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Biomedical subjects

K T Mueser

Publications and source records attributed to K T Mueser.

At least 55 records · Page 3Linked to original sources
PubMed1997

Antisocial personality disorder, conduct disorder, and substance abuse in schizophrenia.

The validity of subtypes based on antisocial personality disorder (APD) or childhood conduct disorder without adult APD (CD only) in patients with schizophrenia (or schizoaffective disorder) and a substance use disorder (abuse or dependence) was examined. APD patients scored lower on personality measures related to socialization and higher on antisocial behavior, psychopathy, and aggression. APD patients also reported higher rates of aggression and legal problems. APD, and to a lesser extent CD only, was associated with more severe psychiatric symptoms, an earlier age of onset of substance abuse, more severe symptoms of substance abuse, and a stronger family history of substance abuse and psychiatric hospitalization. The findings suggest that schizophrenia patients with APD represent a high-risk subgroup vulnerable to more severe substance abuse, psychiatric impairment, aggression, and legal problems.

Adult↗
PubMed1997

Cognition and social functioning in schizophrenia.

This article reviews three studies investigating the relationship between information processing and social functioning in schizophrenia. The most consistent finding is the association between vigilance performance on a hybrid continuous performance/span of apprehension task and various indices of social functioning (e.g., ward behavior). However, the nature of the information processing-social functioning relationships is mutable and appears dependent on a number of factors (e.g., cross-sectional versus longitudinal designs). This article concludes with a discussion of treatment implications and future research directions.

Adolescent↗
PubMed1997

Affect recognition in schizophrenia: a synthesis of findings across three studies.

The results of three studies of affect recognition in schizophrenia, all using the same measures (the Face Emotion Identification Test, the Face Emotion Discrimination Test, and the Test of Facial Recognition), are reviewed. The studies differed on two important subject characteristics: patient chronicity and medication status. One study examined chronically ill, unmedicated patients (Kerr and Neale 1993); a second study included chronically ill, medicated patients (Mueser et al. 1996); and a third study examined acutely ill, medicated patients (Bellack, Blanchard and Mueser 1996). Results across the three studies suggest that chronicity of the illness, but not medication status, was related to poor performance on the affect recognition tests. Furthermore, chronically ill patients tended to perform poorly on the control task (the Test of Facial Recognition) as well as the affect perception tasks, suggesting a generalized impairment in facial perception. The implications of the findings for research on social perception are considered, as well as for interventions designed to improve social competence in schizophrenia.

Acute Disease↗
PubMed1997

Social-Adaptive Functioning Evaluation (SAFE): a rating scale for geriatric psychiatric patients.

Geriatric chronic psychiatric inpatients often remain in a chronic psychiatric hospital because of serious deficits in adaptive life functions. Because the additional complications and adaptive changes associated with aging have not been considered in previous scales, the Social-Adaptive Functioning Evaluation (SAFE) was developed. The items in the scale measure social-interpersonal, instrumental, and life skills functioning and are designed to be rated by observation, caregiver contact, and interaction with the subject if possible. Interrater and test-retest reliability were examined (n = 60) and convergent and discriminant validity were rated against other relevant measures (n = 50) in separate studies, with all being found adequate. The factor structure of the scale was examined with exploratory factor analysis, revealing a three-factor structure. Finally, predictive validity was examined in a preliminary study of 140 patients, 45 of whom were discharged after the assessment. The results indicate that patients who remained hospitalized could be discriminated from those who were sent to nursing homes or community care on the basis of certain SAFE items and subscales. These results support the use of this instrument in later studies of geriatric psychiatric patients.

Activities of Daily Living↗
PubMed1997

Coping with negative symptoms of schizophrenia: patient and family perspectives.

An exploratory study was conducted of the strategies that schizophrenia patients and their relatives employ to cope with negative symptoms. Coping strategies and their perceived efficacy were elicited in semistructured interviews conducted separately with patients and relatives. Coping responses were coded according to the following dimensions: behavioral-cognitive, social-nonsocial, and problem focused-emotion focused. Overall, the number of coping strategies was related to perceived coping efficacy for both patients and relatives, regardless of the type of strategy. Perceived coping efficacy tended to be highest for apathy; intermediate for alogia, anhedonia, and inattention; and lowest for blunting. Relatives with more knowledge about schizophrenia used more coping strategies and reported higher levels of coping efficacy. Patient rejection by relatives and distress (either patient or relative) tended to not be related to coping strategies. The findings suggest that patients and relatives use a wide variety of strategies to cope with negative symptoms of schizophrenia. Future clinical work and research need to evaluate whether families may benefit from psychoeducational approaches to teaching them how to better manage negative symptoms.

Adaptation, Psychological↗
PubMed1997

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.

Child↗
PubMed1997

Relationships between symptoms of schizophrenia and substance abuse.

Previous work posits that severity of substance abuse and severity of schizophrenic symptoms should be linked by either or both of two mechanisms: self-regulation of symptoms and drug-induced exacerbation of symptoms. Research on these relationships has yielded mixed results. We examined the interrelationships of schizophrenic symptoms and substance abuse in 172 patients with co-occurring disorders. Relationships were weak or nonexistent, without any consistent pattern. Our findings do not support the view that substances are used to self-regulate symptoms. In addition, our results suggest that substance abuse may lead to higher rates of institutionalization through mechanisms other than by exacerbating symptoms.

