.004
Hasselbalch, B. J., Knorr, U., & Kessing, L. V. (2011). Cognitive impairment in the remitted state of unipolar depressive disorder: A systematic review. Journal of Affective Disorders, 134(1–3), 20–31. https://doi.org/10.1016/j.jad.2010.11.011
Henry, J., & Crawford, J. R. (2005). A meta-analytic review of verbal fluency deficits in depression. Journal of Clinical and Experimental Neuropsychology, 27(1), 78–101. https://doi.org/10.1080/138033990513654
Ingram, R. E., Slater, M. A., Atkinson, J. H., & Scott, W. (1990). Positive automatic cognition in major affective disorder. Psychological Assessment, 2(2), 209–211. https://doi.org/10.1037/1040-3590.2.2.209
Ingram, R. E., & Wisnicki, K. S. (1988). Assessment of positive automatic cognition. Journal of Consulting and Clinical Psychology, 56(6), 898–902. https://doi.org/http://dx.doi.org/10.1037/0022-006X.56.6.898
Jarrold, W., Javitz, H. S., Krasnow, R., Peintner, B., Yeh, E., Swan, G. E., & Mehl, M. (2011). Depression and Self-Focused Language in Structured Interview with Older Men. Psychological Reports, 109(2), 686–700. https://doi.org/10.2466/02.09.21.28.pr0.109.5.686-700
Korzybski, A. (1935). Science and Sanity. The Journal of Nervous and Mental Disease (Vol. 82). https://doi.org/10.1097/00005053-193509000-00068
Laver, J., & Trudgill, P. (1979). Phonetic and linguistic markers in speech. In R. K. Scherer & H. Giles (Eds.), Social Markers in Speech (pp. 1–26). Cambridge: Cambridge University Press.
Li, M., Zhong, N., Lu, S., Wang, G., Feng, L., & Hu, B. (2016). Cognitive Behavioral Performance of Untreated Depressed Patients with Mild Depressive Symptoms. PLOS ONE, 11(1), e0146356. https://doi.org/10.1371/journal.pone.0146356
MacQueen, G. M., & Memedovich, K. A. (2017). Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options. Psychiatry and Clinical Neurosciences, 71(1), 18–27. https://doi.org/10.1111/pcn.12463
McIntyre, R. S., Cha, D. S., Soczynska, J. K., Woldeyohannes, H. O., Gallaugher, L. A., Kudlow, P., … Baskaran, A. (2013). Cognitive deficits and functional outcomes in major depressive disorder: Determinants, substrates, and treatment interventions. Depression and Anxiety, 30(6), 515–527. https://doi.org/10.1002/da.22063
Pennebaker, J. W., Mehl, M. R., & Niederhoffer, K. G. (2003). Psychological aspects of natural language. use: our words, our selves. Annual Review of Psychology, 54, 547–77. https://doi.org/10.1146/annurev.psych.54.101601.145041
Quraishi, S., & Frangou, S. (2002). Neuropsychology of bipolar disorder: a review. Journal of Affective Disorders, 72(3), 209–26. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12450638
Romero, N., Sanchez, A., & Vazquez, C. (2014). Memory biases in remitted depression: The role of negative cognitions at explicit and automatic processing levels. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 128–135. https://doi.org/10.1016/j.jbtep.2013.09.008
Rosenbach, C., & Renneberg, B. (2015). Remembering rejection: Specificity and linguistic styles of autobiographical memories in borderline personality disorder and depression. Journal of Behavior Therapy and Experimental Psychiatry, 46, 85–92. https://doi.org/10.1016/j.jbtep.2014.09.002
Ross, T. P. (2003). The reliability of cluster and switch scores for the Controlled Oral Word Association Test. Archives of Clinical Neuropsychology, 18(2), 153–164. https://doi.org/10.1016/S0887-6177(01)00192-5
Rude, S., Gortner, E.-M., & Pennebaker, J. (2004). Language use of depressed and depression-vulnerable college students. Cognition & Emotion, 18(8), 1121–1133. https://doi.org/10.1080/02699930441000030
Rude, S. S., Valdez, C. R., Odom, S., & Ebrahimi, A. (2003). Negative cognitive biases predict subsequent depression. Cognitive Therapy and Research. https://doi.org/10.1023/A:1025472413805
Rude, S. S., Wenzlaff, R. M., Gibbs, B., Vane, J., & Whitney, T. (2002). Negative processing biases predict subsequent depressive symptoms. Cognition & Emotion, 16(3), 423–440. https://doi.org/10.1080/02699930143000554
Saragoussi, D. (2016). Functional impairment in major depressive disorder (MDD): real-world evidence of the consequences of cognitive dysfunction. European Neuropsychopharmacology, 26, S757.
