Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations

2011 ◽  
Vol 10 (1) ◽  
pp. 25-33
Author(s):  
Gretchen Snethen, PhD, LRT/CTRS ◽  
Bryan P. McCormick, PhD, CTRS ◽  
Marieke Van Puymbroeck, PhD, CTRS
Keyword(s):  
Community Participation ◽  
Negative Symptoms ◽  
World Health ◽  
International Classification Of Functioning ◽  
Population Increase ◽  
Positive Symptom ◽  
Schizophrenia Spectrum Disorders ◽  
Functional Impairments ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.

scholarly journals Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Structured Interview ◽  
Diagnostic Value ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Speech Technology ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

scholarly journals A Randomized Clinical Trial of Oxytocin or Galantamine in Schizophrenia: Assessing the Impact on Behavioral, Lexical, and Self-Report Indicators of Social Affiliation

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Kristen R Dwyer ◽  
Alexandra M Andrea ◽  
Christina L G Savage ◽  
Ryan D Orth ◽  
LeeAnn Shan ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Controlled Trial ◽  
Self Report ◽  
Schizophrenia Spectrum Disorders ◽  
Social Affiliation ◽  
Subjective Responses ◽  
Randomized Controlled ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Impact

Abstract Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectrum disorders during a role-play designed to elicit affiliative responses. We tested the hypothesis that daily intranasal oxytocin administered for 6 weeks would improve social affiliation as manifested by increased social skill ratings, use of positive, affiliative, and social words, and subjective responses from a previously published randomized controlled trial. Forty outpatients with schizophrenia or schizoaffective disorder were randomized to the oxytocin, galantamine, or placebo group and completed affiliative role-plays and self-report questionnaires of affect, reactions to the affiliative confederate, and willingness to interact at baseline and post-treatment. Results demonstrated that oxytocin was not effective at improving behavioral or subjective indicators of social affiliation. This study adds to a growing literature that the prosocial effects of oxytocin in schizophrenia are limited or null.

scholarly journals Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

2013 ◽  
Vol 23 (3) ◽  
pp. 271-279 ◽  
Author(s):  
B. Schrank ◽  
M. Amering ◽  
A. Grant Hay ◽  
M. Weber ◽  
I. Sibitz
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Stigma Of Mental Illness ◽  
Relevant Variables ◽  
Spectrum Disorders ◽  
Positive And Negative Symptoms

Aims.Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables.Methods.A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables.Results.Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight.Conclusions.This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.

Hallucinations without delusions in patients with first-episode psychosis: Clinical correlates and implications for pathophysiological models

2016 ◽  
Vol 33 (S1) ◽  
pp. S32-S32
Author(s):  
I. Melle
Keyword(s):  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Age At Onset ◽  
Diagnostic Interview ◽  
Clinical Profile ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Competing Interest

IntroductionThe symptomatic distribution in schizophrenia spectrum disorder is heterogeneous. Patients may experience hallucinations, delusions and combinations thereof, in addition to disorganized and negative symptoms. We have previously found that patients with monosymptomatic hallucinations exhibited a different clinical profile than patients with monosymptomatic delusions or combinations of the two; with an earlier age at onset and more suicidal symptoms.AimsTo replicate findings in a new group of patients with schizophrenia spectrum disorders.MethodsA total of 421 consecutive patients with schizophrenia spectrum disorders were included into the study. They were comprehensively assessed by specifically trained psychiatrists or clinical psychologists; using the SCID for DSM-IV for diagnostic purposes, the PANSS to assess current clinical symptoms and CDSS to assess current depression. Lifetime presence of different symptom types was ascertained during the diagnostic interview.ResultsA total of 346 (82%) had experienced both hallucinations and delusion, 63 (15%) had experienced delusions without hallucinations, 10 (2.5%) had experienced hallucinations without delusions and 2 patients (0.5%) had neither but experienced negative and severely disorganized symptoms. Contrary to hypothesis, we did not find any statistically significant differences in age at onset and in clinical symptoms (including suicidality) between these groups. We also did not find any differences in the type of hallucinatory experiences between hallucinating groups.ConclusionsIn a new sample of patients, we did not replicate previous findings of a different clinical profile in patients with monosymptomatic hallucinations. This type of psychotic disorder is relatively rare, which might pose a problem concerning statistical strength.Disclosure of interestThe author has not supplied his declaration of competing interest.

Measuring Motivation in Patients with Schizophrenia with Apathy Evaluation Scale (AES). Pilot Study of the Russian Version

2017 ◽  
Vol 41 (S1) ◽  
pp. S274-S274 ◽  
Author(s):  
M. Minyaycheva ◽  
K. Kiselnikova ◽  
L. Movina ◽  
I. Gladyshev ◽  
O. Papsuev
Keyword(s):  
Negative Symptoms ◽  
Psychosocial Treatment ◽  
Strong Correlations ◽  
Schizophrenia Spectrum Disorders ◽  
Russian Version ◽  
Schizophrenia Spectrum ◽  
Psychometric Tool ◽  
Spectrum Disorders ◽  
Competing Interest ◽  
Positive Correlations

IntroductionReduction of mental productivity and motivation in patients with schizophrenia is one of the core features of negative symptoms of schizophrenia spectrum disorders. Lack of motivation affects social functioning and outcomes, reduces effects of psychosocial treatment and rehabilitation.ObjectivesTo research AES abilities in measuring motivation in patients with schizophrenia spectrum disorders. The aim of the study was to investigate correlations of Russian translation of clinician-rated and self-rated versions with PANSS amotivation subscale and negative subscale items.MethodsFifty patients with schizophrenia spectrum disorders were recruited to participate in the study and were assessed with PANSS, AES-C and AES-S by trained raters. Only patients in “stabilized” state that met inclusion criteria of PANSS total score ≤ 80 points were eligible for consecutive AES assessment.ResultsOverall, moderate positive correlations were established between AES-C and PANSS amotivation subscale N2 and N4 items, N6 item and total PANSS negative subscale. No significant correlations with G16 item were registered. AES-C and AES-S versions also showed positive Spearman correlations (r = 0.43; P < 0.05), while no correlations between AES-S and amotivation PANSS items were registered.DiscussionModerately strong correlations between AES-C and PANSS N2, N4 and N6 items show feasibility of AES-C version in terms of measuring motivation in patients with schizophrenia spectrum disorders. Results of AES-S analysis demonstrate certain problems in patients’ abilities in self-assessing motivation. Patients with prevailing paranoid syndrome showed poorer results in AES-S scores.ConclusionsAES-C is a sensitive psychometric tool with good properties in measuring amotivation in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

2009 ◽  
Vol 24 (4) ◽  
pp. 259-267 ◽  
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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