The Indianapolis Vocational Intervention Program: a cognitive behavioral approach to addressing rehabilitation issues in schizophrenia.

Despite wishing to return to productive activity, many individuals with schizophrenia enter rehabilitation with severe doubts about their abilities. Negative beliefs in schizophrenia have been linked with poorer employment outcome. Accordingly, in this paper, we describe efforts to synthesize vocational and cognitive behavior therapy interventions into a 6-month manualized program to assist persons with schizophrenia spectrum disorders overcome negative beliefs and meet vocational goals.

Vocational function among persons with schizophrenia with and without history of childhood sexual trauma.

This study examined whether history of childhood sexual abuse in schizophrenia is linked with severity of vocational deficits. Work performance was measured using the Work Behavior Inventory and hours of work performed in a vocational rehabilitation program and then compared for 12 participants with schizophrenia or schizoaffective disorder reporting abuse and 18 with schizophrenia with no abuse history. ANOVAs indicated that the sexual abuse group worked fewer hours during the first 4 weeks of the program and demonstrated poorer work performance overall.

Attributional style and symptoms as predictors of social function in schizophrenia.

While the attributions of people with schizophrenia have been hypothesized to play a role in determining social behavior, contradictory predictions can be made about exactly what type of attributions contribute to social dysfunction. One possibility is that attributing undesirable events to internal, stable, and global factors might lead to poorer social function. An alternate possibility is that attributing events in general to internal, stable, and global factors might lead to better social function.

Heightened interpersonal dependency in schizophrenia: associations with graver impairment in neurocognition but not with negative or positive symptoms.

This study sought to clarify how dependency traits may be related to neurocognition and clinical symptoms of schizophrenia. Participants were 35 persons diagnosed with a schizophrenia-spectrum disorder who were recruited from a comprehensive day hospital at a VA Medical Center. Neurocognition, symptoms and level of interpersonal dependency were measured.

Neurocognitive deficits and history of childhood abuse in schizophrenia spectrum disorders: associations with Cluster B personality traits.

Cluster B personality traits have been detected in persons with schizophrenia, at a rate exceeding that of the general population. Unclear, however, is how to account for such high rates of Cluster B traits. Accordingly, this study explored the hypothesis that the presence of these traits may be linked to impairments in neurocognition, and childhood abuse history.

Patterns of obsessive-compulsive symptoms and social function in schizophrenia.

Research has alternately found that obsessive and compulsive (OC) symptoms in schizophrenia are associated with graver and lesser levels of negative symptoms. One possible explanation is that there are two distinct groups of persons with OC symptoms: those with cognitive deficits and high levels of negative symptoms and those who generally function well and have low levels of negative symptoms. To examine this question, we performed a cluster analysis on 66 persons with schizophrenia spectrum disorders on the basis of their level of obsessive-compulsive phenomena and global psychosocial function.

Narrative transformation as an outcome in the psychotherapy of schizophrenia.

Assertions that changes or transformations in narratives contribute significantly to recovery from schizophrenia persist as a cornerstone of some psychotherapies. Yet when narrative transformation occurs in schizophrenia, what is there about the client's story that tangibly changes, and how might that be measured? To address this issue, we review literature on the importance of narrative transformation and identify narrative qualities that might theoretically change. We then report content and thematic analyses of the qualities of narratives that might potentially change over 14 months of psychotherapy.

Neuroticism and visual memory impairments as predictors of the severity of delusions in schizophrenia.

This study examined whether levels of emotional distress and impairments in visual memory were uniquely associated with severity of delusions in schizophrenia. Severity of delusions was assessed using select items from the positive component of the Positive and Negative Syndrome Scale among 44 persons with schizophrenia or schizoaffective disorder in a post-acute phase of illness. Emotional distress was assessed using the neuroticism subscale of the NEO Five Factor Inventory, and visual memory was assessed using the Rey Complex Figure Test.

Social cognition and neurocognitive deficits in schizophrenia.

While research equivocally supports a relationship between social cognition and neurocognition, it is less clear whether social cognition is related to general cognitive functioning or whether specific aspects of social cognition are linked with specific forms of neurocognition. Thus, this study sought to investigate the relationships between various domains of neurocognition and two forms of social cognition, social cue recognition and social problem solving, for 40 people with schizophrenia spectrum disorders. Step-wise multiple regressions found that performance on neurocognitive tests was able to predict 47% and 38% of the variance on measures of the ability to recognize actual and suggested social cues, respectively, and 13% of participants' ability to problem solve in ambiguous social situations.

Patterns of neurocognitive deficits and unawareness of illness in schizophrenia.

It has been alternately theorized that poor insight in patients with schizophrenia results from deficits in executive function and a preference for denial as a coping strategy. One possibility is there are two distinct groups of persons with poor insight: those with impairments in executive function and those with a generally avoidant coping style. To examine this question, the authors performed a cluster analysis on 64 persons with schizophrenia spectrum disorders on the basis of the PANSS insight and judgment item and executive function assessed with the Wisconsin Card Sorting Test.

Insight in schizophrenia: associations with executive function and coping style.

It has been suggested that lack of awareness of illness in schizophrenia may result from deficits in executive function and/or an avoidant style of coping. To examine this question, 132 persons with schizophrenia spectrum disorders were rated as either "aware," "partially unaware" or "unaware" of: (a) their illness, (b) need for treatment and (c) consequences of disorder on the abbreviated Scale to Assess Unawareness of Mental Disorder. We next compared the performance of the aware, partially unaware and unaware groups on the "escape-avoidance" and "positive reappraisal" subtests of the Ways of Coping Questionnaire and on two tests of executive function: the Letter Number Sequencing Subtest of the WAIS III and Wisconsin Card Sorting Test.