What predicts stigmatisation about schizophrenia? Results from a general population survey examining its underlying cognitive, affective and behavioural factors

peer reviewedStigmatisation towards individuals diagnosed with schizophrenia (SZ individuals) remains an important problem, yet few studies to date have examined a theoretically comprehensive set of predictors of stigmatisation. This study aimed to evaluate cognitive, emotional and behavioural aspects of stigmatisation towards SZ individuals in the Belgian general population in order to better understand its underlying factors. A sample of 544 participants completed online questionnaires assessing common stereotypes regarding schizophrenia, desired social distance, level of contact and the Behaviours from Intergroup Affect and Stereotypes map. Most respondents believed SZ individuals are unpredictable and have a poor prognosis. Around 10% believed that they are dangerous. The most frequently reported emotions were pity and fear. Around 65% of the sample indicated that they would have positive behavioural reactions (passive/active facilitation). Around 33% of the sample indicated that they would distance themselves from SZ individuals, and around 20% would flee if in contact with a SZ individual. Fear and stereotypes of dangerousness and incompetence best predicted these fleeing and avoidance reactions. Fear was also explained by stereotypes of dangerousness and unpredictability. These factors should be accounted for when developing anti-stigma campaigns. The effect of contact should be further investigated

A Group Intervention for Motivational Deficits: Preliminary Investigation of a Blended Care Approach Using Ambulatory Assessment.

peer reviewedMotivational deficits are an important predictor of functional outcomes in individuals with a serious mental illness such as schizophrenia and mood spectrum disorders. The aim of the present study was to explore the feasibility, acceptability, and preliminary efficacy of a group version of "Switch," an intervention that targets motivational deficits, enriched with an ecological momentary intervention (EMI) approach (i.e., prompts on the participants' smartphone to encourage the use of trained strategies in their daily life). Eight participants with schizophrenia, schizoaffective, or major depressive disorder entered the study. The intervention took place twice a week for 2 months. Assessment measures included traditional evaluations of motivational negative symptoms, apathy, quality of life and daily functioning, in addition to ambulatory assessment methods strategies, including the experience sampling method (ESM) to assess motivation and related processes, and actigraphy (daily step-count) to assess participants' activity level. Four participants were considered as non-completers (followed less than 2/3 of the program) and four were considered as completers. Only completers presented a decrease in amotivation/apathy and an improvement in functional outcomes after the intervention and at follow-up. Furthermore, mixed-effects ESM models showed significant interaction effects on multiple processes related to motivation, indicating improvements only in completers: heightened motivation, increased engagement in meaningful and effortful activities, better mood, higher levels of confidence, increased frequency of projection into the future (pleasure anticipation), and of positive reminiscence. This preliminary investigation provides evidence that Switch may be an effective intervention, with specific effects on motivation and associated processes

Approche multidimensionnelle de la schizophrénie: évaluations et interventions

Présentation et distribution d’un manuel par clé US

Modèle de la motivation dans la schizophrénie: développement et validation d'une intervention multifactorielle visant à améliorer le fonctionnement quotidien et la qualité de vie

People diagnosed with schizophrenia experience a number of difficulties in their daily life. An important barrier to daily functioning and quality of life is negative symptoms, motivational deficits in particular. Negative symptoms are, however, resistant to pharmaceutical treatment. Yet, very few interventions that target negative symptoms are available and those studies that have included such interventions suffer from a number of limitations. The goal of this research project was to develop a multifactorial intervention, “Switch”, based on a solid model of motivation in schizophrenia which identifies the various affective, cognitive and behavioural processes that underpin motivation and goal-directed behaviours. Switch targets the specific dysfunctions that appear in the processes identified in this model and uses a variety of therapeutic tools. The efficacy and effectiveness of the Switch intervention is evaluated through three studies. The first pilot study evaluates the efficacy of Switch delivered in individual sessions for around one year. The second study assesses the effectiveness of Switch in a naturalistic setting, through three case-studies. The third study evaluates the preliminary efficacy of the group version of Switch. The second and third studies include daily-life assessments which allow to generate hypotheses on how motivation and related processes evolve during the course of the intervention. Finally, a fourth study evaluates the dynamics between the processes related to motivation and goal-directed behaviours through network analyses. Together these four studies provide preliminary evidence that Switch is a promising psychotherapeutic intervention that may increase motivation and guide individuals with schizophrenia on a more enjoyable and meaningful path, and emphasize the benefits of integrating various processes, with a particular focus on hedonic capacities

