Impaired Perspective and Thought Pathology in Schizophrenic and Psychotic Disorders

Impaired perspective was studied in schizophrenic and thought-disordered patients to analyze hypotheses about its role in thought disorder. Eighty-three schizophrenic patients, other psychotic patients, and nonpsychotic patients judged the adequacy of their own and others' verbalizations under several different conditions. Thought-disordered patients had significantly more impaired perspective than nonthought-disordered patients (p < 0.05). Patients had significantly poorer perspective about their own verbalizations than about those of other patients (p < 0.01). Schizophrenic and other psychotic patients showed poor perspective about their own verbalizations. Thought-disordered patients did not view their bizarre verbalizations as stranger than their nonbizarre verbalizations. Impaired perspective and bizarre responses were more frequent under certain conditions. When focusing on the adequacy of their response, patients were significantly less idiosyncratic. The results support the hypothesis that impaired perspective plays a role in thought disorder. A more comprehensive model of thought disorder and disorganization, which includes impaired perspective, is discussed.