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Introduction: There has been a relative lack of research on deaf people with schizophrenia, and no data exist regarding symptom structure in this population. Thus, we determined the factor structure of the 24-item Brief Psychiatric Rating Scale (BPRS) in deaf (n = 34) and hearing (n = 31) people with schizophrenia and compared it to a standard four-factor solution., Method: An obliquely rotated factor analysis produced a solution for the BPRS that resembled others in the literature. Symptom clusters were additionally compared to cognitive and social-cognitive abilities., Results: Activity and disorganised symptoms were the most consistent correlates of visual- and thought and language-related skills for deaf and hearing subjects respectively. Affective symptoms and facial affect processing were positively correlated among deaf but not hearing subjects., Conclusions: The data suggest that current symptom models of schizophrenia are valid in both hearing and deaf patients. However, relations between symptoms, cognition, and outcome from the general (hearing) literature cannot be generalised to deaf patients. Findings are broadly consistent with pathophysiologic models of schizophrenia suggesting a fundamental cortical processing algorithm operating across several domains of neural activity including vision, and thought and language. Support is provided for recent advances in social-cognitive interventions for people with schizophrenia.

Cognition has become prominent in the study of schizophrenia because of its importance for understanding the etiology of the illness and its consequences for living independently. For people with schizophrenia who are also deaf, investigations of cognition and schizophrenia are infrequent. This study examines the role of linguistic ability in relation to cognition, social cognition, and functional outcome among deaf adults with schizophrenia or schizoaffective disorder. The primary finding is that linguistic ability is positively and significantly associated with functional outcome above and beyond the contribution of cognition and social cognition. A younger age of sign language acquisition is significantly associated with superior linguistic ability, but did not moderate the effect of linguistic ability on other domains. Opportunities for deaf mental health consumers to participate in sign language enrichment programs and communicate with other skilled signers may be useful additions to standard psychiatric rehabilitation programming. More research is needed to clarify the consequences of deafness with regards to schizophrenia especially as it relates to language, vision, and symptoms.

It has been suggested in the research literature that facial affect processing (FAP) and theory of mind (ToM) are both potential mediators of the well-established relationship between cognition and functional outcome among people with schizophrenia. The current project tests the mediating potency of these two domains of social cognition among deaf and hearing people with schizophrenia. Sixty-five people (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, visual processing, FAP, and ToM. The results suggest that each domain of cognition, save vigilance, exerts an effect on functional outcome indirectly through its influence on social cognition. The patterns of mediation varied when the samples were broken down by hearing status and analyzed separately. Namely, the cognitive tasks directly involving linguistic ability (early visual processing [EVP] and word memory) were best mediated by social cognition for hearing subjects. For deaf subjects, the nonlinguistic cognitive tasks (e.g., visual-spatial memory-recall and copy [VSM-recall and VSM-copy]) were best mediated by social cognition. While FAP and ToM were equally effective as mediators for hearing subjects, FAP was a more potent mediator than ToM for deaf subjects. This study extends prior work in the area of social cognition and schizophrenia and indicates that the development of cognitive rehabilitation strategies should include not only interventions targeting specific cognitive abilities, such as attention and memory, but should include an emphasis on social-cognitive domains, including FAP and ToM. Further, deaf and hearing subjects may benefit from interventions addressing aspects of cognition that support linguistic ability, especially as they relate to social cognition.

Recent research has highlighted the relationships between impairments in cognitive functioning and poorer functional outcomes among people with schizophrenia (PWS). The purpose of this study was to replicate and extend this work by testing the relationships between cognition and functional outcome among deaf adults with schizophrenia. Empirical findings from deafness-oriented research reveals enhanced abilities in certain aspects of visual-spatial processing compared to hearing people. Sixty-five PWS (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, and visual processing. The first hypothesis tested whether cognition predicted functional outcome in a similar fashion for both deaf and hearing subjects (n=63). For all subjects, higher levels of cognitive ability were associated with higher levels of functional outcome, and the strongest predictors of outcome were verbal memory and visual-spatial memory (recall condition) (VSM recall). However, the deaf and hearing groups did show different patterns of relationships between cognition and functioning when all cognitive variables were examined. The second hypothesis was that deaf subjects would display superior performance in early visual processing, visual-spatial memory (copy condition) (VSM copy), and VSM recall. Deaf subjects displayed superior performance on each task; however, no significant differences emerged. Deaf subjects outperformed hearing subjects in an unexpected domain (word memory/recognition). This study extends prior work in the area of cognition and schizophrenia and indicates that deaf and hearing subjects may benefit from interventions that address different domains of cognition.

HIV-related prevention and intervention efforts for deaf adults with mental illness have been developed in the absence of empirical data regarding the risk behaviors in which this group engages. This study analyzes data provided by 66 deaf adults who received specialized services from a large psychiatric rehabilitation agency. Deafness-related social, linguistic, and behavioral factors are examined in relation to risky sexual behaviors, substance use, and serious mental illness. Risky behavior was significantly elevated among those who use cocaine and alcohol, have a history of sexually transmitted infections, have low levels of social integration and above average linguistic (sign) ability. Proficient sign language ability and engagement in the Deaf community interacted with substance use to increase the risk for HIV. Risk reduction for deaf adults should consider the interaction between mental health symptoms and the social consequences of deafness (e.g., delayed language acquisition). As well, interventions must be straightforward and administered by fluently signing, clinical staff. [ABSTRACT FROM AUTHOR]

Visual illusions allow for strong tests of perceptual functioning. Perceptual impairments can produce superior task performance on certain tasks (ie, more veridical perception), thereby avoiding generalized deficit confounds while tapping mechanisms that are largely outside of conscious control. Using a task based on the Ebbinghaus illusion, a perceptual phenomenon where the perceived size of a central target object is affected by the size of surrounding inducers, we tested hypotheses related to visual integration in deaf (n = 31) and hearing (n = 34) patients with schizophrenia. In past studies, psychiatrically healthy samples displayed increased visual integration relative to schizophrenia samples and thus were less able to correctly judge target sizes. Deafness, and especially the use of sign language, leads to heightened sensitivity to peripheral visual cues and increased sensitivity to visual context. Therefore, relative to hearing subjects, deaf subjects were expected to display increased context sensitivity (ie, a more normal illusion effect as evidenced by a decreased ability to correctly judge central target sizes). Confirming the hypothesis, deaf signers were significantly more sensitive to the illusion than nonsigning hearing patients. Moreover, an earlier age of sign language acquisition, higher levels of linguistic ability, and shorter illness duration were significantly related to increased context sensitivity. As predicted, disorganization was associated with reduced context sensitivity for all subjects. The primary implications of these data are that perceptual organization impairment in schizophrenia is plastic and that it is related to a broader failure in coordinating cognitive activity. [ABSTRACT FROM PUBLISHER]