Adolescent↗
PubMed1997

Work and nonvocational domains of functioning in persons with severe mental illness: a longitudinal analysis.

In this study we sought to understand the relationship between obtaining competitive employment and changes in nonvocational domains of functioning (symptoms, substance abuse, hospitalizations, self-esteem, quality of life) in persons with severe mental illness. A group of 143 unemployed patients participating in a study of vocational rehabilitation programs were assessed in nonvocational areas of functioning at baseline and 6, 12, and 18 months later. Statistical analyses examined the relationship between work status at the follow-up assessments and nonvocational functioning, controlling for baseline levels of nonvocational variables. Patients who were working at follow-up tended to have lower symptoms (particularly thought disorder and affect on the Brief Psychiatric Rating Scale), higher Global Assessment Scores, better self-esteem, and more satisfaction with their finances and vocational services than unemployed patients. Employment is associated with better functioning in a range of different nonvocational domains, even after controlling for baseline levels of functioning.

Activities of Daily Living↗
PubMed1997

Expectations and motives for alcohol use in a psychiatric outpatient population.

The purpose of the study was to assess alcohol expectancies and motives of psychiatric outpatients with and without comorbid current or lifetime substance use disorders. Seventy-five psychiatric outpatients with diagnoses of mood disorders, anxiety disorders, and substance use disorders were administered the Alcohol Effect Expectancy Questionnaire-Abridged Version and the Drinking Motives Measure. Results demonstrated that the internal reliabilities for the two scales were comparable with those reported for these measures in the general population. Psychiatric outpatients with a history of comorbid substance use disorders reported greater expectancies and motives for using alcohol than did patients with no such history. In addition patients with comorbid alcohol and drug use disorders, and only comorbid alcohol use disorder, showed significantly greater expectancies and motives for alcohol use than patients with only comorbid drug use disorders and patients with no history of comorbid substance use disorder. We discuss the implications of the findings for role of expectancies and motives in the maintenance and treatment of substance abuse in psychiatric patients.

Adolescent↗
PubMed1997

An update on supported employment for people with severe mental illness.

OBJECTIVE: This review examines the effectiveness of supported employment for people with severe mental illness. METHODS: A comprehensive search was made for quantitative studies, primarily in the published literature. RESULTS: Seven descriptive studies, three surveys, one quasi-experimental study, and six experimental studies were found. All studies suggested significant gains in obtaining employment for persons enrolled in supported employment programs. In experimental studies, a mean of 58 percent of clients in supported employment programs achieved competitive employment, compared with 21 percent for control subjects, who typically received traditional vocational services. Employment outcomes relating to time employed and employment earnings also favored clients in supported employment over control subjects. No evidence was found that supported employment led to stress levels precipitating higher rehospitalization rates. Two features of many supported employment programs have the most empirical support: integration of mental health and vocational services within a single service team and the avoidance of preplacement training. Two other widely held principles-ongoing support and attention to client preferences-have not been systematically evaluated. CONCLUSIONS: Supported employment appears to be a promising approach for people with severe mental illness, but more studies are needed, with close attention to program implementation and long-term follow-up.

Employment↗
PubMed1997

Physical attractiveness in schizophrenia. The mediating role of social skill.

The role of social skill in mediating perceived physical attractiveness among individuals with chronic schizophrenia was investigated. Twenty five inpatients participated in an unstructured role play. The physical attractiveness of the individuals was rated both before and after observation of the role play by two pairs of raters. Social skill was rated by a third pair of raters. The two ratings of physical attractiveness were only weakly correlated with one another. Social skill contributed variance independent of initial attractiveness to post-role-play attractiveness. Practical implications of the findings (i.e., stigma issues and social skills training) are discussed.

Adolescent↗
PubMed1996

Positive symptoms of psychosis in posttraumatic stress disorder.

The possible presence of hallucinations and delusional thoughts in posttraumatic stress disorder (PTSD) was investigated. Other symptom clusters were also assessed in order to further clarify the nature of PTSD. Twenty combat veterans with PTSD were compared to 18 combat veterans without PTSD on symptom rating scales. The subjects with PTSD exhibited a greater degree of depression, anxiety, agitation, anhedonia, and positive symptoms of psychosis than the comparison group. Specifically, the PTSD group manifested increased hallucinations, delusions, and bizarre behavior. Some of these positive symptoms did not appear to be due to reexperiencing of the trauma. The groups were not significantly different on indices of mania, thought disorder, or inertia. The clinical and diagnostic implications of the results are discussed. A diagnosis of PTSD should be considered with patients who have positive symptoms in the absence of thought disorder.

Adult↗
PubMed1996

Information processing, social skill, and gender in schizophrenia.

The relationships among information processing, social skill, and gender in individuals with chronic schizophrenia were investigated. Although there were no gender differences in information processing, social skill, or negative symptoms, performance on information-processing tasks was related to various indices of social skill (e.g., paralinguistic skill) for female, but not male, inpatients. This pattern of results remained after statistical controls were applied for age, illness chronicity, and positive symptoms.

Adult↗
PubMed1996

Group treatment for dually diagnosed clients.

Group treatment is a widely practiced intervention for persons with dual diagnoses. This chapter reviews the rationale for group treatment and discusses four different approaches to group intervention: twelve-step, educational-supportive, social skills, and stagewise treatment.

Adult↗