Modification of performance on the Span of Apprehension Task in a group of young people with early onset psychosis

The aim of the study was to examine the effect of contingent monetary reinforcement and enhanced instructions on Span of Apprehension (SPAN) performance in a group of young people with early onset psychosis. Twenty-five participants (mean age 16.7) received a 3- and 12-letter version of the SPAN task six times: baseline, three x intervention, post-test, and 10-day follow-up. No significant effects of time were found in the 3-letter condition, indicating a ceiling effect for accuracy. In the 12-letter condition detection rates improved significantly reaching a maximum at the third intervention (p < 0.001). Performance showed a temporary decline at post-test, but performance returned to the maximum level at the 10-day follow-up. The study suggests that SPAN performance can be improved in young people with early onset psychosis using relatively simple interventions and that performance gains are relatively durable.     

Reading and Writing: Psychoanalytical Treatment in a Case of Paranoia

Difficulties encountered in clinical work with psychoses require psychoanalytical approaches different from those used for treating neurosis. The authors use a clinical case of a paranoiac patient to highlight the role played by writing, drawing, and painting in the psychoanalytical treatment of psychosis. They also discuss the role of the reader-analyst in this patient’s transferential process, which led to the emergence of a new subjectivity.     

Prospective memory in early and established psychosis: An Indian perspective

Individuals affected by psychosis often have deficits in several neurocognitive functions. Prospective memory (PM), the ability to remember to do things, is crucial for activities of daily living, social and occupational functioning, but very few studies have attempted to examine this domain of functioning in people with psychosis, particularly in India. A total of 71 patients with psychosis, (both early and established psychosis), and 140 age, gender and education-matched healthy controls were assessed using the Positive and Negative Symptom Scale, Hospital Anxiety and Depression scale, and Addenbrooke's Cognitive Examination. PM was assessed using the Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire (PRMQ). Group differences were evaluated using Mann–Whitney U-tests. Significantly greater cognitive deficits, higher anxiety and depression were evident in the psychosis group compared with controls. The psychosis group performed significantly poorer on both time- and event-based tests in CAMPROMPT than controls. These differences remained when controlling for age, education, general cognitive functioning and mood. The subjective measure of PM (PRMQ) did not differentiate the two groups. The PM performance of early and established psychosis patients was similar. Comparisons with cross-cultural data (PRMQ UK norms and CAMPROMPT and PRMQ Chinese data) revealed important differences in PM performance. Individuals with psychosis have significant deficits in both time- and event-based PM. CAMPROMPT emerged as a more sensitive PM measure compared with PRMQ. Results from cross-cultural comparisons underscore the need for cultural contextualization of assessments.     

Narrative Understanding in Acute Psychosis

Hermeneutical premises are adequate in understanding the psychotic patient. It is more important to hear and try to understand the patient's story told by the latter as an equal partner in conversation than understand events through stories in which the meanings are already determined. Understanding is dependent on the unique way in which the feelings, thoughts, and actions of the patient are connected with those of the ward staff, i.e., mutual knowledge. In this way understanding conforms to the preunderstanding of the interpreter as well as adequately captures the intentions of its originator. These are the preconditions for the integration of the need-adapted approach to the treatment of schizophrenia.     

Reliability of the Halstead-Reitan Battery in individuals displaying acutely psychotic behavior

The purpose of the present study is to examine the test-retest reliability of the Halstead-Reitan Battery (HRB) in an acutely psychotic population. Ten acutely psychotic patients, initially tested upon admission to an inpatient unit of the Austin State Hospital, were selected for retesting on the basis of showing the most complete remission of psychotic symptoms of all patients tested over the 14-month period from June 1978 to August 1979. Only patients showing good remission were selected in order to maximize the potential for changes in test performance to occur and, thus, provide a conservative estimate of test-retest reliability. The average retest interval was 10.4 weeks (SD=6.67), with retest being completed just prior to discharge. Reliability was examined for each HRB subtest across subjects, as well as for each subject across subtest. While the patients generally showed an improved performance at retest, the reliability of the HRB was relatively high.     

ONE BRAIN,TWO MINDS: AN ESSAY ON PRIMORDIAL AND ADVANCED MENTAL ACTIVITY

The Primordial Mind in Health and Illness: A Cross‐Cultural Perspective. By Michael Robbins. London/New York: Routledge, 2011. 240 pp.     

A child’s loss becomes a young man’s violence

Abstract

This paper describes the contribution of earlier traumatic loss to the later violent eruptions, with fatal consequences, of two young men, one who killed his mother and one who killed an unknown woman. Their developing personalities became disordered during their disturbed childhoods and the link between these developing personality disorders and psychoses is referred to. The need for long-term treatments is emphasised, as well as the importance of communication between therapist and clinical team.     

The Ethical Inclusion of Children With Psychotic Disorders in Research: Recommendations for an Educative,Multimodal Assent Process

This article addresses the issue of properly assenting children with psychotic disorders to participate in clinical research. Due to the protective concerns with such a vulnerable population, additional precautions are necessary to ensure that youth with psychotic disorders assent to research with an appropriate level of understanding regarding study procedures. Current literature suggests that positive/negative symptoms and minor cognitive deficits do not interfere with the ability to comprehend study-related information for adults with psychosis if the study information is presented through an educative process. Similarly, youth benefit from repeated presentation of procedures and periodic assessment of their comprehension. An integrated educative process is proposed that emphasizes the importance of an interactive consent through repetition and participant/investigator feedback.