Expressed emotion, social skill, and response to negative affect in schizophrenia.

Examined social skills and social perception of 48 schizophrenia/schizoaffective disorder patients (aged 18–55 yrs) in response to negative affect as a function of family expressed emotion (EE). Ss participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, Ss with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but Ss with highly critical relatives did not. Ss with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and Ss during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. S's ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between Ss with high and low EE relatives.… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically supported couple and family interventions for marital distress and adult mental health problems.

This article evaluates the efficacy, effectiveness, and clinical significance of empirically supported couple and family interventions for treating marital distress and individual adult disorders, including anxiety disorders, depression, sexual dysfunctions, alcoholism and problem drinking, and schizophrenia. In addition to consideration of different theoretical approaches to treating these disorders, different ways of including a partner or family in treatment are highlighted: (a) partner–family-assisted interventions, (b) disorder-specific partner–family interventions, and (c) more general couple–family therapy. Findings across diagnostic groups and issues involved in applying efficacy criteria to these populations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age, socioeconomic status, severity of mental disorder, and chronicity as predictors of physical attractiveness.

The relations of age, SES, race, 3 indexes of chronicity, and 3 indexes of severity of disorder with physical attractiveness were examined in 43 13–66 yr old female psychiatric patients to test whether demographic variables mediate relations found between physical attractiveness and clinical variables. A correlation analysis found only time since 1st breakdown, age, and SES to be significantly related to attractiveness at a multivariate .05 level. A partial correlation analysis showed that age mediated the relation found between time since 1st breakdown and attractiveness, but not the relation between SES and attractiveness. Findings suggest that demographic variables are strongly related to attractiveness and may account for apparent relations found between attractiveness and clinical variables. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role play for assessing the social competence of psychiatric patients.

This study examined the validity and utility of role play for assessing social competence of chronic psychiatric patients. Demographically matched groups of patients with schizophrenia (n?=?57), schizoaffective disorder (n?=?16), major affective disorder (n?=?33), and a nonpatient control group (n?=?20) were assessed on a role-play test, interview measures of role functioning in the community, and a problem-solving discussion with a significant other. A subsample was reassessed on the same instruments 6 months later. Behavior on the role-play test discriminated the groups, was highly correlated with ratings on the other measures, and was relatively stable over the retest interval. The results were interpreted as providing strong support for the value of role play as a general measure of social functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized Trial of Cognitive-Behavioral Therapy for Chronic Posttraumatic Stress Disorder in Adult Female Survivors of Childhood Sexual Abuse.

The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioral therapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be more effective than PCT and WL in decreasing PTSD and related symptoms. CBT participants were significantly more likely than PCT participants to no longer meet criteria for a PTSD diagnosis at follow-up assessments. CBT and PCT were superior to WL in decreasing PTSD symptoms and secondary measures. CBT had a significantly greater dropout rate than PCT and WL. Both CBT and PCT were associated with sustained symptom reduction in this sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models of community care for severe mental illness: a review of research on case management

We describe different models of community care for persons with severe mental illness and review the research literature on case management, including the results of 75 studies. Most research has been conducted on the assertive community treatment (ACT) or intensive case management (ICM) models. Controlled research on ACT and ICM indicates that these models reduce time in the hospital and improve housing stability, especially among patients who are high service users. ACT and ICM appear to have moderate effects on improving symptomatology and quality of life. Most studies suggest little effect of ACT and ICM on social functioning, arrests and time spent in jail, or vocational functioning. Studies on reducing or withdrawing ACT or ICM services suggest some deterioration in gains. Research on other models of community care is inconclusive. We discuss the implications of the findings in terms of the need for specialization of ACT or ICM teams to address social and vocational functioning and substance abuse. We suggest directions for future research on models of community care, including evaluating implementation fidelity, exploring patient predictors of improvement, and evaluating the role of the helping alliance in mediating outcome.     

Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions

An emerging body of research on the physical and sexual abuse of seriously mentally ill (SMI) women documents a high incidence and prevalence of victimization within this population. While causal links are not well understood, there is convergent evidence that victimization of SMI women is associated with increased symptom levels, HIV-related risk behaviors, and such comorbid conditions as homelessness and substance abuse. These abuse correlates may influence chronicity, service utilization patterns, and treatment alliance. This article reviews the research literature on the prevalence, symptomatic and behavioral correlates, and treatment of abuse among SMI women, particularly women with schizophrenia. Within each topic, we discuss relevant research findings, limitations of available studies, and key questions that remain unanswered. We also discuss mechanisms that may underlie the relationship between trauma and schizophrenia-spectrum disorders. We conclude by outlining directions for future research in this area.     

You're only as pretty as you feel: Facial expression as a determinant of physical attractiveness.

In Exp I, photos of 15 female target persons posing happy, neutral, and sad facial expressions were rated by 257 undergraduates for facial attractiveness using paired comparisons and Likert scales. Half of the raters were instructed to compensate for the effects of facial expression. Paired comparisons and Likert ratings were highly correlated. Target persons were less attractive when posing sad expressions than when posing neutral or happy expressions, which did not differ. In addition, independent ratings of 4 dimensions of the target persons' facial expression were obtained: pleasantness, surprise, intensity, and naturalness. Changes in these dimensions from the neutral to the happy and sad expressions and the corresponding changes in attractiveness were consistently related only to pleasantness, supporting the reinforcement-affect theory of attraction. Exp II, with 21 male undergraduates, related overall attractiveness to facial and bodily attractiveness. Both facial and bodily attractiveness were predictive of overall attractiveness, but the face was a slightly more powerful predictor. Results are discussed with respect to the stability of physical attractiveness, and alternative explanations of the mental-illness/physical-unattractiveness relation are proposed. (54 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure and construct validity of the Scale for the Assessment of Negative Symptoms.

Confirmatory factor analysis (CFA) was used to examine the underlying structure of the negative symptoms of schizophrenia as measured by the Scale for the Assessment of Negative Symptoms (SANS). Schizophrenia patients (N?=?457) were assessed with the SANS on at least 1 of 2 occasions: (a) 2–4 weeks after an index hospitalization, and (b) after a clinical stabilization period that lasted 3–6 months. Results of an exploratory factor analysis conducted for the first assessment (n?=?401) were largely supported by the CFAs conducted on the data at the second assessment (n?=?345). The CFA solution included 3 factors: Diminished Expression, Inattention-Alogia, and Social Amotivation. Analysis of patients' clinical characteristics, treatment outcome, chronicity of the illness, premorbid history, and social adjustment supported the validity of the 3 factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anhedonia, positive and negative affect, and social functioning in schizophrenia

This study examines the relationship between anhedonia and the trait dimensions of positive affect (PA) and negative affect (NA) in schizophrenia. The relationship between poor social functioning in schizophrenia and these individual differences in affectivity is also examined. Schizophrenia outpatients (n = 37) and normal controls (n = 15) were assessed at a baseline evaluation and again approximately 90 days later. Consistent with the hypothesized decrease in hedonic capacity in schizophrenia, patients reported significantly greater physical and social anhedonia and less PA than controls. However, the schizophrenia group also reported significantly greater NA and social anxiety than did controls. In support of the dispositional view of these individual differences in affectivity, trait measures demonstrated test-retest reliability, and group differences between the schizophrenia group and controls were stable over the 90-day followup period. Within the schizophrenia group, physical and social anhedonia were comparably negatively correlated with trait PA; however, social but not physical anhedonia was significantly positively correlated with NA and social anxiety. Poor social functioning in the schizophrenia group was associated with greater physical and social anhedonia and greater NA and social anxiety. Alternatively, greater trait PA was related to better social functioning. These findings indicate that schizophrenia is characterized by both low PA and elevated NA and that these affective characteristics are a stable feature of the illness. The results also suggest important links between affect and social functioning in schizophrenia.