Switch, une intervention multifactorielle visant les difficultés de motivation chez les personnes avec un diagnostic de schizophrénie

editorial reviewe

Exploration of cognitive processes underlying multitasking in persons diagnosed with schizophrenia

Objectif: De récentes études ont montré que les personnes schizophrènes (SZ) présentent souvent des difficultés dans les activités quotidiennes, surtout quand elles sont « multitâches ». Les fonctions exécutives seraient engagées dans ces activités multitâches, cependant la recherche n’a à ce jour pas clairement identifié quelles processus cognitifs spécifiques sont impliqués. L’objectif de cette recherche est d’explorer plus en avant quels processus cognitifs sont impliqués dans le multitâche chez des personnes SZ. Méthodologie: Les participants SZ ont réalisé une tâche informatisée de préparation de réunion, New World II (NWII; Laloyaux et al., 2014), basée sur la définition du multitâche de Burgess (2000a, 2000b). Leur performance a été comparée à celle de sujets contrôle sains. Des tests cognitifs ont été soumis aux participants afin de mesurer la vitesse de traitement, la mémoire de travail, la mémoire verbale épisodique, la mémoire prospective, l’initiation, l’inhibition, la flexibilité cognitive, la flexibilité interne-externe, la planification et les capacités de multitâche. Des données démographiques, cliniques et relatives au fonctionnement quotidien ont été collectées. L’hypothèse principale de cette recherche est que la performance des participants SZ à NWII est corrélée aux mesures cognitives, surtout celles des fonctions exécutives. Résultats: Différentes variables de NWII étaient significativement corrélées aux mesures de planification, de multitâche, de flexibilité cognitive, de mémoire de travail (administrateur central), et tendaient à être significativement corrélées aux mesures de mémoire prospective et de flexibilité interne-externe, i.e., principalement des fonctions exécutives.Mémoire de master [120] en sciences psychologiques, Université catholique de Louvain, 201

Belgique

Les personnes atteintes d'une schizophrénie rencontrent de nombreuses difficultés dans leur vie quotidienne. Le meilleur prédicteur de ces difficultés sont les symptômes négatifs, et particulièrement ceux liés au déficit motivationnel. Ces symptômes étant persistants et résistants aux traitements médicamenteux, des interventions ciblant les processus liés à l'amotivation sont nécessaires. « Switch », est une intervention plurifactorielle basée sur un modèle de la motivation dans la schizophrénie (e.g., Kring & Barch, 2014). Switch cible les différents processus cognitifs, émotionnels et comportementaux liés à la motivation afin d'améliorer de manière directe la qualité de vie des personnes atteintes d'une schizophrénie. Dans le cadre de cet atelier, les différents processus de la motivation sont explicités et l'intervention Switch est présentée en détails avec des exemples à l'appui.Switc

Processus liés à l’amotivation dans la schizophrénie : modèle et intervention.

editorial reviewe

Defeatist performance beliefs in a sample of individuals with persistent negative symptoms

Objective Negative symptoms of schizophrenia, in particular motivational deficits, have showed to be linked to dysfunctional attitudes, such as defeatist performance beliefs. This relationship has been found in various types of samples but has not been investigated in samples of individuals presenting persistent negative symptoms (PNS). The present study aimed to assess the relationship between defeatist performance beliefs and negative symptoms in a sample of individuals diagnosed with schizophrenia and PNS. Another objective was to evaluate the link between change in defeatist beliefs and change in negative symptoms, before and after psychosocial intervention. Methods Fifty-one participants diagnosed with schizophrenia and PNS followed 9 months of Motivation and Engagement Training. They were assessed before and after the intervention using the Negative Symptom Assessment (NSA), the Brief Negative Symptom Scale (BNSS), the Clinical Assessment Interview for Negative Symptoms (CAINS), and de the Defeatist Performance Beliefs scale. Results At baseline, defeatist performance beliefs were not significantly associated with negative symptoms, except with the motivation factor of the BNSS, but only at the trend level. However, change in defeatist beliefs was moderately correlated with change in motivation, as measured with the BNSS, but not with the other measures. Conclusion These results underlie the necessity of broadening the targets of psychosocial interventions to factors related to negative symptoms other than dysfunctional attitudes