Conversation skills training of thought-disordered schizophrenic patients through attention focusing.

An attention-focusing procedure was designed as discrete trials and multiple prompts with contingent social reinforcement to facilitate the acquisition of conversational skills in thought-disordered schizophrenia patients. Three patients with DSM-III-R diagnoses of schizophrenia completed a standard social skills training program and the attention-focusing procedure in multiple baseline experimental designs. While social skills training had little effect on the acquisition of skills, patients who completed the attention-focusing procedure significantly increased performance of conversational skills and showed some generalization of trained behaviors.

Evaluating the capacity to work of the mentally ill.

This study explored the relationship between psychiatric symptomatology and the functional capacity to work. Subjects were diagnosed using DSM-III criteria and were grouped into categories of psychotic or nonpsychotic, and disabled or nondisabled, in regard to adjudication for mental impairment from the Social Security Administration (SSA). There were significant relationships between disability status and work capacity, in the direction of better performance for the nondisabled subjects. This finding reflected concordance between the evaluation procedure used in the study and the SSA's disability determination process. There was considerable overlap in work performance among subjects, however, suggesting that a functional assessment of work capacity might improve disability determination in certain cases. Results suggested that these work assessments might be as short as one or two days.

Providing independent recreational activities to reduce stereotypic vocalizations in chronic schizophrenics.

We evaluated the effects of minimally supervised, independent recreational activities on stereotypic vocal behavior in two chronic schizophrenic patients. In baseline sessions, subjects were observed during unstructured free time in the psychiatric ward. In treatment sessions, therapists presented preferred recreational materials (magazines, models, and art projects), verbally prompted on-task behavior every 20 min, and, in one condition, administered contingent tokens. Independent recreational activities reduced medium-rate self-talk in one subject and high-rate mumbling in a second subject by 60%-70%. Results were the same with or without contingent tokens. Apparent self-maintaining characteristics of these vocal responses are discussed.

Training skills in the psychiatrically disabled: learning coping and competence.

Social skills training methods represent a major strategy for psychiatric rehabilitation. Building skills in patients with schizophrenic and other major mental disorders is based on the assumption that coping and competence can override stress and vulnerability in reducing relapses and improving psychosocial functioning. For maximum efficiency, skills training needs to incorporate procedures and principles of human learning and information processing. Several models for skills training have been designed and evaluated, each of which has proved to be effective in raising the social competence of chronic mental patients. The "basic" model involves role playing by the patient and modeling, prompting, feedback, and reinforcement by the therapist. A "problem-solving" model of training provides general strategies for dealing with a wide variety of social situations. This model uses role playing to enhance behavioral performance but also highlights the patient's abilities to perceive and process incoming social messages and meanings. It is essential that social skills training be imbedded in a comprehensive program of rehabilitation that features continuity of care, supportive community services, therapeutic relationships, and judicious prescription of psychotropic drugs.

Social skills training for chronic mental patients.

Social skills training has proved to be effective in increasing the social competence of chronic mental patients. The authors describe three models of social skills training, all of which involve role playing by the patient and modeling, prompting, feedback, and reinforcement by the therapist. Many patients can benefit from the basic training model. For patients functioning at a higher level, the problem-solving model provides general strategies for dealing with a variety of social situations. The attention-focusing model, designed for highly distractible and withdrawn patients, teaches skills through constant repetition of tasks and minimizes demands on cognitive abilities. The authors emphasize the importance of taking steps to ensure that the skills learned during training are generalized to other situations and settings.

The feature-positive effect in adult humans: within-group design.

The feature-positive effect has been demonstrated in several species and has been shown to be robust phenomenon in adult humans when between-group designs are used. The present series of experiments replicated earlier work using between-group designs, found the feature-positive effect using within-group designs, and isolated a factor responsible for an earlier failure to find the phenomenon using a within-group design. The results support the argument for a biological, evolutionary influence in the genesis of the feature-positive effect.