Intergroup Contact and Prejudice Against People With Schizophrenia

There is a growing awareness that responses to mental health disorders differ according to the label. Still, research on contact and prejudice against people with mental health disorders has generally focused on the broader label, “mental illness,” as though various disorders were interchangeable. The present research specifically investigated the relationship between intergroup contact and avoidance of people with schizophrenia—a particularly stigmatized and challenging group—as well as mediators of that relationship. In Study 1, 78 students completed measures of their prior contact with and prejudice against people with schizophrenia. Prior contact predicted less desired avoidance of people with schizophrenia, and this relationship was mediated by more favorable attitudes. Study 2 (N = 122) replicated the results of Study 1, and also found that less fear and less intergroup anxiety mediated the relationship between contact and avoidance. This suggests that contact may effectively reduce prejudice, even against this highly stigmatized group.     

Risk Factors for Suicidality Among Clients With Schizophrenia

Among clients with schizophrenia, suicidality is associated with extreme personal distress, an increased number of inpatient hospitalizations, increased health care expenditures, and early mortality. This study attempted to identify risk factors for current suicidality in clients diagnosed with schizophrenia (N = 223). Results indicated that severity of depressive symptoms most strongly correlated with degree of suicidality. Younger age and recent traumatic stress each significantly predicted suicidality independent of depressive symptoms. Stepwise regression procedures showed that the combination of depression, younger age, and traumatic stress might provide a general prediction model for suicidality among clients diagnosed with schizophrenia. Counseling implications of these findings are outlined.     

The Effects of Imagined Versus Actual Contact With a Person With a Diagnosis of Schizophrenia

Intergroup contact has been demonstrated to reduce prejudice toward out-groups under the right conditions; however, real contact experiences are often difficult to arrange. Imagined contact may be an alternative. The current study randomly assigned participants to imagine or to have real contact with a person with a diagnosis of schizophrenia. Results demonstrated that both imagined and real contact had positive effects on attitudes toward people with schizophrenia, as compared to the effects of imagined and real interactions with an age-matched control person. We discuss the strengths and limitations of imagined contact interventions with an eye toward future research.     

The Personal Significance of Religiousness and Spirituality in Patients With Schizophrenia

Religiousness and spirituality were examined in patients with schizophrenia spectrum disorders. Features and subjective significance are described, and associations with psychopathological phenomena are analyzed. The majority of the patients reported that religiousness and spirituality serve a vital positive influence in their ability to cope with their disorder. This positive influence was observed less among those patients with more negative symptoms. The spiritual experience of a divine presence was a common part of spirituality for our respondents, independent of psychopathology, whereas more extraordinary spiritual experiences were associated with certain psychopathological symptoms. Religious patients ruminated less than nonreligious patients did on existential issues, especially regarding the meaning of life, which, together with self-acceptance, was among the key existential issues for these patients.     

Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia

The objective of this study was to use qualitative methodology to tailor and refine an existing smoking cessation intervention for the population of people who use cigarettes and are diagnosed with schizophrenia, schizoaffective, or psychotic disorder. Successive cohort design methodology was used to iteratively modify the treatment in response to qualitative participant, therapist, and consultant feedback on the intervention. Qualitative methodology for participant feedback included analysis of semistructured interviews with participants, visualization of app utilization data, and stakeholder feedback from study therapists and consultants. Using the successive cohort design, a tailored multicomponent mobile health smoking cessation intervention was developed. The intervention included mobile contingency management (i.e., financial compensation for confirmed abstinence from smoking), pharmacotherapy for smoking cessation, cognitive-behavioral counseling sessions, and the Stay Quit app for relapse prevention. Two cohorts (N = 13) were completed in the study; after each cohort, the treatment protocol was revised. The intervention is described, as well as the qualitative findings from each cohort and subsequent changes made to the intervention based upon patient and provider feedback. Metrics of patient engagement included treatment adherence (40% in Cohort 1 and 63% in Cohort 2). Both participants and therapists reported that the intervention was helpful. Over one third of participants self-reported abstinence at posttreatment. Since qualitative methodology is often underutilized in mental health treatment development, this study demonstrates the utility of the successive cohort design for treatment development of behavior change interventions for at-risk, vulnerable populations.     

