Biomedical subjects

Morris D Bell

Publications and source records attributed to Morris D Bell.

23 records · Page 2Linked to original sources

PubMed2002

Insight and work performance in schizophrenia.

Research has linked impaired insight in schizophrenia to poorer medication compliance and poorer treatment outcome. The current study attempts to replicate previous findings that impaired insight is related to deficits in work function. To examine this question, 121 participants with schizophrenia or schizoaffective disorder enrolled in vocational rehabilitation were classified as having unimpaired (N = 65), or impaired (N = 56) insight. Next, participants were assigned a work placement and their work performance assessed on the third, fifth, and seventh weeks of work by using the Work Behavior Inventory. Among the 85 participants who completed these weeks of work, a multivariate analysis of variance and subsequent analysis of variance showed participants with impaired insight had significantly poorer ratings of work quality, work habits, cooperativeness, and personal presentation. When measures of global intelligence and executive function were entered as covariates in individual analysis of covariance, groups differed on measures of cooperativeness and personal presentation. Implications for rehabilitation are discussed.

Adult↗

PubMed2002

Association of obsessions and compulsions in schizophrenia with neurocognition and negative symptoms.

It is unclear whether obsessions and compulsions in schizophrenia spectrum disorders are associated with a unique pattern of symptoms and deficits. Accordingly, the present study compared symptom levels and neurocognitive function of participants with schizophrenia or schizoaffective disorder with (n=11) and without (n=52) significant obsessive-compulsive symptoms. Analyses of variance revealed that the obsessive-compulsive group performed more poorly on measures of executive function and vigilance and had higher levels of negative and emotional discomfort symptoms. Unexpectedly, the obsessive-compulsive group also demonstrated superior performance on a measure of visual memory. The implications of these clinical correlates of obsessive-compulsive phenomena in schizophrenia spectrum disorders are discussed.

Adult↗

PubMedDate not supplied

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. This program, the Indianapolis Vocational Intervention Program (IVIP), includes weekly group and individual interventions and is intended as an adjunct to work therapy programs. The IVIP was initially developed over a year of working with 20 participants with Structured Clinical Interview for the Diagnostic and Statistical Manual-I (SCID-I) confirmed diagnoses of schizophrenia or schizoaffective disorder who were actively engaged in 20 hours per week of work activity. For this paper, we explain the development of the treatment manual and the group and individual interventions and present case examples that illustrate how persons with severe mental illness might utilize the manualized intervention.

Adult↗

PubMedDate not supplied

Enhanced cognitive-behavioral therapy for vocational rehabilitation in schizophrenia: Effects on hope and work.

To address the effects of dysfunctional cognitions on vocational outcome of people with schizophrenia spectrum disorders, we developed the Indianapolis Vocational Intervention Program (IVIP), a cognitive-behavioral program of group and individual interventions. Fifty participants with schizophrenia or schizoaffective disorder were offered 6-month work placements and randomized to receive IVIP (n = 25) or standard support services (n = 25). Hours worked were measured weekly, and work performance was assessed biweekly with the use of the Work Behavior Inventory. Hope and self-esteem were assessed at baseline and at 5 months with the Beck Hopelessness Scale and the Rosenberg Self-Esteem Schedule. Analysis of variance (ANOVA) revealed that the IVIP group worked significantly more weeks and had better average work performance than the standard support group. Repeated measures ANOVA of baseline and follow-up scores indicated that the IVIP group sustained baseline levels of hope and self-esteem through follow-up, while the standard support group experienced declines. Results provide initial evidence of the effectiveness of the IVIP.

Adult↗

PubMedDate not supplied

Neurocognitive enhancement therapy with work therapy: Productivity outcomes at 6- and 12-month follow-ups.

Neurocognitive enhancement therapy (NET), which involves computerized cognitive training and other methods, has been shown to improve working memory and executive function in schizophrenia. In the present study, 145 outpatients with diagnoses of schizophrenia or schizoaffective disorder recruited from a Department of Veterans Affairs mental hygiene clinic and from a community mental health center were ran domized to 6 months of paid work therapy (WT) or to NET+WT. Mixed random effects analyses revealed significant increase in hours worked and money earned over time for both conditions (p < 0.0001). NET+WT worked more hours than WT (p < 0.03), with differences emerging after rehabilitation. Responders to NET+WT worked the most during follow-up and tended to have more competitive-wage employment. Results indicate that work outcomes were enhanced by NET training. Effects were greatest for NET responders. Findings support the efficacy of cognitive training when it is integrated into broader rehabilitation programs.

Adult↗