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Biomedical subjects

A S Bellack

Publications and source records attributed to A S Bellack.

At least 55 records · Page 3Linked to original sources
PubMed1990

Gender, social competence, and symptomatology in schizophrenia: a longitudinal analysis.

The relationship between gender and social skill measured by performance on a role play test was examined in a sample of 57 schizophrenics, 33 affective disorder patients, and 20 nonpatient controls. Female schizophrenics were more skilled than male schizophrenics, but no gender differences were present in the affective patients or the controls. Longitudinal analyses conducted on the schizophrenic group indicated that the superior social skill of women was stable over the year following a symptom exacerbation. Symptoms and social adjustment improved for both men and women over the year, but did not differ according to gender. The implications of the results for gender differences in the long-term outcome of schizophrenia are discussed.

Adolescent↗
PubMed1990

Prevalence of substance abuse in schizophrenia: demographic and clinical correlates.

Methodological issues involved in assessing the prevalence of substance abuse in schizophrenia are discussed, and previous research in this area is comprehensively reviewed. Many studies suffer from methodological shortcomings, including the lack of diagnostic rigor, adequate sample sizes, and simultaneous assessment of different types of substance abuse (e.g., stimulants, sedatives). In general, the evidence suggests that the prevalence of substance abuse in schizophrenia is comparable to that in the general population, with the possible exceptions of stimulant and hallucinogen abuse, which may be greater in patients with schizophrenia. Data are presented on the association of substance abuse with demographics, diagnosis, history of illness, and symptoms in 149 recently hospitalized DSM-III-R schizophrenic, schizophreniform, and schizoaffective disorder patients. Demographic characteristics were strong predictors of substance abuse, with gender, age, race, and socioeconomic status being most important. Stimulant abusers tended to have their first hospitalization at an earlier age and were more often diagnosed as having schizophrenia, but did not differ in their symptoms from nonabusers. A history of cannabis abuse was related to fewer symptoms and previous hospitalizations, suggesting that more socially competent patients were prone to cannabis use. The findings show that environmental factors may be important determinants of substance abuse among schizophrenic-spectrum patients and that clinical differences related to abuse vary with different types of drugs.

Adolescent↗
PubMed1990

Positive and negative symptoms in schizophrenia. A cluster-analytic approach.

The relationships between positive and negative symptoms of schizophrenia and between negative symptoms and social dysfunction were investigated using cluster analysis. Clustering across schizophrenic subjects produced three distinct groups, each characterized by some mix of positive and negative symptoms. Clustering across symptoms and behavioral variables produced a cluster comprising negative symptoms and measures of social adjustment and an additional cluster comprising only measures of social skill. A series of correlations revealed a positive relationship between positive and negative symptom measures. chi 2 analysis revealed a significant relationship between the cluster solution across subjects and classification of patients according to negative symptoms based on previously published criteria. Results are discussed in terms of the implications for the further development and refinement of subclassification schemes for schizophrenia.

Adult↗
PubMed1990

Hallucinations in schizophrenia.

The prevalence of different types of hallucinations and their clinical correlates were examined in 117 DSM-III-R schizophrenic or schizoaffective disorder patients. Auditory hallucinations were by far the most common, followed by visual hallucinations, and then by tactile and olfactory or gustatory hallucinations. Auditory hallucinations were associated with an earlier age of first hospitalization among the schizophrenics. Global severity of the illness for schizophrenics was related to the presence of visual hallucinations, but not other types of hallucinations. Tactile and olfactory or gustatory hallucinations were strongly correlated with each other and with the severity of delusions for both schizophrenic and schizoaffective patients. The results suggest that important clinical differences exist between patients with different types of hallucinations, and that these clinical variables need to be controlled for in cross-cultural studies of hallucinations.

Adolescent↗
PubMed1990

Remediation of cognitive deficits in schizophrenia.

Studies have suggested that schizophrenia is characterized by an impairment in the dorsolateral prefrontal cortex that prevents learning of some elementary information processing tasks. To test this hypothesis, the authors administered the Wisconsin Card Sorting Test to 16 schizophrenic inpatients with standard instructions and either contingent or noncontingent reinforcement. Performance was markedly impaired under each condition. A second cohort (N = 12) was tested after receiving instructions plus rehearsal and feedback. These subjects' performance was comparable to nonpatient norms and was maintained on a subsequent day. The results indicate that deficits in performance on the Wisconsin Card Sorting Test are remediable, whether or not they are due to neurological impairment.

Adult↗
PubMed1990

An analysis of social competence in schizophrenia.

Twenty-one schizophrenics with prominent negative symptoms were compared with 37 schizophrenics without them, 33 patients with major affective disorder and 20 non-patient controls on a battery of measures including a role-play test of social skills, the Social Adjustment Scale, and the Quality of Life Scale. The negative schizophrenics were most impaired on every subscale of each measure, followed in order by the non-negative schizophrenics, affective disorder patients, and non-patient controls. The social skill measures were not correlated with positive symptom levels, but were highly correlated with measures of community functioning. The results are consistent with the hypothesis that social dysfunction results from focal deficits in social skills.

Adolescent↗
PubMed1989

Social problem solving in schizophrenia.

The recent literature on social skills training has placed an increasing emphasis on the role of cognitive factors in social failure, as opposed to deficits in motoric skills. It has been hypothesized that schizophrenic patients are markedly deficient in social problem-solving abilities, and several programs have been developed to teach problem-solving skills. Despite high face validity, there is little empirical support for these training programs or the problem-solving model on which they are based. Research on information processing and problem solving in nonpatient populations is discussed, and it is concluded that the model used in these treatment programs is not a good representation of the problem-solving process. In particular, means-ends analysis is not an appropriate strategy for dealing with most interpersonal problems and conflicts. The difficulties experienced by schizophrenic patients in social situations might be due to a number of factors other than deficits in problem-solving skill, including sensitivity to negative affect and disordered communication. It is concluded that further research on problem-solving training programs is clearly warranted but that the validity of the problem-solving model and the utility of the training is uncertain.

