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Biomedical subjects

D L Penn

Publications and source records attributed to D L Penn.

36 records · Page 2Linked to original sources

Use of peer ratings to assess sociability among inpatients with severe psychiatric disorders.

OBJECTIVE: A critical component of inpatient treatment for persons with severe psychiatric disorders is an evaluation of their social impairments. Most existing methods for such evaluations involve staff input and can be both time-consuming and expensive. This paper reports on the use of peer ratings as a method for assessing sociability, an aspect of social functioning in this clinical population. METHODS: Thirty-two inpatients with severe psychiatric disorders who had spent an average of 18 months on an inpatient unit in a state facility rated the popularity of their inpatient peers by completing a 7-point scale measuring how much they enjoyed visiting with each patient. The reliability of peer ratings and their association with staff ratings of patients' behavior on the unit were assessed. RESULTS AND CONCLUSIONS: The peer ratings had excellent test-retest reliability and were highly associated with staff members' independent evaluations of patients' behavior. Peer ratings appear to have promise as a measure of social functioning among inpatients with severe psychiatric disorders.

Adult↗

Social cognition in schizophrenia.

The study of social cognition in schizophrenia may augment the understanding of clinical and behavioral manifestations of the disorder. In this article, the authors describe social cognition and differentiate it from nonsocial cognition. They garner evidence to support the role of social cognition in schizophrenia: Nonsocial information-processing models are limited to explain social dysfunction in schizophrenia, measures of social cognition may contribute greater variance to social functioning than measures of nonsocial cognition, task performance on nonsocial-cognitive measures may not parallel performance on social-cognitive tasks, and symptomatology may be best understood within a social-cognitive framework. They describe the potential implications of a social-cognitive model of schizophrenia for the etiology and development of the disorder.

Cognition Disorders↗

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↗

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↗

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↗

The relationship of social cognition to ward behavior in chronic schizophrenia.

The relationship between social cognition (i.e., cognition for social stimuli) and ward behavior among individuals with chronic schizophrenia was investigated. Twenty-seven inpatients completed a battery of cognitive and social-cognitive tasks and were rated by staff on various indices of ward behavior. Overall, there was a relationship between the measures of social cognition and behavior on the ward. Social cognition contributed unique variance beyond cognition to maladaptive behavior on the ward (i.e., irritability). Implications for assessment and future research are discussed.

Adult↗

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↗

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↗

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↗

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↗

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↗

Social anxiety in schizophrenia.

The relationship between social anxiety and positive and negative symptomatology in schizophrenia was investigated. Thirty eight inpatients with schizophrenia completed a battery of self-report measures of anxiety, a modified Stroop task, and an unstructured role play. Positive symptoms were related to fear in a number of self-report domains (i.e., social and agoraphobic). Negative symptoms were related to global observational ratings of anxiety during the role play as well as specific behaviors associated with self-reported social anxiety (i.e., speech rate and fluency). Positive symptoms generally were not associated with role play ratings. Thus, specific behaviors related to social anxiety appear to be associated with negative symptoms, while self-report is associated with positive symptoms. Problems in the assessment of social anxiety in individuals with schizophrenia and implications of these findings for social skills training in this population are discussed.

Adult↗

Dispelling the stigma of schizophrenia: what sort of information is best?

This study investigated what type of information reduces stigmatization of schizophrenia. Subjects were presented with one of six varying descriptions of a hypothetical case in which a target individual had recovered from a mental disorder. Subjects were asked if they knew someone with a mental illness. Those individuals who had no previous contact perceived the mentally ill as dangerous and chose to maintain a greater social distance from them. In general, knowledge of the symptoms associated with the acute phase of schizophrenia created more stigma than the label of schizophrenia alone. In contrast, more information about the target individuals post-treatment living arrangements (i.e., supervised care) reduced negative judgments. Implications for public education and future research are discussed.

Activities of Daily Living↗

Information processing and social cognitive problem solving in schizophrenia. Assessment of interrelationships and changes over time.

The relationship between basic information processing and social cognitive problem solving (SCPS) was studied in 31 schizophrenic, 16 depressive, and 31 control subjects. The clinical subjects were assessed twice, during symptom exacerbation and 3 months later, after partial remission. Control subjects were tested during the same time period. Subjects completed a means-ends problem-solving test, an alternative solution generation task, and an information-processing test battery. Results showed that schizophrenic subjects demonstrated significant improvement in a number of information-processing indices over time. No significant changes on the social cognitive problem-solving variables were found. Furthermore, all three groups demonstrated different patterns of relationships between information processing and social cognitive problem solving. Implications for treatment are discussed.

Adult↗

Normative contrast sensitivity functions: the problem of comparison.

Sixty college age observers who were prescreened for 6/6 (20/20) acuity were examined twice on an automated contrast sensitivity system. A significant practice effect was evident in the obtained contrast sensitivity functions (CSF's). In addition, marked differences were found between the contrast sensitivity scores in the present work and the normative CSF reported by other investigators using similar methods. Implications for the rapid assessment of CSF in applied settings and for the use of published CSF norms are discussed.

Adult↗

The effects of impression management demands on heart rate, self-reported social anxiety, and social competence in undergraduate males.

The effects of self-presentation demands were evaluated through conversational probe (CP) role-play tasks. Participants (N = 29) were required to manage their self-presentations (i.e., the impression they made, in each of two conditions). During high impression management (IM) demand, participants were evaluated on their performance. During Low IM demand, participants evaluated a confederate's performance. The High IM demand condition produced significantly higher heart rate (HR) and self-reported anxiety. HR and self-reported anxiety accounted for a significant amount of the variance in criterion measures of social competence. Greater social competence during High IM was associated with higher HR. Greater social competence during Low IM was associated with lower HR and lower self-reported anxiety. Although preliminary, these results suggest that uncontrolled IM demands contributed to mixed results found within and between social anxiety studies in the literature. Implications for the treatment of social anxiety are discussed.

Adult↗