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Biomedical subjects

I R Falloon

Publications and source records attributed to I R Falloon.

53 records · Page 3Linked to original sources
PubMed1983

Interactions between drug and psychosocial therapy in schizophrenia.

Research on the interactions between drug and psychosocial interventions in the community management of schizophrenia is related to a stress/vulnerability conception of this disorder. Earlier findings that psychosocial treatments were not efficacious in the community management of schizophrenia are contrasted with promising recent data from psychosocial treatments aimed at reducing environmental stressors and promoting interpersonal competence. Family interventions and social skills training may contribute significantly to the clinical and social outcomes achieved by optimal pharmacotherapy.

Adaptation, Psychological↗
PubMed1983

Family educational intervention in the treatment of schizophrenia.

In the aftermath of deinstitutionalization, when current public policy dictates greater community management of schizophrenia, patients and their families play an increasing role in the treatment of the illness. Since mental health professionals often neglect to educate them on the causes, symptoms, and treatment of schizophrenia, patients and their families are often misinformed, fearful, and ill-equipped to aid in treatment. The authors describe a brief family educational intervention and the questionnaire that was used to compare the knowledge of patients and their families who received the intervention with the knowledge of those who did not. The findings suggest that patients and their families in family treatment programs can acquire and retain information about schizophrenia more readily than patients and families involved in individual treatment. This knowledge enables them to become more effective participants in aftercare and helps surmount the problems associated with posthospital adjustment.

Adolescent↗
PubMed1982

Family management in the prevention of exacerbations of schizophrenia: a controlled study.

Environmental stress has been implicated as an important factor in the relapse of schizophrenic patients receiving optimal drug therapy. In a randomized controlled study, we compared at-home family therapy with clinic-based individual supportive care in the community management of schizophrenia in 36 patients taking neuroleptic maintenance medications. The family-treatment approach sought to enhance the stress-reducing capacity of the patient and his or her family through improved understanding of the illness and training in behavioral methods of problem solving. The results at the end of nine months revealed the superiority of this approach in preventing major symptomatic exacerbations. Only one family-treated patient (6 per cent of all patients) was judged to have had a clinical relapse, as compared with eight patients (44 per cent) treated individually. Family-treated patients averaged 0.83 days in the hospital, as compared with 8.39 days for the comparison group. Significantly lower levels of schizophrenic symptomatology on blind rating-scale assessments supported these clinical observations of the superiority of family management.

Adolescent↗
PubMed1982

Family factors in schizophrenic relapse: a replication.

Family factors have been reported to influence the course of schizophrenia. In a replication of British studies, schizophrenic patients from the Los Angeles area were evaluated for symptomatic relapse 9 months after hospital discharge as a function of the level of "expressed emotion" in their relatives. In striking confirmation of the British findings, patients who came from families that were excessively critical, emotionally overinvolved, or both were much more likely to relapse than their counterparts who came from more tolerant and accepting families.

Affective Symptoms↗
PubMed1982

Achieving the goals of day treatment.

The problem of defining relevant goals in the rehabilitation of severely ill psychiatric patients was addressed in a day treatment program. A method was evolved from a detailed assessment of each patient's specific community functioning. Behavioral treatment strategies were individually tailored to meet the needs of a wide variety of patients in an intensive time-limited day treatment program. The provision of long term supportive outpatient services as well as overnight hospital care was considered essential for the program. Evaluation of the effectiveness of the day treatment program suggested that it did meet the needs of severely ill psychiatric patients; that good outcome was associated with high levels of participation of patients in defining their goals; and that goals concerning social and vocational functioning were achieved more frequently than intrapersonal goals.

Adult↗
PubMed1981

Persistent auditory hallucinations: coping mechanisms and implications for management.

The strategies used by 40 chronic schizophrenic out-patients with persistent auditory hallucinations to cope with the intrusive phenomena were explored. Frequent coping mechanisms included changes in activity, interpersonal contact, manipulations of physiological arousal, and attentional control. A high risk of suicide was noted. Coping behaviour appeared somewhat independent of clinical and sociodemographic variables. Successful coping appeared to result from systematic application of widely used coping strategies. The implications for the clinical management of patients with persistent auditory hallucinations are discussed.

Adaptation, Psychological↗
PubMed1981

The treatment of social phobia. Real-life rehearsal with nonprofessional therapists.

