家庭治疗在我国临床实践中的应用

家庭治疗作为心理治疗领域的“第四势力”,将个体置于关系之中去考察其心理问题,通过改变家庭成员围绕症状所表现出来的交往方式,从而达到治疗症状的治疗方法。该疗法的研究与实践很快渗透到心身疾病,成瘾、抑郁、强迫、精神分裂症等许多领域,在临床实践中得到广泛的使用并取得了较好的效果。     

Fixed-time schedule effects in combination with response-dependent schedules

We evaluated the effects of fixed-interval (FI), fixed-time (FT), and conjoint (combined) FI FT reinforcement schedules on the responding of 3 adults who had been diagnosed with schizophrenia. Responding on vocational tasks decreased for 2 of 3 participants under FT alone relative to FI alone. Responding under FI FT resulted in response persistence for 2 of 3 participants. Results have implications for the maintenance of desirable behavior, as well as for situations in which FT treatment has been implemented for problem behavior and problem behavior is nevertheless reinforced by caregivers.     

精神分裂症遗传学研究的理性思辨

精神分裂症是一种常见的重性精神障碍,属于复杂的多基因遗传性疾病。随着分子生物学技术和遗传学数据分析方法的进步,精神分裂症易感基因方面的研究取得了一定的进展,但是至今还没有一个精神分裂症的易感基因得到准确定位。系统生物学是采用系统科学的方法研究一个生物系统的一种大科学,为寻找精神分裂症等复杂疾病的易感基因提供一种新的思路。     

Effects of Cognitive Behavioral Therapy and Vocational Rehabilitation on Metacognition and Coping in Schizophrenia

The Indianapolis Vocational Intervention Program (IVIP) is a cognitive behaviorally based program of group and individual interventions that seeks to help persons with schizophrenia improve vocational function and sustain hope. In this study we compared baseline and follow-up assessments of coping and metacognition among 50 participants with schizophrenia spectrum disorders offered a six-month job placement and randomized to receive IVIP (n = 25) or standard services (n = 25). ANCOVA controlling for baseline suggest that the IVIP group gained greater ability to think about their own thinking and to cope by seeing what were previously perceived as negative stressors in more positive light. An erratum to this article can be found at     

Group Cognitive Behavioral Therapy for Delusions: Helping Patients Improve Reality Testing

Group Cognitive Behavior Therapy (CBT) was used to treat residual delusions in patients with schizophrenia. Initially all patients (N = 6) reported delusions of various types, such as persecution, body/mind control, grandiosity, and religious themes. The group format allowed patients to share their experiences and beliefs, thereby eliminating shame and providing support and coping strategies; as well as allowing for peer–peer discussion of irrationalities and inconsistencies in each other's beliefs. After 13 sessions there was a statistically significant reduction in delusional conviction, unhappiness associated with thinking about a delusion, intensity of distress associated with delusion, and an increased ability to dismiss a delusional thought.     

Psychoanalysis and Psychosis: Trends and Developments

This paper presents the basic principles of insight-oriented therapy for schizophrenia, emphasizing the effectiveness of this approach: each treatment effort is a unique adventure, fueled by hopefulness in both participants. Next, it reviews the history of such treatment efforts and current tensions in the field. It presents information on the International Society for the Psychological treatments of the Schizophrenias and other psychoses (I.S.P.S.) and its current mission, to promote quality care for patients suffering from schizophrenia, to promote and facilitate research into this work, and to provide organizational support and ongoing educational programs for clinicians involved in these efforts.     

Self- and interview-rated negative mood states in schizophrenia: Their convergence and prediction of thought disturbance

This longitudinal study evaluated the relations between self- and interview-rated negative mood in schizophrenics and compared the prognostic utility of these two methods. Thirty schizophrenics who had been stabilized on neuroleptic medications were evaluated with self-report and interview-based measures of mood and symptomatology at an initial assessment and again at 6-month follow-up. Results indicated that measures of self- and interview-rated negative mood showed little agreement at the initial assessment; however, at follow-up, significant convergent correlations between the two methods were obtained. Self-reported negative mood at the initial evaluation predicted the severity of thought disturbance at follow-up, whereas interview-based ratings of mood did not. The results underscore the importance of conducting multimethod assessments of mood and support other research suggesting that self-reported negative mood states may predict course of the illness in schizophrenia.This research was supported by National Institute of Mental Health (NIMH) Grants MH38636 and MH39998 and by a grant from the National Alliance for Research in Schizophrenia and Depression (NARSAD). Jack J. Blanchard was also supported in part by NIMH Grant MH18932 for the Collaborative Training Program in Schizophrenia Research at the Medical College of Pennsylvania/EPPI. Portions of this research were presented at the 24th Annual Meeting of the Association for the Advancement of Behavior Therapy, San Francisco, California, November 2, 1990, and at the 3rd International Congress on Schizophrenia Research, Tucson, Arizona, April 22, 1991.     

Destructive and reparative transference in multiple levels of group psychotherapy

Group members are challenged to form psychologically meaningful relationships with therapists, other members, and the group as a whole. The way in which individuals perceive this challenge is based on their past experiences. Early relationships establish a perceptual frame in which fears of being hurt and concern about hurting others coexist. Balance between these two ways of generating meaning enables individuals to form relatively healthy relationships. Imbalance in this perceptual frame results in distorted perceptions and maladaptive patterns emerging as transference manifestations. Working through involves repeatedly addressing distortions as members relate to therapists, others and the group as a whole.     

Borderline and schizophrenic patients: A comparison using the MCMI-II

In the present study we examined the Millon Clinical Multiaxial Inventory-II scores of psychiatric patients with a diagnosis of either borderline personality disorder (BPD;n=13) or schizophrenia (n=13). The analyses revealed that the BPD patients were significantly elevated on a number of scales in addition to the Borderline scale. The second goal of this study was to assess the discriminative validity of the Borderline and Thought Disorder Scales with both base rate (BR) cutoffs and the number of endorsed prototypic items. The Borderline scale demonstrated the most diagnostic power when using BR cutoffs, whereas the Thought Disorder scale performed poorly, no better than chance levels, with all cutoffs.This research was supported by Social Sciences and Humanities Research Council of Canada Grant 410-89-0335 and by a grant from the Department of Research and Programme Evaluation, Brockville Psychiatric Hospital. The authors thank Renate Simmons for her assistance.     

Maternal Representations of Patients with Schizophrenia as Measured by the Parental Bonding Instrument

Maternal perceptions were assessed, using the Parental Bonding Instrument (PBI) in 19 subjects with schizophrenia, 14 subjects with borderline personality disorder and 15 non-clinical subjects. Subjects with schizophrenia and subjects with borderline personality disorder reported significantly less care and more overprotection than did non-clinical subjects. No significant differences were found in representations by subjects with schizophrenia and subjects with borderline personality disorders. To the extent that the reported negative maternal behaviour gives a true picture of childhood and adolescent experiences, it does not seem to be specific for schizophrenia, but may be one factor in the development of severe mental disorders.