The relationship between the therapeutic alliance and client variables in individual treatment for schizophrenia spectrum disorders and early psychosis: Narrative review

Schizophrenia spectrum disorders are chronic and debilitating mental illnesses characterised by both cognitive impairments and sleep deficits. In this systematic review protocol, we outline an approach to examine the available literature investigating the relationship between sleep and cognition in individuals with schizophrenia spectrum disorder.

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Personality traits, interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2013.05.016 ◽

2013 ◽

Vol 54 (8) ◽

pp. 1169-1176 ◽

Cited By ~ 21

Author(s):

Ragnhild Johansen ◽

Ingrid Melle ◽

Valentina Cabral Iversen ◽

Knut Hestad

Keyword(s):

Therapeutic Alliance ◽

Personality Traits ◽

Interpersonal Problems ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Early Schizophrenia

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Variable Insight in OCD

10.1093/med/9780190228163.003.0013 ◽

2017 ◽

Author(s):

Rebecca J. Hamblin ◽

Jennifer Moonjung Park ◽

Monica S. Wu ◽

Eric A. Storch

Keyword(s):

Obsessive Compulsive Disorder ◽

Assessment Tools ◽

Schizophrenia Spectrum Disorders ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Definition Of ◽

The Relationship ◽

Insight Into

Individuals with obsessive-compulsive disorder (OCD) often have good insight into the irrational nature of their obsessions and the excessive character of their compulsions, but insight exists along a continuum and is markedly poor in some patients. This chapter reviews the assessment and phenomenological correlates of variable insight in OCD in both pediatric and adult populations. It reviews the definition of insight and its relationship to the evolution of diagnostic criteria for obsessive-compulsive disorder, as well as the major assessment tools used to measure and quantify insight for clinical and research purposes. The relationships between insight and clinical characteristics of OCD, including symptom severity, comorbidity, and treatment response are reviewed, followed by a review of neurobiological correlates of insight and the relationship between poor insight and schizophrenia spectrum disorders.

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A review of autobiographical memory studies on patients with schizophrenia spectrum disorders

BMC Psychiatry ◽

10.1186/s12888-019-2346-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yujia Zhang ◽

Sara K. Kuhn ◽

Laura Jobson ◽

Shamsul Haque

Keyword(s):

Autobiographical Memory ◽

Psychotic Symptoms ◽

Control Group ◽

Schizophrenia Spectrum Disorders ◽

Autobiographical Memories ◽

Memory Specificity ◽

Autobiographical Memory Specificity ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

The Relationship

Abstract Background Patients suffering from schizophrenia spectrum disorders demonstrate various cognitive deficiencies, the most pertinent one being impairment in autobiographical memory. This paper reviews quantitative research investigating deficits in the content, and characteristics, of autobiographical memories in individuals with schizophrenia. It also examines if the method used to activate autobiographical memories influenced the results and which theoretical accounts were proposed to explain the defective recall of autobiographical memories in patients with schizophrenia. Methods PsycINFO, Web of Science, and PubMed databases were searched for articles published between January 1998 and December 2018. Fifty-seven studies met the inclusion criteria. All studies implemented the generative retrieval strategy by inducing memories through cue words or pictures, the life-stage method, or open-ended retrieval method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines were followed for this review. Results Most studies reported that patients with schizophrenia retrieve less specific autobiographical memories when compared to a healthy control group, while only three studies indicated that both groups performed similarly on memory specificity. Patients with schizophrenia also exhibited earlier reminiscence bumps than those for healthy controls. The relationship between comorbid depression and autobiographical memory specificity appeared to be independent because patients’ memory specificity improved through intervention, but their level of depression remained unchanged. The U-shaped retrieval pattern for memory specificity was not consistent. Both the connection between the history of attempted suicide and autobiographical memory specificity, and the relationship between psychotic symptoms and autobiographical memory specificity, remain inconclusive. Patients’ memory specificity and coherence improved through cognitive training. Conclusions The overgeneral recall of autobiographical memory by patients with schizophrenia could be attributed to working memory, the disturbing concept of self, and the cuing method implemented. The earlier reminiscence bump for patients with schizophrenia may be explained by the premature closure of the identity formation process due to the emergence of psychotic symptoms during early adulthood. Protocol developed for this review was registered in PROSPERO (registration no: CRD42017062643).