Sixteen socially phobic outpatients underwent a 4-week course of social skills training that attempted to maximize rehearsal in real-life settings. The therapy was largely conducted by nonprofessional volunteers after a 2-hour training workshop. It consisted of multiple role-played practice in the clinic, followed immediately by rehearsal in a real-life setting in the company of a nonprofessional therapist and a fellow patient. Subsequently, patients were randomly paired to perform further rehearsals between sessions. Drug therapy was controlled by double blind assignment to propranolol or inert placebo throughout the course of treatment. Measures of specific fears, generalized social anxiety, self-image, and global tension and anxiety were administered 1 month before treatment, immediately before and after treatment, and at 6 months follow-up. During a 4-week drug-free period prior to active treatment no improvement was noted on any measures. After the 4-week treatment period significant improvement had occurred on all outcome measures. Propranolol and placebo subgroups showed very similar results. Treatment gains were sustained at follow-up. It was concluded that repeated behavior rehearsal, both in the clinic and in real life is a cost-effective treatment procedure for many social phobias. The approach is straightforward and can be applied by nonprofessionals, including the patients themselves, after limited training and with minimal supervision.

Adolescent↗
PubMed1981

Family therapy of schizophrenics with high risk of relapse.

Three families that demonstrated factors associated with relapse of florid symptoms ina schizophrenic family member underwent a course of 25 sessions of behavioral therapy in a multi-family group. Details of the treatment and assessment procedures are presented along with evidence of significant beneficial change in two families. The problem of providing continuing care for schizophrenic patients and their families is discussed.

Adult↗
PubMed1981

Interpersonal variables in behavioural group therapy.

Attraction towards the group as a whole and to male and female co-leaders was self-rated after each of 10 sessions of behavioural group therapy. Fifty-one patients with specific interpersonal skills deficits completed the course after being randomly assigned to nine small groups employing either (a) role rehearsal and modelling, or (b) guided discussion. Higher levels of attraction were obtained in role-rehearsal groups. This was associated with improved self-esteem and a reduction of specific social fears at the end of treatment. Drop-outs showed less attraction and tended to leave the groups at critical stages in their development. The findings suggest that greater attention to specific interpersonal variables may enhance the effectiveness of group therapies.

Behavior Therapy↗
PubMed1981

Family participation in the community rehabilitation of schizophrenics.

Families of schizophrenic patients frequently are ill equipped to handle the primary caretaking responsibilities that have fallen to them due to deinstitutionalization. The authors describe a program begun at a medical center in Southern California in 1978 to assist schizophrenic patients living at home and their families. The program, which consists of family therapy sessions in the home, focuses on education about schizophrenia, development of communication skills, and acquisition of structured problem-solving and other behavioral strategies. Preliminary findings of a controlled study of program participants suggest that the family interventions are both cost-effective and highly successful in reducing the incidence of relapse and hospitalization.

Behavior Therapy↗
PubMed1979

Monoamine oxidase (MAO) of platelets, plasma, lymphocytes and granulocytes in schizophrenia.

Monoamine oxidase (MAO) levels in plasma, platelets, lymphocytes and granulocytes have been compared in schizophrenics and controls using three substrates. No significant difference was found between MAO levels in controls and the schizophrenic group as a whole, but platelets and lymphocytes of the latter (tyramine or benzylamine substrate) showed greater variation and in some cases higher values than controls, irrespective of treatment. Schizophrenics who experienced auditory hallucinations had significantly lower MAO levels in lymphocytes and platelets than those who did not.

Adult↗
PubMed1977

Social skills training of out-patient groups. A controlled study of rehearsal and homework.

Fifty-one out-patients with social skills deficits (two-thirds men) completed ten weekly sessions of 75-minute group treatment; 44 were followed up for a mean of 16 months. Random assignment was to one of three conditions: (I) Cohesive group discussion; (2) Modelling and role-rehearsal; or (3) Modelling and role-rehearsal + daily social homework. All three treatment conditions produced significant but incomplete improvement at the end of treatment and follow-up. The two role-rehearsal conditions were significantly superior to group discussion on several measures. Patients who completed daily social homework assignments did significantly better than patients who completed control homework. Alcohol and drug abuse patients usually dropped out. Schizophrenic patients in remission had lost their improvement at follow-up. Patients with other diagnoses retained their gains to 16-month follow-up.

Ambulatory Care↗
PubMedDate not supplied

Psychotherapy of schizophrenia.

Recent developments in the psychotherapy of schizophrenia have integrated educational methods, skills training, family-based stress management and specific cognitive-behavioural strategies with optimal pharmacotherapy. These approaches have demonstrated considerable promise in alleviating the impairments, disabilities and handicaps associated with schizophrenia.

Humans↗