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    Centrality statistics of symptom networks of schizophrenia: a systematic review
    (Cambridge University Press, 2024-01-04) Buchwald K; Narayanan A; Siegert RJ; Vignes M; Arrowsmith K; Sandham M
    The network theory of psychological disorders posits that systems of symptoms cause, or are associated with, the expression of other symptoms. Substantial literature on symptom networks has been published to date, although no systematic review has been conducted exclusively on symptom networks of schizophrenia, schizoaffective disorder, and schizophreniform (people diagnosed with schizophrenia; PDS). This study aims to compare statistics of the symptom network publications on PDS in the last 21 years and identify congruences and discrepancies in the literature. More specifically, we will focus on centrality statistics. Thirty-two studies met the inclusion criteria. The results suggest that cognition, and social, and occupational functioning are central to the network of symptoms. Positive symptoms, particularly delusions were central among participants in many studies that did not include cognitive assessment. Nodes representing cognition were most central in those studies that did. Nodes representing negative symptoms were not as central as items measuring positive symptoms. Some studies that included measures of mood and affect found items or subscales measuring depression were central nodes in the networks. Cognition, and social, and occupational functioning appear to be core symptoms of schizophrenia as they are more central in the networks, compared to variables assessing positive symptoms. This seems consistent despite heterogeneity in the design of the studies.
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    Schizophrenia (and other psychotic disorders) cognitive-behaviour therapy research programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2006) Gillingham, Ruth
    The present study evaluated the effectiveness of a treatment that combined techniques from Cognitive-Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to alleviate the psychological distress and symptom severity resultant from psychotic-type disorders. This treatment (EVoLVE Therapy: an acronym for Exposing Virtues of Living Valued Existences) was designed to primarily target the psychological distress associated with psychotic disorders and secondarily to facilitate improvement in psychotic-type symptoms. Participants in this study were selected based on previous diagnoses of schizophrenia, schizoaffective, and other psychiatric disorders with psychotic features. Seven participants, who had each been long-term consumers of mental health services, completed 10 weeks of therapy. Post-graduate students, in training to become professional psychologists, delivered supervised therapy using a structured treatment manual written by the researcher. Pre-treatment, post-treatment and 5-week follow-up data were collected, using a variety of measures to assess the effectiveness of treatment. Results were quite positive overall, with some clients making considerable improvements in a number of domains. All 7 participants showed a decrease in symptom severity after treatment. In addition, 6 out of the 7 participants reported an improved quality of life following treatment. Marked improvement in negative affect was also evident, with a slight improvement in positive affect noted.
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    Two kinds of abstraction in schizophrenia : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1981) Cade, Philip Nigel
    An impairment in abstracting ability has frequently been proposed as a reason for schizophrenic thought disorder. The performance of hospitalized chronic paranoid schizophrenics and non-paranoid schizophrenics were compared to a normal control group on two types of abstraction; a traditional conceptual abstraction task (similarities, Trunnell, 1964) and an inferential abstraction task (relational abstraction, Bransford, Barclay & Franks, 1972). These two measures allowed a differential interpretation of the nature of the abstraction impairment in schizophrenia. The two clinical groups did not significantly differ on the traditional hierarchical measure of abstraction. Performance of both schizophrenic groups, however, differed significantly from that of controls in that schizophrenic subjects employed less abstract concepts to classify items in this task. On the second measure of abstraction no significant differences were found between schizophrenic subjects and the control group. Differences between paranoid and non-paranoid subjects did not reach significance on this task but there was some indication that each of these schizophrenic sub-groups used different cognitive strategies on this measure. Paranoid schizophrenics appeared not to elaborate information beyond its original form. The non-paranoids, on the other hand, appeared to elaborate stimulus material but were confused between inferential and original information. The present results indicate that chronic paranoid schizophrenics have a different type of abstraction impairment to chronic non-paranoid schizophrenics on the inferential conceptual abstraction task. These findings indicate the utility of using two indices of abstraction and the importance of not treating schizophrenics as a homogeneous group.
