Matching alcoholics to coping skills or interactional therapies: Posttreatment results.

This study tested the hypothesis that patients could be matched to effective treatments on the basis of certain pretreatment characteristics. Specifically, it was hypothesized that those Ss who showed more sociopathy, more psychopathology, and greater neuropsychological impairment would have better outcomes when treated with coping skills training and, conversely, that those with less impairment in these areas would have better outcomes with interactional treatment. Ninety-six male and female Ss were recruited from an inpatient alcoholism treatment program and randomly assigned to 1 of these 2 types of aftercare group treatment. Linear and logistic regression analyses partially confirmed the hypotheses. Coping skills training was more effective for Ss higher in sociopathy or psychopathology, and interactional therapy was more effective for Ss lower in sociopathy. Generally, both treatments appeared equally effective for Ss lower in psychopathology. Contrary to expectations, those more neuropsychologically impaired appeared to have better outcomes after interactional therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood theme and bizarreness of delusions in schizophrenia and mood psychosis.

Narratives of the delusions of 83 schizophrenic and 55 nonschizophrenic Ss were categorized as of 1 or more of 12 types. Narratives were also independently assessed along dimensional scales of bizarreness and mood theme. Schneiderian and grandiose types were found to be more common in schizophrenics and mood psychotics, respectively. Dimensional measures showed that the delusions of schizophrenics were more unlikely and that those of mood psychotics had a stronger mood theme. Regression analysis determined that Schneiderian delusions and a dimensional estimate of mood theme best differentiated schizophrenics from mood psychotics. Assessments along dimensions of other parameters, particularly those represented by Schneiderian delusions, may further discriminate the functional psychoses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fabrication of delusional thinking in normals.

Tested a learning model for paranoid development by requiring Ss in the laboratory to fabricate ideation under conditions approximating those thought to be conducive to actual clinical delusions. Measures used on the 92 male undergraduate Ss included the Parent Attitude Research Instrument, the Parent–Child Interaction Rating Scales, and the Adjective Check List. Ss proposed to be susceptible to paranoid ideation, that is, late-adolescent males who have adopted an open style of adapting to the aversive-maternal-control experience, demonstrated the proposed signs of delusional thinking in their belief systems. Ss were required to formulate a rationale for the view that they believed others held concerning them. The open-style group, relative to control groups, provided beliefs that were more extensive, less credible, more concerned with negative information, and, for the more extended beliefs, better integrated and more presumptive of outside social influence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coding of cognitive input in delusional patients.

Constructed a manual for categorizing themes present in delusions, using interviews of a group of 6 females and 8 males representative of 68 currently delusional patients. Interjudge reliability for the manual's categories ranged from .73 to .93. A cognitive congruence hypothesis, which predicted that dominant themes in an S's delusional material would match the dominant categories used to construct his reality, was supported. The reality constructs obtained from 54 Ss on a Logical Consequences Test were significantly correlated with the dominant delusional themes. Moreover, males perceived significantly more negative interpersonal pressure, whereas females perceived significantly more negative sexual pressure. Both also perceived more negative pressure coming from the environment rather than from within, whereas a control group of 31 normal Ss did not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does psychiatric disorder predict violent crime among released jail detainees? A six-year longitudinal study.

Examined whether jail detainees with schizophrenia, major affective disorders, alcohol or drug use disorders, or psychotic symptoms (hallucinations and delusions) are arrested more often for violent crimes 6 yrs after release than are detainees with no disorders. Trained interviewers assessed 728 randomly selected male jail detainees using the National Institute of Mental Health Diagnostic Interview Schedule and then obtained follow-up arrest data for 6 yrs. Neither severe mental disorder nor substance abuse or dependence predicted the probability of arrest or the number of arrests for violent crime. Ss with symptoms of both hallucinations and delusions had a slightly higher number of arrests for violent crime, but not significantly so. These findings held even after controlling for prior violence and age. The findings do not support the stereotype that mentally ill criminals invariably commit violent crimes after they are released. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proverb word counts as a measure of overinclusiveness in delusional schizophrenics.

