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Biomedical subjects

K T Mueser

Publications and source records attributed to K T Mueser.

At least 73 records · Page 4Linked to original sources
PubMed1996

Emotion recognition and social competence in chronic schizophrenia.

This study evaluated (a) whether chronic, medicated schizophrenia patients show deficits in emotion recognition compared to nonpatients, and (b) whether deficits in emotion recognition are related to poorer social competence. Two emotion recognition tests developed by S. L. Kerr and J. M. Neale (1993) and Benton's Test of Facial Recognition (A. Benton, M. VanAllen, K. Hamsher, & H. Levin, 1978) were given to patients with chronic schizophrenia and nonpatient controls. Patients' social skills, social adjustment, and symptomatology were assessed. Like Kerr and Neale's unmedicated patients, these patients performed worse than controls on both emotion recognition tests and the control test. For patients, facial perception was related to the chronicity of illness and social competence. Chronicity of illness may contribute to face perception deficits in schizophrenia, which may affect social competence.

Adult↗
PubMed1996

The course, treatment, and outcome of substance disorder in persons with severe mental illness.

Individuals with co-occurring substance abuse and severe mental illness are particularly vulnerable to negative outcomes. This paper reviews findings on the longitudinal course of dual disorders in traditional treatment systems, which provide separate mental health and substance-abuse programs; describes the movement toward programs that integrate both types of treatment at the clinical level; reviews evidence related to outcomes in integrated treatment programs; and discusses health-care policy changes that would encourage effective treatments.

Humans↗
PubMed1996

Cue availability and affect perception in schizophrenia.

This study examined affect perception in schizophrenia. Subjects were 35 patients with schizophrenia or schizoaffective disorder, 11 with bipolar disorder, and 19 matched nonpatient controls. All patients were in the latter stages of an acute hospitalization. Measures included a videotaped test of affect perception administered with and without sound, two tests of facial affect perception based on photographs, and two measures of nonaffect perception. The patient groups did not differ from one another on any of the affect perception measures, and few differences occurred between schizophrenia patients and nonpatient controls. Affect perception in schizophrenia patients was not correlated with symptomatology or history of illness, and there were no gender differences. Deficits reported in prior studies may reflect limitations in the assessment methodology commonly employed.

Adult↗
PubMed1996

Research update on the psychosocial treatment of schizophrenia.

OBJECTIVE: This review is an update on the research evidence supporting psychosocial treatment for schizophrenia. It extends previous review articles by summarizing the literature on social skills training, family interventions, cognitive rehabilitation, and coping with residual positive symptoms. METHOD: The authors reviewed controlled treatment outcome studies of social skills training and family interventions. Different models of family therapy were contrasted. The current literature on cognitive rehabilitation and coping with residual positive symptoms was also examined. RESULTS: Social skills training produces improvement on specific behavioral measures, although changes in symptoms and community functioning are less pronounced. Family interventions (i.e., family psychoeducation and behavioral family therapy) are highly effective for reducing families' expressed emotion and improving patients' relapse rates and outcomes. Furthermore, family interventions are also associated with reduced family burden. Cognitive rehabilitation and training in coping with positive symptoms appear to be promising interventions, but more controlled, group trials are needed before definite conclusions can be drawn. CONCLUSIONS: The efficacy of a variety of different family intervention models, as well as social skills training, is supported by a large body of research. Future work needs to address improving delivery of existing psychosocial interventions, integrating these interventions with other psychosocial approaches (e.g., vocational rehabilitation and case management), identifying which patients will benefit from which treatments, isolating the "active" ingredients of family interventions (i.e., psychoeducation versus behavioral intervention), and identifying the amount of treatment (e.g., number of sessions) needed before treatment response is expected.

Adaptation, Psychological↗
PubMed1996

Family burden of schizophrenia and bipolar disorder: perceptions of relatives and professionals.

OBJECTIVE: The study compared the burden that specific problem behaviors of patients with schizophrenia or bipolar disorder placed on relatives and evaluated the accuracy of mental health professionals' judgment of the burden. METHODS: A questionnaire was developed to assess the burden of 20 common problem behaviors associated with manic, positive, and negative symptoms. The questionnaire was given to 48 relatives of patients with schizophrenia or bipolar disorder. In addition, 39 mental health professionals completed separate questionnaires indicating the amount of burden they believed relatives experienced due to these behaviors. RESULTS: Relatives of patients with bipolar disorder rated manic symptoms as more burdensome than did relatives of patients with schizophrenia, but relatives of patients in the two groups did not differ in their ratings of burden associated with positive or negative symptoms. Professionals' perceptions of the burden associated with manic symptoms were relatively accurate, but they tended to underestimate the burden of positive and negative symptoms experienced by relative of patients with bipolar disorder. CONCLUSIONS: Psychiatric diagnosis may be of limited value in understanding the burden relatives experience due to specific psychiatric symptoms. Professionals are encouraged to assess the burden that is associated with specific problem behaviors regardless of psychiatric diagnosis.

