During the last 20 years, a body of research has emerged suggesting that deficits in the self-monitoring of willed intention to act may be responsible for the expression of positive symptoms in schizophrenia (Frith, 1992). Empirical evidence supporting this theory indicates that schizophrenics with positive symptoms are impaired on motor and speech based tasks that involve monitoring of internal cognitive mechanisms and behavior plans, but are less impaired when monitoring external sensory feedback. The current project extends this research by comparing the performance of two groups of schizophrenics (hallucinators, n=16; and nonhallucinators, n=15) with a group of nonpsychotic psychiatric patients (n = 15) on measures of speech monitoring of internal and overt speech. On two measures of internal speech monitoring (silent reading and identification of speech errors in a white noise environment), the schizophrenics were found to be impaired relative to controls; however, the schizophrenics were also impaired on a task of self-monitoring when they had access to external feedback. Analysis of the subgroups data (hallucinators vs. nonhallucinators) indicated very similar performances across tests and no significant differences were identified, with the exception of the silent reading test in which the hallucinators did perform significantly worse. These results indicate that the speech-monitoring deficit in schizophrenia is not limited to the internal speech plan, but can also involve a failure to monitor overt speech, contrary to previous report. Furthermore, speech-monitoring deficits are not limited to schizophrenics who experience hallucinations. An additional experiment involving delayed auditory feedback (DAF) was also conducted to replicate a previous finding in the literature that schizophrenics were more dysfluent in DAF. On the DAF task, the combined schizophrenic group were found to be more dysfluent than controls, and there were no differences between the two schizophrenic subgroups. Further correlational analysis revealed a strong relationship between the level of dysfluency in DAF and self-monitoring impairment. While the results of the experiment were similar to those found by previous authors (Goldberg, Gold, Coppola, & Weinberger, 1997), the correlational analysis allows for an explanation of dysfluency in DAF based on self-monitoring. / Graduate

No description available.

Thesis ( M Med (Clinical Psychology))--University of Limpopo, 2010. / The aim of this study was to determine the effect of therapeutic ‘reality validation’ on the ‘schizophrenic dance’ based on the principles of a therapy outcome study. The objective of this study was to reduce the observable degree of psychosis in the schizophrenic patient and to facilitate the patient into entering a closer relationship with the therapist through the use of a new therapeutic approach called ‘reality validation’. This was done using a qualitative, exploratory research design. The research was conducted by examining transcribed video recordings of the administered therapeutic ‘reality validation’ by a trained clinician with patients diagnosed with schizophrenia. The analysis of the video recorded data was conducted independently by three trained clinicians who were each given the recordings along with the transcriptions of the recordings. The clinicians each gave a clinical description of each the patient’s behaviour separately during the sessions according to predetermined questions which were all indicative of the effect of ‘reality validation’ and were asked to conclude whether it had resulted in a reduction in symptomatic behaviour. The analyses of the six ‘reality validation’ sessions showed promising results. Based on five of the conducted sessions, there were clear indications that with ‘reality validation’ there was a reduction in symptomatic behaviour. In three of the sessions ‘reality validation’ had been at times incorrectly conducted, impacting on the outcome of the study. In two of these three sessions reductions in symptomatic were less evident yet still clearly present. In one session ‘reality validation’ was conducted so inaccurately that it appeared to maintain or increase the patient’s symptomatic behaviour. Despite the shortcomings in this study there was evidence to suggest that therapeutic ‘reality validation’ when used accurately can be an effective intervention, resulting in a reduction in symptomatic behaviour.

No description available.

Social skills deficit has been a long-standing functional impairment among people with Schizophrenia. This pervasive problem affects multiple aspects in life. Most interventions focus on the enhancement of expressive social skills; in the contrary, receptive social skills are less emphasized. However, receptive skills such as social intelligence and theory of mind (ToM) are the pre-requisites and foundation of expressive skills. Researches also suggested that people with schizophrenia have various extent of impairment in social cognition, i.e. receptive skills. Incorporation of receptive skills modules into convention intervention may be effective to enhance overall social and occupational performance. The Integrated Social Skill Training (ISST) is a hybrid intervention introducing social cognition components into convention skills training model. The effectiveness on the mental state, and social occupational function was evaluated through a pilot study. 12 Subjects were recruited in a local psychiatric day training unit and were divided into control and experimental group. The experimental group went through the 8-sessions ISST on top of day training; while control group were put on the waiting list and received purely day training within the research period. Psychopathology was measured with Positive and Negative Syndrome Scale (PANSS) and the level of social and occupational functions was measured by Social and Occupational Functioning Assessment Scale (SOFAS). Measurements were taken before and after the administration of ISST on both groups of subjects. Repeated measures ANOVA and paired samples t-test were used for between-group and within-group data analysis respectively. Results suggested a neutral effect of ISST to mental states; whereas a positive effect of ISST was reported on improving the social occupational performance for subjects within the experimental group but not within the control group. However, the magnitude of improvement was yet to meet a statistical difference when compared with that of the control group. By incorporating social cognition elements into convention skills training model can improve the social and occupational performance of people with schizophrenia. Further refinement of the ISST is to be made to achieve a higher efficacy. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

The redundancy-associated deficit often found in schizophrenic simple reaction time was studied utilizing hypothetically schizophrenia-prone college students. The embedded-set procedure established by Bellissimo and Steffy (1972) with two methodological modifications was employed. As predicted normal and psychiatric controls did not show the redundancy-associated deficit. The hypothetically schizophrenia-prone college students did not show the cross-over effect typically produced by process schizophrenics. Several explanations were offered for these results.

