Thesis (Ph.D.)--University of Nebraska-Lincoln, 2006. / Title from title screen (site viewed on Nov. 13, 2006). PDF text: viii, 124 p. : ill. ; 5.12Mb. UMI publication number: AAT 3217589. Includes bibliographical references. Also available in microfilm and microfiche format.

Thesis (Ph.D.)--York University, 2005. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 70-90). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNR11600

Thesis (D.N.S.)--Boston University

Thesis (Ph.D.)--Boston University / The purpose of the present study was to determine whether positive reinforcement, chlorpromazine and secobarbital alter the ability of chronic schizophrenics to maintain sustained attention and whether these affect their psychomotor functioning. Eight male, chronic schizophrenic patients, with an age range of 25-50 and in good physical health, served as the subjects. All subjects had been hospitalized continuously for at least three years. Medication was discontinued for all subjects two months before the study started. In the course of the study, each subject was tested twice under all of the following conditions: no-drug, placebo, chlorpromazine 100 mg, chlorpromazine 200 mg, secobarbital 100 mg, secobarbital 200 mg. The drugs were given once weekly in single doses. A testing day consisted of four sessions: 1/2, 1 1/2, 2 1/2, and 3 1/2 hours post-medication. The different drug conditions were administered according to a modified Latin Square design with each active drug following each other active drug an equal number of times. Half of the trials in each session were reinforced by candy and cigarettes and the other half were not. Two tests were employed: The Continuous Performance Test (CPT), and the Subject Paced Test (SPT). On the CPT, a test of sustained attention, a subject is required to respond, by pulling a lever, to one of twelve letters which are randomly exposed at the rate of 1.10 sec. for a period of .10 second.[TRUNCATED]

This work addresses some of the difficulties encountered while working in psychotherapy with a residual schizophrenic. While there is an abundance of literature on psychotherapy for schizophrenia, both supporting and also refuting its merit, what the literature fails to reveal is that there appears to be a class of schizophrenic who, while apsychotic and able to communicate in the everyday sense of the word, is in a psychic space which speaks of a break with the basic relational elements of the human order. The quality of the patient's psychic life is such that almost nothing of what the literature describes as useful and appropriate in working with schizophrenics seems to help in the psychotherapeutic work with this type of patient. This study describes these issues with relevance to a particular residual schizophrenic. The Illustrative-didactic case-study method was used to discuss the four-and- a-half month psychotherapy with this patient. The patient's early developmental history, premorbid personality functioning, family and interpersonal relationships, mental state, diagnosis and a rationale for psychotherapy were presented and considered in detail. The structure of the psychotherapeutic process was reviewed in depth. The hermeneutic guidelines to understanding the case were drawn from Object-Relations Psychoanalytic theory, particularly Balint, Khan, Karon & VandenBos, Bollas, Romanyshyn, Perry, Symington, Fordham and others. Various psychic and personality features, as unveiled through the psychotherapeutic process, were elaborated and the implications of these for the therapeutic endeavour were considered as follows: Firstly, the psychic space of the patient, which precluded mirroring, symbolization find object-relationship - and which made psychotherapy untenable, was discussed. Secondly, therapeutic ambivalence and other counter-transference issues were reviewed. Thirdly, the shadow sides of both therapeutic optimism and of psychotherapeutic change were considered. Fourthly, the issues of therapeutic failure and of other treatment possibilities for a residual schizophrenic patient were examined. It was concluded that there needs to be an important countertransference shift with regard to the psychotherapeutic goals for those patients whose condition may be chronic, and for whom it appears that psychotherapy is not going to be of any therapeutic benefit - find where an 'empathic accompaniment' might be as much as it is possible to hope for or achieve.

I examined the effects of a residential treatment program on symptoms and mental health service use in 14 chronic schizophrenics. The clients chosen for this study were the most difficult clients in this population due to continued high service usage (i.e., time spent in locked facilities). All 14 clients had been in a locked facility at least 1 year immediately prior to treatment. The program included skills training, reinforcement for incompatible behavior, and a token economy. The clients' symptomology was recorded twice a day. My hypotheses were that symptoms would decrease due to the program, and clients mental health service use would also decrease in a 1 year follow-up. Mental health service use (time spent in a locked facility) did decrease dramatically after treatment. All 14 clients had a decrease in the amount of time spent in locked facilities after treatment. The total cost for these clients in locked facilities the year immediately prior to treatment was conservatively estimated at $776,500. The annualized figure of the total cost of these 14 clients after treatment was estimated at $44,775, saving San Joaquin County approximately $721,725 in 1 year. The results did not support the hypothesis that the program reliably decreases schizophrenic symptomology as we measured it.

An important step in learning to understand social behavior is the development of a technique to measure the degree of attraction between individuals. A number of researchers have suggested the usefulness of a figure placement technique as a nonverbal measure of interpersonal attraction (Weinstein, 1965; Carlson & Price, 1966; Fisher, 196?; Levinger Sc Gunner, 196?; Gottheil, Corey, & Paredes, 1968; Tolor, 1968; Higgins , Peterson, & LiseLotte, 1969), This technique is based on the earlier work of Kuethe (1962, 196^) on social schemata. Silhouette representations of huiaan figures are placed upon a neutral background in order to assess subjects' cognitive dispositions toward their interpersonal world.

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