Activities of Daily Living↗
PubMed1996

Physical aggression against psychiatric inpatients by family members and partners.

The rate of recent violence against newly admitted psychiatric inpatients by partners and family members was assessed. Sixty-nine patients who had a partner or contact with a family member participated. A high proportion of respondents reported physical victimization by either their partner (62.8 percent) or a family member (45.8 percent). Physical abuse was rarely documented in medical charts, and most respondents did not consider the violence they experienced to be abuse. Almost half of the respondents met criteria for posttraumatic stress disorder in response to their physical victimization. The findings underscore the importance of assessing recent partner and family violence in the routine evaluation of psychiatric patients.

Adult↗
PubMed1996

A survey of preferred terms for users of mental health services.

To determine how users of mental health services would like to be addressed by professionals, a survey of 302 persons participating in a variety of inpatient and outpatient psychiatric programs was conducted. Forty-five percent of the sample preferred the term "client," 20 percent preferred the term "patient," 8 percent preferred the term "consumer," and 27 percent either expressed no clear preference for one term or provided another term. The results suggest that no one term is favored by users of mental health services. Professionals and persons receiving mental health services are encouraged to talk over individual preferences to help establish a working alliance.

Attitude↗
PubMed1995

Relations between social skills and ward behavior in chronic schizophrenia.

The relationship between social skills and ward behavior among chronic schizophrenia patients was investigated. Twenty-eight inpatients participated in an unstructured role play test and were rated by staff members on a number of indices of ward behavior (e.g., social interactions, inappropriate behavior). Overall, there was a relationship between social skill on the role play and social behavior on the ward. Speech clarity was the social skill most strongly related to ward behavior, even when controlling for symptomatology. However, several other social skill variables (e.g., gaze, affect) were not related to social adjustment. The results are discussed in terms of the validity of social skill assessments in patients with chronic schizophrenia, and their implications for psychosocial treatment of this population.

Adolescent↗
PubMed1995

Memory and social skill in schizophrenia: the role of gender.

The relationship between social skill and memory was examined in a group of patients with schizophrenia and schizoaffective disorder. There were few or no differences between male and female patients in history of the illness, symptomatology, memory, and other cognitive factors, or social skill. Despite the absence of differences, impaired memory was related to poorer social skills for the women, but not the men. Reanalysis of data on social skill and memory from an earlier study (Mueser et al., 1991) revealed a similar pattern of results. The findings suggest that the contribution of cognitive factors to impaired social competence in schizophrenia may differ in men and women. Alternatively, the results may reflect sampling bias, whereby more severely ill women are studied than men, relative to their respective populations.

Adolescent↗
PubMed1995

Family interactions of schizophrenic and schizoaffective patients: determinants of relatives' negativity.

Videotaped family problem-solving interactions of 57 schizophrenic or schizoaffective patients and their relatives were examined for predictors of negativity of their communication behavior. Ratings of patients' behaviors and independent assessments of patients' symptomatology were used to predict the negativity of relatives in the videotaped interaction. The results indicated that severity of symptomatology was not related to relatives' negativity. Patients' social skill, as independently assessed by a role-play test, also was not associated with relatives' negativity. The regression results suggest that with both members of a patient-relative dyad, the quality of communication in a discussion is related to the other participant's level of negativity.

Adolescent↗
PubMed1995

Information processing and social competence in chronic schizophrenia.

The relationship between social competence and information processing among individuals with chronic schizophrenia was investigated. Thirty-eight inpatients participated in a role play test of social competence and completed a battery of information-processing tasks. Information processing was found to be significantly related to social competence, even after controlling for patient demographics, chronicity, and symptomatology. Higher global social competence was related to more efficient early information processing on a continuous performance/span of apprehension task. Composite indices of specific social competence (i.e., paralinguistic and nonverbal skills) were related to other aspects of information processing (e.g., reaction time). Implications for behavioral assessment and cognitive rehabilitation are discussed.

Adult↗
PubMed1995

Expectations and motives for substance use in schizophrenia.

This study examined the internal reliability of standardized measures of substance use expectancies and motives in a schizophrenia population (n = 70) and the relationship of these expectancies and motives to alcohol and drug use disorders. Internal reliabilities were uniformly high for the subscales of the expectancy and motive measures. Analyses of the relationship between substance use disorders and expectancies revealed strong substance-specific expectations. Alcohol expectancies were related to alcohol disorders but not to drug disorders; cocaine expectancies were related to drug but not to alcohol disorders; and marijuana expectancies were more strongly related to drug than to alcohol use disorders. In contrast, motives were related to substance use disorders, and self-reported substance use problems were related to expectancies and motives in a non-specific manner. These results suggest that expectancy and motive questionnaires developed for the primary substance abuse population may be valid for psychiatric populations. Research on motives and expectancies may help to clarify the functions of substance abuse in persons with schizophrenia.

Adult↗
PubMed1995

The Allen Cognitive Level Test and social competence in adult psychiatric patients.

