加强和促进被诊断为精神分裂症的注意力受损患者的康复:部分医院项目中注意力塑造的随机对照试验结果

Steven M Silverstein, Matthew W Roché, Zaynab Khan, Sarah J Carson, Igor Malinovsky, William A Newbill, Anthony A Menditto, Sandra M Wilkniss
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引用次数: 11

摘要

与精神分裂症相关的注意力障碍是有据可查的。精神药理学和大多数社会心理干预已被证明在提高注意力能力方面效果有限。也就是说,社会心理治疗的一种形式,即注意塑造程序(ASP),已被反复证明能在参与者注意力行为的各个方面产生重大而有意义的变化。到目前为止,ASP的研究受到限制,因为它们主要是在住院患者中进行的,没有评估ASP效果的普遍性,也没有探索是否需要强化取决于注意行为的表现。为了解决这些局限性,我们对在部分医院项目中接受治疗的精神分裂症患者进行了首次ASP随机临床试验。我们的研究结果表明,在这些类型的项目中,ASP在提高精神分裂症患者的注意力方面是有效的,ASP的影响可以在即时治疗环境之外推广到其他治疗组和现实世界的功能,偶然强化是ASP的一个关键成分。该项目为使用ASP对患有严重注意力缺陷的精神分裂症患者进行康复治疗的益处提供了进一步的证据。
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Enhancing and Promoting Recovery In Attentionally Impaired People Diagnosed With Schizophrenia: Results From A Randomized Controlled Trial Of Attention Shaping In A Partial Hospital Program.

The attentional impairments associated with schizophrenia are well-documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who are being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside of the immediate treatment context to both other treatment groups and real world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments.

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