A partial replication was conducted of Payne's (1964) report concerning the relationship between delusions and overinclusive thinking as measured by proverbs word counts. Word counts were made of Gorham Proverbs Test responses given by age and intelligence-matched groups of 21 delusional schizophrenics, 21 nondelusional schizophrenics, and 21 nonschizophrenic, nondelusional psychiatric in-patients. 23 paranoid, 23 nonparanoid, and 23 nonschizophrenic control Ss, similarly matched, from the same population, were also compared. No significant differences in proverb word counts were found among the groups. Although the possibility of increased irrelevant side remarks could not be excluded, paranoid or delusional schizophrenics do not produce higher proverb relevant word counts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The paradox of normal neuropsychological function in schizophrenia.

Mounting evidence suggests that compromised neurocognitive function is a core feature of schizophrenia. However, some studies have found neuropsychologically normal schizophrenia patients. To address this apparent contradiction, we blindly rated individual neuropsychological profiles of 75 schizophrenia patients and 91 control participants on the basis of methods developed by L. J. Seidman, S. V. Faraone, W. S. Kremen, J. R. Pepple, M. J. Lyons, and M. T. Tsuang (1993). Almost one-quarter of the patients were classified as neuropsychologically within normal limits (WNL). Despite significantly worse neuropsychological performance, WNL patients had higher estimated premorbid ability than did controls. Compared to a subset of controls matched on overall neuropsychological function, WNL patients had higher estimated premorbid ability and current IQs. Our results favor the view that even neuropsychologically normal schizophrenia patients have compromised cognitive function relative to their presumed expected or premorbid level of intellectual ability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptual styles and their correlates among schizophrenic patients.

Replicated the experimental procedures on which a tridimensional model of schizophrenic perceptual functioning was based, other potentially relevant procedures included, and the resultant relationships delineated and tested through multivariate statistical techniques. Factor analysis supported the existence of the 3 dimensions of the original model stimulus intensity control, scanning control, and field articulation. Through cluster analysis there emerged groups of Ss whose differing perceptual styles paralleled the previously reported pattern of differences between paranoid and nonparanoid schizophrenics. Other results made several major qualifications of the original theory necessary: (1) perceptual inefficiency and anchoring emerge as additional meaningful dimensions of perceptual functioning; (2) behavioral guardedness replaces coherent paranoid delusions as a significant correlate of scanning; and (3) stimulus augmentation is related to strong internal affect only among acute patients; among chronic patients the relationship is reversed. (30 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural themes in the psychotic symptoms of African American psychiatric patients.

Professional psychologists need to recognize ethnic/racial differences between African Americans and European Americans in psychotic symptom expression to treat individuals with severe mental illness from various cultural backgrounds. Specifically, they need to understand confluent paranoia or the interaction between culture and pathology in psychotic symptom expression. To assist mental health professionals, the present study identified cultural themes in the delusions and hallucinations of a sample of 156 African American psychiatric patients via content analysis. Race-related themes and religious themes were observed in the psychotic symptoms of these patients assessed with the Structured Clinical Interview for DSM IV. Race-related and religious content were manifested in different types of delusions. Race-related themes were more common in persecutory delusions, whereas religious themes occurred more often in other delusions. Race-related themes were associated more with delusions, while religious themes correlated with both delusions and hallucinations. Implications for the treatment of confluent paranoia in African Americans are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The jumping to conclusions bias in delusions: Specificity and changeability.

There are indications that a jumping to conclusions bias (JTC) plays a role in the formation and maintenance of delusions and should be targeted in therapy. However, it is unclear whether (a) JTC is uniquely associated with delusions or simply an epiphenomenon of schizophrenia or impaired intellectual functioning and (b) it can be changed by varying task demands, motivational factors, or feedback. Seventy-one patients with schizophrenia spectrum disorders and either acute or remitted delusions and 68 healthy controls were included. Patients were assessed with self- and observer-rated symptom measures. All participants were assessed for intellectual ability and performed the classic beads task with a ratio of 80:20. They were then presented with task variations that involved increasing the difficulty of the ratio to 60:40, introducing a rule for which correct decisions were rewarded by monetary gains and false decisions led to financial losses, and providing feedback on the accuracy of the previous decisions. Participants with current delusional symptoms took fewer draws to decision (DTD) than did those in remission and healthy controls. DTD were associated with observer-rated delusions, but controlling for negative symptoms or intelligence rendered this association insignificant. DTD increased after the difficulty of the task increased and after feedback. The study demonstrated that JTC is linked to delusions but that this association is not unique. Patients with delusions are principally able to adapt their decisions to altered conditions but still decide relatively quickly even when decisions have negative consequences. These difficulties might stem in part from impaired intellectual functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why Do People With Delusions Fail to Choose More Realistic Explanations for Their Experiences? An Empirical Investigation.

Delusions can be viewed as explanations of experiences,. By definition, the experiences are insufficient to merit the delusional explanations. So why have delusions been accepted rather than more realistic explanations? The authors report a study of alternative explanations in 100 individuals with delusions. Patients were assessed on the following criteria: symptom measures, the evidence for the delusions, the availability of alternative explanations, reasoning, and self-esteem. Three quarters of the patients did not report any alternative explanation for the experiences on which the delusions were based. These patients reported significantly more internal anomalous experiences and had a more hasty reasoning style than patients who did have alternative explanations available. Having doubt in a delusion, without an alternative explanation, was associated with lower self-esteem. Clinicians will need to develop plausible and compelling alternative accounts of experience in interventions rather than merely challenge patients' delusional beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classification and validation of behavioral subtypes of learning-disabled children.

63 1st and 2nd graders recently identified as having a learning disability (LD) and 66 normally developing Ss matched by grade, sex, and race with LD Ss were rated by teachers on the 60-item Classroom Behavior Inventory and observed using a time-sampling schedule of classroom activity norms. Analysis identified 7 distinct behavioral subtypes of LD Ss. In Cluster 1, 28.6% Ss had deficiencies in task-oriented behavior and independence. In Cluster 2 (25.4% of Ss) and Cluster 5 (9.5% of Ss), 2 variations of normal classroom behavior were represented. In Cluster 2, Ss had slightly elevated ratings on considerateness and introversion, while in Cluster 5, Ss were seen as slightly less considerate and more hostile. In Cluster 3, mild attention deficits in 14.3% of Ss were combined with high ratings on distractibility and hostility and low ratings on considerateness. In Cluster 4, 11% of Ss were withdrawn and overly dependent with low ratings on independence and extraversion and high ratings on dependence and introversion. In Cluster 6, 6.3% of Ss showed a pattern of a mild version of a global behavior disorder. In Cluster 7 (3 males), Ss were impaired on all classroom behaviors. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overinclusive thinking and delusions in schizophrenic patients.

15 schizophrenics with paranoid delusions, 15 schizophrenics with no delusions, and a control group of 15 nonschizophrenic hospitalized patients were given the Benjamin Proverbs test, the Mill Hill Vocabulary Scale, and 3 of Babcock's psychomotor speed tests. As predicted, there was a significant relationship between the presence or absence of delusions, and overinclusive thinking, as assessed by the average number of words needed to explain the proverbs and 2 time scores. Overinclusive patients tend to have paranoid delusions. There was no significant relationship between retardation, as assessed by the Babcock tests, and the presence of delusions. This finding complements an earlier finding of Harris and Metcalfe (see 32: 719) that slowness in schizophrenic patients is specifically associated with inappropriate affect and a poor prognosis, and Payne's (see 37: 5499) finding that a group of chronic schizophrenics was not overinclusive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multimethod comparison of popular and unpopular children.

