Reference Across Pathologies: A New Linguistic Lens on Disorders of Thought

Abstract

According to a linguistic tradition here termed ‘Cartesian’, language is relegated to an expressive system considered to provide the means to encode or communicate an independently constituted thought process. An alternative vision here termed ‘un-Cartesian’ regards language as an organizational principle of human-specific thought, with the implication that thought of the same type would not become available to a cognitive system without language and that clinical thought disturbances implicate language dysfunction. I here explore the latter view in the context of intra-species variation of the human cognitive type: cognitive disorders that, as in the case of autism and schizophrenia, come with language-related clinical symptoms. If language is the configurator of human-specific thought, cognitive and linguistic phenotypes should illuminate one another. I specifically review evidence for impairment in one universal linguistic function, namely reference. Linguistic meaning is referential meaning: we cannot utter sentences without referring to persons, objects, and events, based on lexicalized concepts that provide descriptions of these referents. Reference in this sense takes a number of human-specific forms, from generic to specific, deictic and personal ones, which empirically co-vary with forms of grammatical organization. As reference in some of these forms proves to be highly vulnerable across major mental disorders, grammar is thereby linked to forms of thought and selfhood critical to normal cognitive functioning. In this way clinical linguistic and cognitive diversity provides an important new window into the foundational question of the thought-language relationship and the cognitive significance of grammar.

Language disintegration under conditions of severe formal thought disorder

“…2 nd Person, and hence as a mis-localization of herself as a 1 st Person. Problems with felicitous uses of personal pronouns thus deserve further study, in line with theoretical approaches stressing the importance of disturbances of deixis to the psychopathology of schizophrenia (Crow 2010;Hinzen & Rosselló 2015;Hinzen et al 2017). Deictic disturbances clearly extend beyond personal pronouns, reflecting remarkable problems of these patients in locating events or themselves as event participants in space and time, e.g.…”

“…a declarative) sense has long been linked to language, given its essential absence in non-human primates (Butterworth 2003;Tomasello 2006;Tomasello & Call 2018), its close association with language development even in its nonverbal forms in humans (Iverson & Goldin-Meadow 2005;Colonnesi et al 2010), and given its severe reduction or absence in non-or minimally verbal children with autism spectrum disorders (Maljaars et al 2011;Slusna et al 2018). Since, in turn, thought that was not expressible in language as used normally would not be thought of the same kind (but might be emotion, imagery, music, or pathological thought), it is arguable that language, thought, and reference are inseparable in humans, forming an integrated, single species-specific scheme, in which they are all co-dependent (Davidson 2004;Hinzen & Sheehan 2015;Hinzen 2017). From this point of view, it makes sense that language in FTD is seen to disproportionally disintegrate at this referential end the level of grammatical complexity where thought becomes referentially anchored in speech.…”

“…her favourite grandmother, do not as such give us any idea of who is being referred to. Both reference and truth are utterance level (root) phenomena, which require multiple grammatical elements to come together configurationally in the right way so to allow identifying a referent and event in context (Hinzen & Sheehan 2015;Hinzen 2017).…”

The language profile of formal thought disorder

“…Consequently, language carries content and informs us about the state of the world. The neurocognitive basis of such reference has been linked to our language capacity, 30 , 31 including its non-verbal forms (e.g., pointing) which are closely correlated with language development. 32 – 34 Referentiality in language is never solely a lexical property (i.e., a property of words in isolation).…”

“…Words occurring on their own, e.g., HOUSE, BEAR, WIN, or CUP, do not refer to any particular object: they capture general classes of things and can become referential only when embedded in noun phrases (NPs), which are in turn embedded in utterances. 30 NPs are grammatical configurations which contain a grammatical function word ( the , a ) together with one or more content words providing a description of the referent ( man with a hat , red car ), or else consist of pronouns ( she , this ) in isolation. Reference to individuals can firstly be ‘generic’, when no particular individual(s) is (are) singled out, as in the sentence I like dogs (generic NP underlined).…”