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    A comparison study of the presenting symptoms between Maori and Pakeha patients diagnosed with schizophrenia : a thesis presented in partial of the requirements for the degree of Master of Arts in Psychology, Massey University
    (Massey University, 1994) Cherrington, Lisa
    The exact relationship between culture and the expression of psychopathology among different cultural goups within New Zealand has yet to be firmly established. The present study investigated the relationship between culture and presenting symptomatology of Maori and Pakeha patients diagnosed with schizophrenia. More specifically, the main aim of the study was to investigate whether differences exist between Maori and Pakeha in the expression of schizophrenia and to explore whether paranormal beliefs and cultural knowledge influence the frequency and content of specific symptoms. Three specific hypotheses were tested. First, the hypothesis that Maori and Pakeha differ in respect to levels of Maori knowledge and strength of paranormal beliefs was explored. Second, the hypothesis that Maori have higher frequencies of hallucinations, delusions of control and subcultural delusions and hallucinations was investigated. Third, the hypothesis that paranormal beliefs and cultural knowledge influence the frequency of presenting symptoms between Maori and Pakeha was explored. A total of 14 Maori and 16 Pakeha patients currently admitted to mental health services with a diagnosis of schizophrenia were interviewed using the Present Status Examination (PSE). The Test of Maori Knowledge (TMK), Revised Paranormal Belief Scale (PBS-R) and a Provisional Maori Cultural Identity Questionnaire (PMCIQ) were also administered during the interview (the latter administered only to Maori participants). The findings indicated that Maori participants experienced significantly higher frequencies of hallucinations and delusions than Pakeha participants. There were no significant differences between groups in strength of paranormal beliefs nor were paranormal beliefs found to influence the frequency with which hallucinations and delusions were reported. However, Maori participants had significantly higher levels of Maori knowledge. Moreover, the findings suggest that Maori knowledge was an influencing variable in the content and frequency of subcultural delusions and hallucinations. Limitations of the study, future research recommendations and implications of the findings for the assessment, diagnosis and treatment of Maori psychiatric patients are discussed.
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    Temporal integration theory, schizophrenia, and the lateralised paced auditory serial addition task : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University (Palmerston North, New Zealand)
    (Massey University, 2000) Norman, Bernard F
    The Paced Auditory Serial Addition Task ( PASAT ) was lateralised for the purpose of investigation into hemispheric specialisation for temporal integration. A right ear advantage ( REA ), representing a left hemisphere ( LH ) advantage in normal participants, was predicted due to the sequential nature of the PASAT, the previous finding of a REA by Norman ( 1984 ), and Miller's ( 1996 ) theory on the LH specialisation for delayed axonal conduction. The REA was also expected given other abundant evidence on LH superiority for the processing of temporal information ( Bradshaw & Nettleton, 1981; Bryson, Mononen, & Yu, 1980; Elfgren & Risberg, 1998; Gordon, 1978; Leek & Brandt, 1983; Prior, Kinsella, & Giese, 1990; Robinson, & Solomon, 1974; Troyer, Moscovitch, Winocur, Alexander, & Stuss, 1998 ). However, no REA was found in the present research. Careful precision in randomising and counterbalancing arithmetic outcomes, removal of the digit seven because of its two-syllable pronunciation, and the randomisation of ear of presentation and stimulus presentation rate, possibly eliminated procedural artefacts that were present in Norman's ( 1984 ) study. Therefore, despite the sequential nature of the PASAT it now appears to lack efficacy for research into temporal integration. Other findings from the present research instead showed support for the hypotheses of the right hemisphere's ( RH ) specialisation for vigilance ( Coslett, Bowers, & Heilman, 1987; Dimond, 1979; Heilman & van den Abell, 1979, 1980; Howes & Boller, 1975; Ladavas, Del Pesce, Mangun, & Gazzaniga, 1994; Ladavas, Del Pesce, & Provinciali, 1989; Loring, Meador, & Lee, 1989; Pardo, Fox, & Raichle, 1991; Simos & Molfese, 1997; Whitehead, 1991; Wilkins, Shallice, & McCarthy, 1987; Yokohama et al., 1987 ). For normal participants a left ear advantage ( LEA ) was found and more clearly demonstrated with an unpredictable task condition and with the faster presentation rates ( 1.2 & 2.0 s ) of the lateralised PASAT. The LEA was shown with both the same ear stimulus pairings ( LL ) and the left then right pairings ( LR ). Inferior performance with the right then left ( RL ) stimulus pairings was found in the unpredictable task condition and another task condition in which the side of stimulus presentation was predictable. Clinical participants (i.e., participants with a history of schizophrenia ) did not demonstrate a LEA, and they showed no difference compared to normal controls in performance with the right ear ( LH ). However, the clinical participants