Transference in Psychotherapy with Schizophrenic Patients

Three current approaches to the group therapy of the cognitively intact, depressed elderly are reviewed. Examination of the strengths and limitations of these three models—self psychology, developmental considerations such as reminiscing and life review, and cognitive—behavioral therapies—points in the direction of the usefulness of an integrated model. The main objectives of an integrated approach include: stabilization of the individual's sense of self, establishment of interpersonal competence, and enhanced mastery over the affects of depression and demoralization. Clinical illustrations are provided to demonstrate the practical considerations in this model of group therapy.     

Interaction Process Differences between Groups of Paranoid Schizophrenic and Depressed Patients

Group psychoanalytic treatment has special value for helping people form intimate attachments, in particular, for enabling them to resolve lifelong unconscious resistances to closeness. The group serves both as an amphitheater and as an agent for change.

As group therapists, we may break the task down into three stages. First, we bring the character resistances into play; second, we resolve the fears underlying them; and third, we empower our patients to develop mature ways of expressing intimacy.

Our task requires that we establish a contract with our patients so as to study any breach as a possible resistance to intimacy with other members. We study these resistances, which are expressed in words and attitudes. Beneath such resistances lie various fears, which we bring to the surface. As our patients resolve these fears, they begin to act toward each other as they did toward significant figures in their formative years. We work with these vestigial modes of relating, and help our patients turn them into mature modes of expression.     

The Use of Humor with Chronic Schizophrenic Patients

The use of a humorous therapeutic approach combined with drug therapy in the treatment of chronic schizophrenia patients institutionalized for protracted periods of time led to positive changes in their symptoms. The majority of the patients responded well to humorous interpretations. The patients felt that they had the option of adopting the doctor's humorous manner. This approach appealed to them and raised self-esteem; they likewise gained confidence in their own ability to form judgments. They cooperated better with the doctor in issues pertaining to treatment. The fact that humor made an impact on the patients' cognition demonstrated that patients with disturbed thought processes could be influenced in ways which improved coping. The patients' condition was evaluated according to the BPRS scale, before the treatment, on a monthly basis during the treatment, and three months upon the completion of the experiment. In the course of the experiment, pharmacological treatment remained unchanged. On the average, a perceptible reduction in the BPRS value (p < .05) was detected as a result of humor therapy. Amusing representations of affective external stimuli were incorporated into the patients' cognition and, along with a newly gained awareness of the possibility of relating to them with humor, were retained long after the termination of the project.     

Case Studies of Two Schizophrenic Patients

A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer &; Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.     

精神分裂症患者的大脑两半球关系特点

1引言 精神分裂症是最常见的精神疾病之一.多年来,大量生物医学研究成果给精神分裂症的预防及治疗带来了希望.但这些研究成果尚未就精神分裂症的病理心理学基础达成统一明确的意见.     

Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to singificantly delay relapse, reduce symptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.     

Short-Term Stability of Task-Generated,Interactional Patterns in Families of Schizophrenic Patients

Both researchers and therapists who study schizophrenia make inferences about enduring family roles from observed patterns of interactional talking behavior within families. Evidence regarding the stability of these patterns is rarely investigated. The present study examined the short-term stability of intrafamilial speech patterns (who talks to whom) across two consecutive discussions. The sample was composed of families containing a recent-onset, adult schizophrenic patient. All discussions involved two biological parents and a young adult patient (N = 28 ). Families were classified into one of three interactional role-structure categories based on the intrafamilial speech patterns in two 10-minute discussions obtained in the same session. In addition, the affective style ( 4 ) of the content of the discussions was coded. The results indicated that intrafamilial speech patterns were relatively stable across two discussions despite variations in the focus of the problem discussed. Further, when one parent was predominant in the discussion, a higher rate of negative affective statements was observed than when both parents were equal participants. The results provide further support for the use of discussion tasks in generating meaningful family interaction data.     

齐拉西酮与氯丙嗪对精神分裂症首次发作患者心电图影响的比较研究

为了探讨齐拉西酮与氯丙嗪对首发精神分裂症患者心电图(ECG)的影响,将221例首发精神分裂症患者随机分为两组,齐拉西酮组111例,氯丙嗪组110例,分别给予齐拉西酮和氯丙嗪治疗.于治疗前和治疗后的第2、4、8周末定期进行心电图检查,并对两组患者的心电图结果进行对比分析.服药后两组患者的心电图均有不同程度的改变,以窦性心动过速和ST-T改变为主,齐拉西酮组与氯丙嗪组患者心电图异常发生率分别为24.3％、54.5％,齐拉西酮组所致心电图改变明显低于氯丙嗪组(P＜0.01).齐拉西酮与氯丙嗪治疗精神分裂症疗效相当,而齐拉西酮对首发精神分裂症患者心电图的影响显著低于氯丙嗪,临床安全性高.     

齐拉西酮与氯丙嗪对精神分裂症首次发作患者心电图影响的比较研究

为了探讨齐拉西酮与氯丙嗪对首发精神分裂症患者心电图（ECG）的影响,将221例首发精神分裂症患者随机分为两组,齐拉西酮组111例,氯丙嗪组110例,分别给予齐拉西酮和氯丙嗪治疗。于治疗前和治疗后的第2、4、8周末定期进行心电图检查,并对两组患者的心电图结果进行对比分析。服药后两组患者的心电图均有不同程度的改变,以窦性心动过速和ST—T改变为主,齐拉西酮组与氯丙嗪组患者心电图异常发生率分别为24．3％、54．5％,齐拉西酮组所致心电图改变明显低于氯丙嗪组（P〈0．01）。齐拉西酮与氯丙嗪治疗精神分裂症疗效相当,而齐拉西酮对首发精神分裂症患者心电图的影响显著低于氯丙嗪,临床安全性高。