Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Schizophrenia is a serious mental illness characterized by hallucinations, delusions, cognitive deficits, and disorganized behaviour. Disorganized speech has long been recognized as a core feature of the disorder; it does not respond to pharmacological medication and is thought to perpetuate stigma, as it is one of the most salient symptoms of psychosis. Disorganized speech is present across the course of schizophrenia and is a limiter of functioning in domains of social skills, academic achievement, and workplace success. Thus, disordered speech is a challenging barrier on the road to true recovery. However, any type of treatment has been almost completely ignored. I will address this gap in the research by conducting a large-scale multi-site randomized controlled trial to evaluate a treatment that I developed entitled Structured Therapy for the Enhancement of Purposeful Speech (STEPS). STEPS is a novel behavioural treatment designed to increase goal-directed speech and promote gains in interpersonal skills. Treatment incorporates asking participants to engage in conversations and correcting speech errors in real-time as they occur. Replicating and extending the results from our efficacy study, I hypothesize that immediate feedback will shape organization of thoughts resulting in a decrease in disordered speech, and I will elucidate possible neural mechanisms related to disordered speech using fMRI. During STEPS, individuals will practice their newly acquired communication skills in a social setting allowing for generalization to everyday community behaviour. With better communication skills individuals will be able to better advocate for themselves and build social connections thereby increasing quality of life. Through this study we will determine whether disorganized speech can be remediated and further understand how these improvements may be transferred to real-world behaviour to better the lives of the millions of North Americans afflicted by schizophrenia.