did manifest a particular disadvantage when stimulus processing required a shift from left to right ear ( LR ), but not the reverse ( RL ). The clinical participants manifested the LR deficit in the unpredictable and predictable task conditions. This LR disadvantage bears some resemblance to a previous finding, using the Visual Reaction Time Task, of a lateralised deficit in disengaging attention from the left visual field. Some researchers ( Bustillo et al., 1997; Posner, Early, Reiman, Pardo, & Dhawan, 1988; Posner & Raichle, 1994; Wigal, Swanson, & Potkin, 1997 ) interpret this LR deficit as a problem of slowness of responding by the LH ( right visual field ) after having attention oriented to the opposite field. However, the findings in the present research of a LEA for normal controls (i.e., LL and LR ), a relative deficit with RL for normals, and no difference in right ear ( RR ) performance between controls and clinical participants, and notably with the unpredictable condition, suggests an alternative interpretation. The LR deficit in schizophrenia may instead be due to difficulty in disengaging from the left visual or auditory field rather than impaired performance with the right field. The LR deficit may be as a result of dysfunction of vigilance, which is normally attributed to greater proficiency of the right hemisphere. In addition, opposing trends were observed for the clinical participants compared to the normal participants at particularly slow presentation rates, and with the predictable task condition in which stimuli were presented singularly to each hemisphere. Clinical participants showed a worsening of performance with the task. Normal participants demonstrated better performance with this task compared to another task condition, much like the standard PASAT, in which both ears received a stimulus simultaneously. These trends reflect Hellige's ( 1987, 1993 ) model of cross-hemispheric integration in which it is hypothesised that for normal participants single hemisphere processing has some advantage with lighter tasks. These trends also reflect the possibility that people with schizophrenia, in slow stimulus conditions, have difficulty whereby they unnecessarily over engage both hemispheres, which wastes attentional resource that could otherwise be utilised for various other aspects of ongoing processing.
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    Schizophrenia, a way of being-in-the-world : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1995) Walton, Jo Ann; Walton, Jo Ann
    This phenomenological study describes what it is like to live with a schizophrenic illness and relates the understanding gained from this descripton to implications for nursing practice. The participants in the study were ten adults who have been diagnosed with schizophrenia, who take regular medication and who are living independent lives in the community. Over a period of sixteen months they were interviewed about the effects of the illness on their everyday lives. During this time they explained the challenges and difficulties which have faced them, both during and long after the resolution of acute illness. As they describe it, schizophrenia is a part of who they are. The narrative contained in this thesis presents the participants' stories in aggregated form, setting their experiences alongside ideas from the early work of Martin Heidegger, whose phenomenological writing informed the analysis and interpretation of the data. As the participants explain, schizophrenia has touched every aspect of their lives. Living with schizophrenia is shown to affect their whole Being-in-the-world. It incorporates Being-with-others, living carefully and taking a stand on life. While hoping for a cure, their reality is of living with a chronic illness which has major effects on their lives. At the same time the participants are shown to define themselves not in terms of their illness and treatment, but in respect of their hopes and dreams and the stance each is taking on his or her own life. In this way their existential predicament is highlighted in the study. Participants are on the one hand very much like all other people, while on the other hand they have to contend with very different concerns than do most others. In itself the description of the experience of schizophrenia contained in the thesis is useful for its potential to increase understanding of the illness by nurses and other health professionals. Further than this, however, the study is shown to have implications in terms of nursing practice and the provision of health care. With regard to the seriously mentally ill the data bring into question some of the theoretical positions which have held sway in nursing for many years. The research demonstrates that it is practicable to attend to the subjective experiences of people who suffer from schizophrenia and to understand their needs and desires from the position of fellow human being, without the need for a guiding theory from which to interpret what they are saying or what their words "really mean." It is argued that relationships between nurses and clients which are based on understanding and trust rather than distance hold promise in the care of those with schizophrenia. Heidegger's concept of solicitude as care for others is addressed in this regard, and is shown to be most appropriate as a basis for nursing care in the mental health arena.