OBJECTIVES: The purpose of this study was to investigate the relationship between cognitive disability and social skills in an acute care adult inpatient psychiatric population (n = 55). METHOD: Independent ratings of patient's social skills were made during a semistructured interview using the Social Interaction Test (SIT), followed by measurement of cognitive disability using the revised Allen Cognitive Level Test (ACL-90). Reliability of the assessments was established. RESULTS: Significant correlations were found between the ACL-90 and SIT scores: patients with greater cognitive disability had poorer social skills. ACL-90 scores were not related to gender or diagnosis. A gender difference was found for SIT scores with women having better social skills than men. CONCLUSION: These findings suggest there is a relationship between cognitive disability and social skills in adult psychiatric inpatients. Implications for occupational therapy treatment include better integration of the grading of the cognitive and social requirements of tasks to achieve optimal functioning.

Adult↗
PubMed1994

Educational Family Therapy for schizophrenia: a new treatment model for clinical service and research.

A new family therapy model for schizophrenia is described, Educational Family Therapy (EFT). This model employs didactic teaching methods and 'user friendly' educational handouts and is provided in a flexible, interactive manner. The results of pilot data show that the model is feasible and suggest family members improve in their understanding of the illness. Data are also presented demonstrating that EFT can be distinguished from another model of family therapy for schizophrenia, Behavioral Family Therapy. The need for research comparing EFT and other family therapy models for schizophrenia is discussed. Such research may have implications for the dissemination of effective family interventions, matching treatment models to family needs and understanding the mechanisms underlying the impact of family therapy on the course of schizophrenia and on family burden.

Adult↗
PubMed1994

Evaluation of social problem solving in schizophrenia.

We examined social problem solving in schizophrenia. Twenty-seven schizophrenic patients in an acute hospital, 19 patients with bipolar disease, and 17 demographically matched nonpatient controls were tested on an empirically developed problem-solving battery that assessed the ability to generate solutions to problems, the ability to evaluate the effectiveness of solutions, and the ability to implement solutions in a role-playing format. Schizophrenic Ss were impaired on all 3 problem-solving domains compared with the nonpatient controls, but bipolar Ss were equally impaired. Several alternative explanations for these findings were considered. The most compelling hypothesis is that the deficits resulted from different factors: cognitive impairment for schizophrenic Ss and acute illness for bipolar Ss. However, longitudinal studies are required to determine whether problem-solving deficits in schizophrenic patients persist during periods of remission. Implications for rehabilitation strategies are discussed.

Adult↗
PubMed1994

Affective and social-behavioral correlates of physical and social anhedonia in schizophrenia.

The association between scales measuring physical and social anhedonia, self-reports of affective response to emotion-eliciting films, and role play measures of social skill was evaluated in patients with schizophrenia, schizoaffective disorder, and bipolar affective disorder. We hypothesized that patients with schizophrenia would report significantly greater anhedonia than the bipolar patients and that higher scores on the anhedonia scales would be related to attenuated reports of the experience of positive affect and poorer social skill. Patients with schizophrenia and schizoaffective disorder did not differ in ratings of anhedonia, but both groups had higher physical and social anhedonia scores than did bipolar patients. Higher scores on the physical anhedonia scale, but not the social anhedonia scale, were related to attenuated reports of positive affect following viewing of affect-eliciting films in schizophrenia-schizoaffective disorder patients. Neither anhedonia scale was related to role play measures of social skill performance for any patient group.

Adolescent↗
PubMed1994

A multisite investigation of the reliability of the Scale for the Assessment of Negative Symptoms.

OBJECTIVE: The Scale for the Assessment of Negative Symptoms is a widely used instrument for measuring negative symptoms in schizophrenia, but few studies have examined its reliability. This study examined the interrater, internal, and test-retest reliabilities of the scale and its factor structure in the context of a multisite study. METHOD: Two hundred seven patients with schizophrenia who were participating in the Treatment Strategies in Schizophrenia study were assessed with the Scale for the Assessment of Negative Symptoms following a symptom exacerbation and again 3-6 months later. All assessments were performed by trained psychiatrists who were treating the patients. RESULTS: Interrater reliabilities ranged from low to high for the items on the Scale for the Assessment of Negative Symptoms but were statistically significant in most cases. Most correlations between individual items and subscale total scores were moderate to high, as were coefficient alphas for each subscale, indicating adequate internal consistency. Test-retest correlations were of moderate magnitude. Few differences in reliability statistics between sites were found, although differences in mean scale ratings between sites were present. A factor analysis indicated three factors corresponding to the Affective Flattening or Blunting subscale, the Avolition-Apathy and Anhedonia-Asociality subscales, and the Alogia and Inattention subscales. CONCLUSIONS: The results suggest that the Scale for the Assessment of Negative Symptoms has good reliability and is a useful instrument for the measurement of negative symptoms in multisite clinical studies. The internal reliability of the Alogia, Avolition-Apathy, and Inattention subscales could be improved by replacing some items and including additional items.

Adult↗