Schizophrenia

ABSTRACT— Theoretical conceptualizations of schizophrenia have undergone significant change in the past century. Through the application of behavioral science methodology, psychologists have played a major role in the pivotal scientific advances that have led us to contemporary models. The field has moved from simplistic conceptualizations of mind–brain distinctions to models that encompass complex gene–environment interactions and neural pathways that mediate the relation between psychosocial events and brain dysfunction.     

精神分裂症心理社会治疗

药物治疗虽然能改善精神分裂症的许多显性症状,而复发、残留症状和功能衰退单靠药物是不能解决的。从现代医学的角度看精神分裂症的预防与康复应该采取整体、多维度、综合性预防和康复措施,在进行生物学治疗的同时给予心理社会治疗,使病人达到最好的疗效。     

Effective Psychotherapy With Low-income Clients: The Importance of Attending to Social Class

The purpose of this article is to explore some of the issues associated with conducting psychotherapy with low-income clients. Throughout the article, we draw from our specific clinical experiences working with low-income Latina mothers in a depression prevention program. The themes that we address regarding class and psychotherapy are in the areas of assessment of social class, integration of class issues into the therapy process, and managing differences in social class between therapists and clients. As we discuss these themes, we provide concrete recommendations in order to advance awareness and effectiveness in working with economically disadvantaged populations.     

Overinclusive Thinking and Schizophrenia

The empirical literature relating to the schizophrenic thought disorder of overinclusive thinking is reviewed with special consideration to its measurement, the variables related to over-inclusive thought patterns, its relationship to other psychopathological groups, and the conditions under which schizophrenic conceptual performance is either facilitated or impaired. While a number of criticisms and suggestions are included in summary statements following each main section of the paper, it is suggested that future research stress conditions which improve rather than inhibit schizophrenic performance. Some studies in related areas are presented to illustrate the ability of schizophrenics to overcome their “psychological deficit”.     

Schizophrenia and emotional rubbernecking

Orienting toward emotionally salient information can be adaptive, as when danger needs to be avoided. Consistent with this idea, research has shown that emotionally valenced information draws attention more so than does neutral information in healthy individuals. However, at times this tendency is not adaptive, and it may distract the individual from goals. People with schizophrenia (PSZ), though they frequently show deficits in attentional control, have also been shown to exhibit diminished recognition of and attention to emotional information. In the present study, we investigated how the presentation of emotionally salient information affected performance on a working memory task for PSZ and healthy controls (HC). We found that although hit rates were equal to those of HCs for PSZ, the PSZ made fewer false alarms—resulting in overall better performance—than did the HCs. Deficits in emotional processing in PSZ appear to provide an advantage to them in situations in which salient emotional information competes with active cognitive goals.     

Cognitive Remediation in Schizophrenia

Cognitive deficits are routinely evident in schizophrenia, and are of sufficient magnitude to influence functional outcomes in work, social functioning and illness management. Cognitive remediation is an evidenced-based non-pharmacological treatment for the neurocognitive deficits seen in schizophrenia. Narrowly defined, cognitive remediation is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning, but from the vantage of the psychiatric rehabilitation field, cognitive remediation is a therapy which engages the patient in learning activities that enhance the neurocognitive skills relevant to their chosen recovery goals. Cognitive remediation programs vary in the extent to which they reflect these narrow or broader perspectives but six meta-analytic studies report moderate range effect sizes on cognitive test performance, and daily functioning. Reciprocal interactions between baseline ability level, the type of instructional techniques used, and motivation provide some explanatory power for the heterogeneity in patient response to cognitive remediation.