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1977. / Bibliography: leaves 376-388. / Microfiche. / vi, 388 leaves

AIM: The aim of this thesis was to explore insight in schizophrenia from the perspectives of patients, relatives and clinicians. Insight scales were examined in order to collate items that were comprehensive with respect to key dimensions of insight but also sufficiently simple to allow use in everyday psychiatric practice. Background "Insight" describes the person's understanding of the nature of their mental illness. Assessment of insight for people with schizophrenia has always been an essential part of clinical practice. Often there are differences in understanding of the illness between patients, their relatives and their clinicians. Patients and relatives can feel that clinicians do not consider their views when making clinical decisions. Insight is multidimensional, more than just saying, "I have mental illness". It was postulated that the quality and range of what constitutes a lack of insight may vary according the viewpoint of the assessor. Another question was whether the scope of currently available insight scales was sufficient to encompass dimensions felt to be important to patients and relatives. The assessment of insight also has a transactional quality - the views of patients, relatives and clinicians interact in a dynamic fashion. There has been little direct assessment of the role of relatives in considering insight into psychosis, and limited consideration of the transactional nature of assessments of patient's insight. This study has a unique perspective. It looks at the assessment of patient's awareness of various dimensions of insight from three points of view patient, relative and clinician. STUDY DESIGN: Through consideration of the theoretical underpinnings and practical applications of existing Insight Measures, conducting focus groups of patients and relatives, and seeking expert opinion, the candidate proposed six dimensions of insight into schizophrenia to be studied in this three-way comparison: Awareness of the presence of symptoms or a change Acknowledgement it is a mental illness Expressed intention to or acknowledgement of the need to do something about the mental illness Actively engaging in (appropriate) treatment for the mental illness Patient's awareness of effects of their mental illness on the self Patient's awareness of effects of their mental illness on other people As no existing Insight Measure catered for multiple views over all of these dimensions, a number of new measures to supplement existing measures were devised. In this study, patients (n=39) with Schizophrenia or Schizoaffective disorder were assessed soon after admission to an acute psychiatry unit. They were invited to nominate a relative or significant other (n=28) who had close contact with the patient. Relatives were separately interviewed about the patient insight. The clinician's view of patient illness was assessed using Schedule for the Assessment of Insight Expanded Version (SAI-E), and the Scale to Assess Unawareness of Mental Disorder (SUMD). The patient's view was assessed by the New Insight Measure for patients (New IM) and the self-rated Markova & Berrios Scales. The SUMD and Markova & Berrios Scales were adapted for the relative assessment of patient awareness (SUMD-rel and M&Brel). Other measures assessed psychopathology (PANSS) and various clinical and demographic variables (Diagnostic Interview for Psychosis; DIP). In order to select appropriate measures for the clinician's view, the existing Insight Measures were also compared. A three-way comparison of views of patient awareness across the six dimensions was conducted. The clinical utility of all measures was considered. The measures were repeated at follow-up one year later. RESULTS: The new insight measures were generally easy to use and understood by the patients and relatives. There was some variation in scores for each of the six dimensions of insight reported by patients, relatives and clinicians indicating that they saw the dimensions as different. There was a high positive correlation for Acknowledgement it is a mental illness for all three reporters across time, but this was less consistent for the other dimensions. The key findings were that the patients and the clinician showed a significant positive correlation for Awareness of the effects of the illness on themself, while patients and relatives showed a significant positive correlation for Awareness of the effects of illness on others. These findings have relevance for clinical interaction and decision-making. There was limited change in overall insight scores or the pattern of correlations over the follow-up period, despite changes in psychopathology and mental health act status. DISCUSSION AND CONCLUSIONS: The study describes, for the first time, the similarities and differences in insight when assessed by patients, relatives and clinicians. When differences arise between patients, families and/or clinicians, these need not be dismissed as poor understanding on the relative's or patient's part. Family members have different views about patients' insights. The implications for clinical understanding of this are discussed. The proposed six dimensions of insight seen from the viewpoint of patient, relative and clinician are easily understood. The overall perspective developed in this thesis could inform a lexicon to describe aspects of clinical assessment and decision-making in areas such as compulsory treatment, compliance with treatment or understanding the effects of illness on self or others' all areas where insight into illness is usually considered.

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, . / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

Thesis (M.A.)--University of Adelaide, 1991. / Errata (2 leaves) inserted. Includes bibliographical references (leaves 149-156).