Humans↗
PubMed1988

Deficits in facial-affect recognition and schizophrenia.

It has been widely demonstrated that schizophrenic patients show a broad range of deficits in interpersonal skills. Recently, considerable attention has been focused on the ability of these patients to decode affective cues. This article reviews findings about facial-affect recognition in schizophrenia. While the literature on this topic is extensive, many investigations have suffered from significant methodological shortcomings. Strategies to resolve these shortcomings are presented. Possible relationships between problems of affect recognition and other symptoms that characterize schizophrenia are discussed. Neurological mechanisms of facial-affect recognition are reviewed and related to data on lateralized neurological impairment in schizophrenia. Suggestions for future research emphasize careful consideration of affect-recognition deficits in relation to other parameters of schizophrenia.

Affect↗
PubMed1987

Social functioning of schizophrenic patients: clinical and research issues.

Social dysfunction is generally considered an essential feature of schizophrenia. However, despite considerable interest in the social functioning of schizophrenic patients, the precise nature of the social deficits exhibited by these patients remains unspecified. No widely accepted criterion of social competence has been used to investigate their social functioning. Also, social skills researchers have often failed to recognize the heterogeneity of schizophrenia and the impact that this heterogeneity may have on attempts to implement psychosocial interventions. The adverse findings regarding the social behavior of schizophrenic patients are reviewed. Factors relating to schizophrenia that may affect their social functioning are discussed, as are directions for future research that may lead to more effective psychosocial interventions for schizophrenia.

Humans↗
PubMed1986

A comprehensive treatment program for schizophrenia and chronic mental illness.

The failure of deinstitutionalization and the community mental health movement to improve the treatment of chronic psychiatric patients, particularly schizophrenics, is described. Problems with the current treatment paradigm include unrealistic expectations concerning the rehabilitative effects of antipsychotic medications, inadequate funding of the community mental health system, and the predominance of the "infectious disease model," rather than the more appropriate "chronic disease model" of mental illness. A model for the comprehensive treatment of chronic mental illness is proposed that includes: treatment, rehabilitation, social services, and continuity of care. The need for an integrated community approach to rehabilitating chronic psychiatric patients is stressed, and some of the specific ingredients essential to such a program are identified.

Antipsychotic Agents↗
PubMed1985

Alcohol use in wife abusers and their spouses.

The present study provided an assessment of alcohol use in couples characterized by wife abuse. The Michigan Alcoholism Screening Test, Quantity-Frequency Index, Impairment Index, and a questionnaire tapping frequency and magnitude of violent episodes were administered to couples who were: (a) physically abusive, (b) maritally discordant but nonviolent, and (c) satisfactorily married. Results indicated significantly higher scores on the Michigan Alcoholism Screening Test in physically abusive males based on their self-reports as well as wives' reports of husbands' drinking behavior. No significant differences were found between groups of wives on alcohol measures. In addition, correlational analyses revealed a number of significant relationships between husbands' self-reported drinking and wives' responses concerning their spouses' alcohol use. Findings are discussed in terms of the need for more extensive assessment of physically abusive males, and the utility of examining the interactive influences of alcohol and other factors on marital violence.

Adult↗
PubMed1985

Patterns of attrition for psychosocial and pharmacologic treatments of depression.

Patient characteristics associated with early termination from psychosocial and pharmacologic treatments of depression were delineated. Patients were 125 female primary nonbipolar depressives randomly assigned to 12 weeks of protocol treatment in one of four conditions: social skills training plus placebo; short-term psychotherapy plus placebo; amitriptyline alone; and social skills training plus amitriptyline. Results indicated that premature terminators from pharmacotherapy tended to be mildly depressed and intolerant of medication side effects. In contrast, dropouts from psychosocial treatment were more severely depressed and dissatisfied with the lack of early response which often accompanies interventions of this type. These findings may support the use of short-term psychosocial approaches in lieu of pharmacotherapy in mild nonendogenous depressions. However, antidepressant medication, either alone or in conjunction with psychosocial treatment, should continue to be considered the treatment of choice in more severely depressed melancholic patients.

Amitriptyline↗
PubMed1984

Social skills training and endogenous depression.

The clinical response to social skills training was studied in four women with definite endogenous depression (melancholia) to ascertain if a behavioral intervention could be effective with more severe and pervasive affective syndromes. Three of four patients responded to social skills training, although both patients available for longitudinal follow-up relapsed within 24 months post-treatment. Implications for research and practice are discussed.

Adult↗
PubMed1984

Symptomatic volunteers in depression research: a closer look.

Seventy-nine carefully screened volunteers were compared with 46 clinically referred outpatient primary depressives to assess the validity of use of symptomatic volunteers in research on depression. Overall, symptomatic and clinical referral samples were similar on the majority of demographic and symptomatic variables, although volunteers were less likely to be single, had slightly lower Hamilton scores, less self-reported anxiety, and a longer index episode of depression. Symptomatic volunteer and clinical referral groups had a similar prevalence of endogenous depression by either RDC or DSM-III criteria. Results in 60 patients treated with amitriptyline indicated that both groups were comparable with respect to overall dropout rate, side-effect attrition, dosage of amitriptyline received, and clinical response. Only the proportion of patients who dropped out between completion of assessment and initiation of treatment significantly differed between groups (symptomatic volunteers = 19%; clinical referrals = 0%; p less than 0.05). These findings support use of rigorously screened symptomatic volunteers in outpatient depression research.

Adult↗