Psychological Medicine

Original Articles

Evaluation sensitivity as a moderator of communication disorder in schizophrenia

P. M. Granta1 c1 and A. T. Becka1

a1 Department of Psychiatry, University of Pennsylvania, USA


Background Communication disturbance (thought disorder) is a central feature of schizophrenia that predicts poor functioning. We investigated the hypothesis that memory and attention deficits interact with beliefs about the gravity of being rejected (i.e. evaluation sensitivity) to produce the symptoms of communication disorder.

Method Seventy-four individuals diagnosed with schizophrenia or schizo-affective disorder completed a battery of tests assessing neurocognition (attention, working and verbal memory, abstraction), symptomatology (positive, negative and affective), functioning, and dysfunctional beliefs.

Results Patients with communication deviance (n=33) performed more poorly on the neurocognitive tests and reported a greater degree of sensitivity to rejection than patients with no thought disorder (n=41). In a logistic regression analysis, evaluation sensitivity moderated the relationship between cognitive impairment and the presence of communication disorder. This finding was independent of hallucinations, delusions, negative symptoms, depression and anxiety.

Conclusions We propose that negative appraisals about acceptance instigate communication anomalies in individuals with a pre-existing diathesis for imperfect speech production.

(Received September 01 2008)

(Revised January 14 2009)

(Accepted January 24 2009)

(Online publication April 20 2009)


c1 Address for correspondence: P. M. Grant, Ph.D., Room 2032, 3535 Market Street, Philadelphia, PA 19104-3309, USA. (Email: