A revised psychoanalytic conception of schizophrenia: An interdisciplinary update.

The psychoanalytic conception and treatment of schizophrenia is in need of fundamental revision because of (a) refinements in nosology which have separated out the borderline and affective disorders with which it had formerly been confused; (b) the development of newer psychoanalytic schools; and (c) the impact of various aspects of neurobiological research, the putative outcome of which seems to confirm that many, if not most, schizophrenics begin with a hereditary and/or congenital vulnerability to life and are disadvantaged in how they experience life, not only emotionally, but also neuroperceptually, neurocognitively, and neurobehaviorally. This contribution seeks to put schizophrenia and psychoanalysis in an interdisciplinary perspective by assigning the concept of disorders of psychical meaningfulness to the neurotic portion of the schizophrenic personality and of psychical meaninglessness to the psychotic portion of the personality. Whereas all psychoanalytic schools traditionally employ models that address meaningfulness, I suggest the employment of a newer model to deal with schizophrenia as a "disorder of self-regulation" (of meaninglessness), the latter being the neurobiological contribution. To the former I should like also to append the concept of a "disorder of interactional regulation" as its interpersonal complement in the sense of psychosocial, object relations, and systems theory interactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral rehabilitation of the "treatment-refractory" schizophrenia patient: Conceptual foundations, interventions, and outcome data.

This article describes an intensive, inpatient behavioral rehabilitation program for patients with schizophrenia who have been considered "treatment-refractory" at state hospitals. The program is a public-private partnership involving state and private hospitals and community residence providers. The essential elements of this program are described, along with the conceptual and philosophical bases of its treatment and examples of staff behaviors critical to treatment success. Outcome data are then discussed to emphasize the point that when evidence-based psychological treatment is implemented with this population, outcomes can be positive in most cases, and therefore, the number of treatment-refractory patients is actually far less than is estimated on the basis of response to medication alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

结构式团体心理治疗在精神分裂症康复期的应用研究

目的：研究结构式团体心理治疗对康复期精神分裂症患者整体社会功能的影响。方法将120例康复期精神分裂症患者按简单随机方法分成2组,每组60例。研究组在原有药物治疗及康复训练基础上实施结构式团体心理治疗,每周1次,每次1 h,共10次;对照组则维持原有药物治疗及康复训练。分别在治疗前后及随访12周时,使用住院慢性精神病患者社会功能评定量表（SSSI）、自尊量表（SES）、自我和谐量表（SCCS）进行评估。结果研究组治疗后 SES 总分高于治疗前,SSSI、SCCS 总分低于治疗前（均 P ＜0．05）。对照组治疗后 SES 总分低于治疗前（P ＜0．05）,而治疗前后 SSSI 和 SCCS 总分差异无统计学意义（均 P ＞0．05）。2组治疗后 SSSI、SES、SCCS总分差异均有统计学意义（均 P ＜0．05）。研究组12周随访时与治疗后 SSSI、SES、SCCS 总分比较差异均无统计学意义（均 P ＞0．05）。结论结构式团体心理治疗可以明显改善康复期精神分裂症患者的社会功能,且治疗效果相对稳定、持久。     

Data driven analysis of functional brain networks in fMRI for schizophrenia investigation

The purpose of this article is to present a methodology to identify the sources of activity in brain networks from functional magnetic resonance imaging (fMRI) data using the multiset canonical correlation analysis algorithm. The aim is to lay the foundations for a screening marker to be used as indicator of mental diseases. Group analysis blind source separation methods have proved reliable to extract the latent sources underlying the brain activities but currently there is no recognized biomarker for mental disorders. Recent studies have identified alterations in the so called default mode network (DMN) that are common to several neuropsychiatric disorders, including schizophrenia. In particular, here we account for the hypothesis that the alterations in the DMN activity can be effectively highlighted by analyzing the transient states between two different tasks. A set of fMRI data acquired from 18 subjects performing working memory tasks is investigated for such purpose. Subjects are patients affected by schizophrenia for one half and healthy control subjects for the other. Under these conditions, the proposed methodology provides high discrimination performances in terms of classification error, thereby providing promising results for a preliminary tool able to monitor the disease state or to perform a prescreening for patients at risk for schizophrenia. © 2014 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 24, 239–248, 2014     

What Is Perseverated in Schizophrenia? Evidence of Abnormal Response Plasticity in the Saccadic System.

Although perseveration is sometimes attributed to defective set switching, the authors have recently shown that set-switching is normal in schizophrenia. In this article, the authors tested for persistent states of the saccadic response system, rather than set perseveration. Schizophrenic and healthy subjects performed antisaccades and prosaccades. The authors analyzed for 3 carry-over effects. First, whereas the latency of the current saccade correlated with that of the prior saccade in both groups, the correlations under mixed-task conditions declined in healthy but not in schizophrenic subjects. Second, antisaccades in penultimate trials delayed upcoming saccades in schizophrenic but not in healthy subjects. Third, schizophrenic subjects were more likely to erroneously perseverate the direction of a prior antisaccade but not a prior prosaccade. The authors concluded that, in schizophrenia, the effects of correct antisaccades are persistent not weak. Saccades in schizophrenia are characterized by perseveration of antisaccade-induced changes in the saccadic response system rather than failures to switch task set. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of internalized object relations in borderline and schizophrenic patients.

This paper explores two dimensions of internalized object relations in borderline and schizophrenic patients using Rorschach scales. A thematic and a structural Rorschach measure of object relations is applied to the Rorschachs of two borderline groups (an infantile personality group and an obsessive-paranoid group) and a schizophrenic group. The findings suggest the value of both a multidimensional definition of internalized object relations and the use of such an approach to clarifying the diagnostic concept of borderline personality disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential autonomic responsiveness in the process-reactive classification of schizophrenia.

"This investigation consisted of two studies which were concerned with the relationship between the process-reactive classification of schizophrenia and autonomic nervous system activity… . [Both]… studies revealed that the patients classified as 'reactive' exhibited a significantly greater fall in blood pressure after the administration of mecholyl than the process patients… . It was concluded that the process-reactive classification seems to provide a fruitful frame of reference for research in schizophrenia." (31 ref.) From Psyc Abstracts 36:01:1JS60K. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A further note on "Prognostic scales in schizophrenia".

Replies to commentary by A. Farina (see record 2005-10655-011) on the original article by S. L. Garfield and D. M. Sundland (see record 1966-04456-001) regarding prognostic scales in schizophrenia. Marital status and premorbid personality are discussed as prognostic indicators of improvement in schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Scanning-control mechanism and "cognitive filtering" in paranoid and non-paranoid schizophrenia.

Recent studies of individual consistencies in cognitive behavior, termed studies of "cognitive controls," have emphasized the importance of differing characterological response dispositions which also serve ego defensive functions. This report concerned 2 such response dispositions—extensiveness of scanning and breadth of categorization. Highly significant differences in scanning behavior, inferred from performances on a certain form of size-estimation procedure, were found between paranoid and nonparanoid schizophrenics. Significant differences were also found between the groups on a measure of breadth of categorization. These findings were discussed in terms of some developmental aspects of the 2 cognitive controls and also in terms of the relevance of these findings to a theory of delusional thinking. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distortions in the gradient of stimulus generalization related to cortical brain damage and schizophrenia.

Measurement of the gradient of stimulus generalization (GSG) of 60 schizophrenics (S group), 60 medical control patients (C group), and 60 patients with cortical brain damage (O group), by means of an apparatus consisting of a panel of 11 lamps placed in an arc around the subject, showed: "(1) The GSG for both the C and S groups is considerably more elevated than that of the control group (O group). (2) The differences between the S and C groups, while in the main in the predicted direction, are not conclusive. (3) Damage to the cortex of the dominant hemisphere results in considerably more diminution of the elevation of the GSG than damage to the cortex of the non-dominant hemisphere. (4) The number of EST's received by patients in the S group was found to vary inversely with the degree of SG responsivity; but in view of the limitations of the data, no conclusions were drawn." (PsycINFO Database Record (c) 2010 APA, all rights reserved)