Concretism is a well-known feature of schizophrenia, tracing back to the early descriptions of the disease and commonly associated with the literal interpretation of figurative expressions such as proverbs, metaphors, and idioms. However, figurative expressions are not all alike in terms of linguistic and pragmatic processes. Determining if some figurative types are more impaired than others and if the type of task affects the performance constitutes an open issue with implications for the description of the clinical profile and for treatment. We run a fine-grained assessment of figurative language comprehension by comparing 47 patients with schizophrenia and 39 controls in three figurative types (idioms, metaphors, proverbs) presented in two response formats (multiple-choice, verbal-explanation), considering also the role of cognitive and clinical variables and the impact on quality of life. Mixed-effects models analysis revealed that: i) patients performed worse than controls across figurative types and response formats, indicating a diffuse impairment; ii) there is an interplay of figurative type and response format, which makes verbal-explanation of proverbs especially challenging; iii) in patients, problems in figurative language are largely connected with formal thought disorder and global IQ. Moreover, multiple-choice of metaphors was associated with patients' quality of life. This study offers a novel account of concretism, framed in pragmatics and figurative language processing. Adopting this perspective allowed us to describe the nuances of concretism, which areas in the figurative domain are especially challenging for patients and which ones capture differences in functioning, in order to guide intervention programs and integration in society.

中文翻译：

---

豹子不能改变自己的位置：精神分裂症中一种新的实用主义的神秘主义。

保守主义是精神分裂症的一个众所周知的特征，可以追溯到该疾病的早期描述，并且通常与诸如谚语，隐喻和习语等象征性表达的字面解释有关。然而，就语言和语用过程而言，比喻表达并非全部相同。确定某些比喻类型是否比其他比喻更受损害，以及任务的类型是否影响工作表现，是一个尚待解决的问题，对临床资料的描述和治疗具有影响。我们比较了47位精神分裂症患者和39位对照者，以两种回应方式（多项选择，口头解释）呈现的三种比喻类型（惯用语，隐喻，谚语），对比喻语言理解进行了细粒度评估，还应考虑认知和临床变量的作用以及对生活质量的影响。混合效应模型分析表明：i）患者在比喻类型和反应形式方面的表现较对照差，表明存在弥散性损伤；ii）比喻类型和回应格式之间存在相互作用，这使得谚语的口头解释特别具有挑战性；iii）在患者中，比喻语言的问题在很大程度上与形式思维障碍和整体智商有关。而且，选择的隐喻与患者的生活质量有关。这项研究以务实和比喻性语言处理为视角，提出了一种新的具体主义解释。采用这种观点可以使我们描述具体主义的细微差别，