Schmid, M. (2013). Cognitive function in first episode major depressive disorder : Poor inhibition and semantic fluency performance. Cognitive Neuropsychiatry, 18(6), 515–530.
Schwartz-Mette, R. A., & Rose, A. J. (2016). Depressive Symptoms and Conversational Self-Focus in Adolescents’ Friendships. Journal of Abnormal Child Psychology, 44(1), 87–100. https://doi.org/10.1007/s10802-015-9980-3
Şimşek, Ö. (2013). The relationship between language use and depression: Illuminating the importance of self-reflection, self-rumination, and the need for absolute truth. The Journal of General Psychology, 140(February 2013), 37–41. https://doi.org/10.1080/00221309.2012.713407
Slama-Cazacu, T. (1959). Limbaj şi context problema limbajului în concepţia exprimării şi a interpretării prin organizări contextuale. Bucureşti: Editura Ştiinţifică.
Slama-Cazacu, T. (1980). Lecturi de psiholingvistica. (E. D. si Pedagogica, Ed.). București.
Smimova, D., Romanov, D., Sloeva, E., Kuvshinova, N., Krasnov, A., & Nosachev, G. (2014). Mild depression and normal sadness: Language diagnostic criteria. In Klinik Psikofarmakoloji Bulteni (Vol. 24, p. S3). [Istanbul], Turkish Association for Psychopharmacology.
Smirnova, D. (2013a). Language Phenomenon in the Diagnostic Criteria of Mild Depression. P.2.b.060. European Neuropsychopharmacology, 23(2), S354–S355.
Smirnova, D. A. (2011). Clinical Linguistics as the Basic Element of Methodological Knowledge in Psychotherapy. Asian Journal of Psychiatry, 4, S27. https://doi.org/10.1016/S1876-2018(11)60107-X
Smirnova, D., Sloeva, E., Kuvshinova, N., Krasnov, A., Romanov, D., & Nosachev, G. (2013b). 1419 – Language changes as an important psychopathological phenomenon of mild depression. In European Psychiatry (Vol. 28, p. 1). Elsevier Masson. https://doi.org/10.1016/S0924-9338(13)76454-X
Volkert, J., Schiele, M. A., Kazmaier, J., Glaser, F., Zierhut, K. C., Kopf, J., … Reif, A. (2016). Cognitive deficits in bipolar disorder: from acute episode to remission. European Archives of Psychiatry and Clinical Neuroscience, 266(3), 225–237. https://doi.org/10.1007/s00406-015-0657-2
Watters, A. J., & Williams, L. M. (2011). Negative biases and risk for depression; integrating self-report and emotion task markers. Depression and Anxiety, 28(8), 703–718. https://doi.org/10.1002/da.20854
WHO. (2017a). WHO | Depression. Retrieved March 5, 2017, from http://www.who.int/mediacentre/factsheets/fs369/en/
WHO, R. O. for E. (2017b). Data and statistics. Prevalence of mental disorders. World Health Organization.
Ye, Z., & Zhou, X. (2009). Executive control in language processing. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2009.03.003