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A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis

European Psychiatry ◽

10.1192/j.eurpsy.2020.67 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Libby Igra ◽

Michal Lavidor ◽

Dana Atzil-Slonim ◽

Nitzan Arnon-Ribenfeld ◽

Steven de Jong ◽

...

Keyword(s):

Therapeutic Alliance ◽

Meta Analysis ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Mean Differences ◽

Therapist Perspectives ◽

Therapist Perspective ◽

Moderating Role

Abstract Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument. Method: We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders. We then analyzed the data using a random-effects meta-analytic model with Cohen’s d standardized mean effect size. Results: Heterogeneity analyses (k = 22, Cohen’s d = −.46, 95% confidence interval = .31–1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate. Conclusions: Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client’s diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients’ and therapists’ estimations than do more general instruments that are applied to assess TA.

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The influence of baseline symptoms and insight on the therapeutic alliance early in the treatment of schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2008.12.015 ◽

2009 ◽

Vol 24 (4) ◽

pp. 259-267 ◽

Cited By ~ 55

Author(s):

Andreas Wittorf ◽

Ute Jakobi ◽

Andreas Bechdolf ◽

Bernhard Müller ◽

Gudrun Sartory ◽

...

Keyword(s):

Therapeutic Alliance ◽

Negative Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Alliance Formation ◽

Treatment Patient ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Positive And Negative Symptoms

AbstractBackgroundThe consistent association between therapeutic alliance and outcome underlines the importance of identifying factors which predict the development of a positive alliance. However, only few studies have examined the association between pretreatment characteristics and alliance formation in patients with schizophrenia.ObjectiveThe study examined whether symptoms and insight would predict the therapeutic alliance in psychotherapy of schizophrenia. Further, the associations and differences between patient and therapist alliance ratings were studied.MethodsEighty patients with schizophrenia spectrum disorders received manual-based psychotherapy. Assessment of symptoms and insight was conducted at baseline, and questionnaire-based alliance ratings were obtained three weeks into treatment. Patient and therapist alliance ratings were examined separately.ResultsPatient and therapist alliance ratings were not significantly correlated (r = 0.17). Patient ratings of the alliance were significantly higher than the ratings of their therapists (d = 0.73). More insight in psychosis significantly predicted higher patient ratings of the alliance. Less positive and negative symptoms were significant predictors of higher therapist alliance ratings.ConclusionThe findings indicate that symptoms and insight have an influence on the therapeutic alliance in the treatment of schizophrenia spectrum disorders. Patients' and therapists' perceptions of the alliance do not seem to demonstrate much convergence.

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Characterizing the sensorimotor domain in schizophrenia spectrum disorders

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-021-01354-9 ◽

2021 ◽

Author(s):

Stefan Fritze ◽

Fabio Sambataro ◽

Katharina M. Kubera ◽

Geva A. Brandt ◽

Andreas Meyer-Lindenberg ◽

...

Keyword(s):