Differences between 101 popular and unpopular 3rd and 4th graders were assessed by teacher reports, classroom observations, the Peabody Individual Achievement Test, the Children's Depression Inventory, ratings on role-play situations, interviews that elicited information on Ss' knowledge of social skills, and responses to hypothetical situations. Unpopular Ss were perceived as being more depressed and deviant by teachers than were popular Ss. Classroom observations indicated that unpopular Ss spent significantly less time on-task than popular Ss and engaged in significantly more negative interactions. There was a trend for popular Ss to perform at a higher academic level than unpopular Ss, and the latter Ss were more depressed than Ss in the former group. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delusions and dementia: clinical and CT correlates

INTRODUCTION: Delusions occur frequently during the course of Alzheimer's disease (AD) and multi-infarct dementia (MID). Their clinical significance and their relationship with progression of disease and involvement of selected cerebral areas are still unclear. The aim of the study was to determine the clinical and CT correlates of delusions in patients with dementia. MATERIAL AND METHODS: A series of 67 probable AD and 32 MID patients, underwent computed tomographic scans, psychometric tests, neurologic and psychiatric examination, and blood and serum tests. RESULTS: Twenty-four patients were found to have delusions during the clinical evaluation. Delusional patients showed a significantly higher age when compared with non-delusional patients. The results of a multiple logistic regression (with stepwise deletion of the redundant variables) of the CT lesions on the presence of delusions, showed that only the presence of isolated white matter lesions in the frontal lobes were significantly related to the occurrence of delusions (Exp B = 3.42; Beta = 1.2; S.E. = 0.6; Sig T = 0.04). Frontal white matter changes were significantly related to delusions when a multiple regression analysis, entering age and total number of lesions at CT scans, was carried out. CONCLUSIONS: We found that focal lesions in the frontal areas were the only variable that appeared to be significantly and independently associated with delusional disorders.     

Hypnosis, task-motivating instructions, and learning performance.

40 Ss, including 30 who had been previously rated as suggestible and 10 as nonsuggestible, were pretested and then retested on equivalent forms of 3 learning tasks: digit symbol substitution, memory for words, and abstract reasoning. All Ss received the pretests in the same way. The 30 suggestible Ss were retested under 1 of the following 3 experimental treatments with 10 Ss assigned at random to each treatment: task-motivating instructions, hypnotic induction procedure with task-motivating instructions, and control. The 10 nonsuggestible Ss were retested under a task-motivating-instructions treatment. Analyses of covariance indicated that (a) task-motivating instructions given alone or following a hypnotic induction procedure did not significantly affect performance on the memory for words or abstract reasoning tasks; and (b) task-motivating instructions produced a comparable enhancement of performance on the digit symbol substitution task in hypnotized and nonhypnotized Ss and in suggestible and nonsuggestible Ss. (33 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative efficacy of self-reward, self-punishment, and self-monitoring techniques for weight loss.

Randomly assigned 48 female and 5 male obese adults to 5 groups: (a) self-reward, (b) self-punishment, (c) self-reward and self-punishment, (d) self-monitoring, and (e) information control. All Ss were given information on effective stimulus control techniques for weight loss. Self-monitoring Ss were asked to weigh in twice per week for 4 wks and to record their daily weight and eating habits. Self-reward and self-punishment Ss, in addition to receiving self-monitoring instructions, were asked to award or fine themselves a portion of their deposit contingent on changes in their weight and eating habits. After 4 wks of treatment, self-reward Ss lost significantly more weight than either self-monitoring or control Ss. At a 4-mo follow-up, Ss who had received self-reward instructions continued to show greater improvement than either the self-punishment or control Ss. Findings provide a preliminary indication that self-reward strategies are superior to self-punitive and self-recording strategies in the modification of at least some habit patterns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)