Evaluation of social problem solving in schizophrenia.

Abstract

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.

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

“…Social problem solving deficits have also been shown in groups of participants with bipolar disorder, depression and anxiety disorders (Bellack, Sayers, Mueser, & Bennett, 1994;Marx et al, 1992) Consistent with the proposal that problem solving deficits can contribute to the persistence of persecutory delusions, there is an indication in the literature that problem solving therapy might lead to significant improvements in psychotic symptoms, including delusions (Tarrier et al, 1993).…”

Assessment of Community Functioning in People With Schizophrenia and Other Severe Mental Illnesses: A White Paper Based on an NIMH-Sponsored Workshop

“…It is generally assumed that this is the most valid approach because it circumvents several sources of inaccuracy or bias. 57,58 Observations can be conducted in the natural environment or in simulated situations. Observation in naturalistic settings is considered to be the most robust approach because it allows the rater to evaluate whether the skills are actually implemented in the environment.…”

190. Social Cognition in Early Schizophrenia: Exploratory Factor Analysis and Subcortical Biomarkers

“…Methodology for assessing these features are diverse, some are self-report, others are observer rated, and a few are performance-based. Even amongst the broad range of measures and methods, there is a general consensus that patients with schizophrenia have poorer performance amongst social and nonsocial categories of functional outcome (Refer to appendix 3 for examples of social and nonsocial measures of functional outcome) (Bowie et al, 2008;Couture et al, 2006;Harvey, Green, Keefe, & Velligan, 2004;Bellack, Sayers, Mueser, & Bennett, 1994;Perivoliotis, Granholm, & Patterson, 2004;Mausbach et al, 2011).…”

“…Interperson al skills -eye gaze, meshing (smoothness of turn taking and conversational pauses), latency and duration of verbal responses, use of illustrative gestures and social reinforcers (Bellack et al, 1994) -fluency, interest/disinterest, clarity, focus, affect, social appropriateness (Patterson, Moscona, McKibbin, Davidson, & Jeste, 2001) Communic ation -how to use a telephone for emergency services, call a number to acquire information, call physician to reschedule a medical appointment (Mausbach et al, 2011) -Ability to generate effective verbal content in conversation and conflict situations (Bellack et al, 1994) Social problem solving -defining the goals of the individual and determining alternate solutions to hypothetical social problems. Answers rated on relevance and how likely they are to work (Bellack et al, 1994) NonSocial Work Skills -work skill acquisition via index card filing and toilet tank assembly (Sergi, Kern, Mintz, & Green, 2005) -task orientation (works steadily drung work period), work motivation (works at routine jobs without resistance), work conformance (conforms to rules and regualtions), personal presentation (arrives appropriately dressed) (P. Lysaker & Bell, 1995) Basic Living Skills -count and make change for an item purchased at a store, write a check for a utility bill (Mausbach et al, 2011) -money management, medication management (Patterson et al, 2001) Self-care -personal hygiene, appearance and care of clothing, care of personal possessions, food preparation/storage, health maintenance (Perivoliotis et al, 2004) …”