Disease Process ◽

Cognitive Domain ◽

Schizophrenia Spectrum Disorders ◽

Neurocognitive Performance ◽

Ongoing Debate ◽

Cognitive Correlates ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

The Relationship ◽

Intrinsic Component

AbstractThe rapidly evolving field of sensorimotor neuroscience reflects the scientific and clinical relevance of sensorimotor abnormalities as an intrinsic component of the disease process, e.g., in patients with schizophrenia spectrum disorders (SSD). Despite previous efforts, however, prevalence rates and relationships between different categories of sensorimotor abnormalities in SSD patients are still subject of ongoing debate. In this study, we examined five different categories of the sensorimotor domain (Neurological soft signs (NSS), parkinsonism, catatonia, akathisia, and tardive dyskinesia) according to well-established clinical ratings scales and the respective cut-off criteria in a sample of 131 SSD patients. We used a collection of statistical methods to better understand prevalence, overlap and heterogeneity, as well as psychopathological and cognitive correlates of sensorimotor abnormalities. 97.7% of the SSD patients considered by this study exhibited at least one categorically defined sensorimotor abnormality that tended to co-vary within three different sensorimotor subgroups (moderate, hyperkinetic and hypokinetic). Finally, hyperkinetic and hypokinetic groups differed significantly in their neurocognitive performance compared with the moderate group. The results suggest different patterns of clinical overlap, highlight the relationship between sensorimotor and cognitive domain and provide clues for further neurobiological studies.

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M122. DEPRESSION IN SCHIZOPHRENIA SPECTRUM DISORDERS: LONGITUDINAL COURSE AND THE RELATIONSHIP WITH OTHER CLINICAL PARAMETERS AND QUALITY OF LIFE

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.434 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S181-S182

Author(s):

Lebogang Phahladira ◽

Laila Asmal ◽

Bonginkosi Chiliza ◽

Hilmar Luckhoff ◽

Stefan du Plessis ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

First Episode ◽

Clinical Parameters ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

First Episode Schizophrenia ◽

The Relationship

Abstract Background The relationship between schizophrenia and depression is complex. Longitudinal studies on the course of depression in first episode schizophrenia populations are scarce and there are conflicting results on the predictive value of some baseline measures. Methods We conducted an open label longitudinal cohort study which included 126 patients with first-episode schizophrenia spectrum disorders treated with long-acting antipsychotic medication over 24 months. Depression was assessed at three monthly intervals using the Calgary Depression Scale for Schizophrenia. Changes in depression over time were assessed using the linear mixed-effect models for continuous repeated measures. The relationship between depression and other clinical parameters was assessed with regression models. Results Depressive symptoms were most prominent at baseline and showed highly significant reductions in the first three months (p<0.0001). Majority of the patients with depression improved with antipsychotic medication alone and we found associations between depressive symptoms with insight and poorer quality of life, however only illness awareness (p=0.0035) was the only significant predictor on depression in our regression analysis. There were a few differences between patients who experienced depression during the acute phase of treatment and those in the post-acute phase. Discussion Our findings suggest that depression in schizophrenia is common and generally responds well to treatment. The relationship between depression and insight has implications for further treatment considerations

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The Relationship Between Multisensory Temporal Processing and Schizotypal Traits

10.31234/osf.io/79hdz ◽

2020 ◽

Author(s):

Tyler C. Dalal ◽

Anne-Marie Muller ◽

Ryan A Stevenson

Keyword(s):

Temporal Processing ◽

Temporal Order Judgment ◽

Judgment Task ◽

Schizophrenia Spectrum Disorders ◽

Magical Thinking ◽

Schizotypal Personality ◽

Schizophrenia Spectrum ◽

Schizotypal Personality Questionnaire ◽

Spectrum Disorders ◽

The Relationship

Recent literature has suggested that atypical sensory processing observed in schizophrenia may contribute to clinical symptomatology. Specifically, multisensory temporal processing was shown to be strongly associated with hallucination severity. Here, we explored whether this relationship extends to a broader spectrum of schizotypal traits, in line with the DSM-5’s shift towards a more dimensional approach to diagnostic criteria within Schizophrenia Spectrum Disorders. Fifty-one participants completed an audiovisual temporal order judgment task as a measure of multisensory temporal processing and self-reported levels of schizotypal traits using the Schizotypal Personality Questionnaire. These data revealed two novel findings. First, less precise multisensory temporal processing was related to higher overall levels of schizotypal traits. Second, this relationship was specific to the cognitive-perceptual domain, and more specifically, the Unusual Perceptual Experiences and Odd Beliefs or Magical Thinking measures. Previous literature has shown that less precise multisensory temporal processing was related to the severity of hallucinations in schizophrenia. These findings provide a novel, direct extension of this previous work by demonstrating that this relationship applies to traits across the schizophrenia spectrum, including at the subclinical level.

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