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Spiritual and Religious Issues in Psychotherapy with Schizophrenia: Cultural Implications and Implementation
Religions 2012, 3, 82–98; doi:10.3390/rel3010082 OPEN ACCESS religions ISSN 2077-1444 www.mdpi.com/journal/religions Review Spiritual and Religious Issues in Psychotherapy with Schizophrenia: Cultural Implications and Implementation Lauren Mizock *, Uma Chandrika Millner and Zlatka Russinova Center for Psychiatric Rehabilitation, 940 Commonwealth Avenue West, Boston, MA 02215, USA; E-Mails: [email protected] (U.C.M.); [email protected] (Z.R.) * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel.: +1-617-353-3549; Fax: +1-617-353-7700. Received: 18 February 2012; in revised form: 6 March 2012 / Accepted: 6 March 2012 / Published: 12 March 2012 Abstract: The topics of spirituality and psychotherapy have often been controversial in the literature on schizophrenia treatment. However, current research indicates many potential benefits of integrating issues of religion and spirituality into psychotherapy for individuals with schizophrenia. In this paper, implications are presented for incorporating spiritual and religious issues in psychotherapy for individuals with schizophrenia. A background on the integration of spirituality into the practice of psychotherapy is discussed. The literature on spiritually-oriented psychotherapy for schizophrenia is provided. Clinical implications are offered with specific attention to issues of religious delusions and cultural considerations. Lastly, steps for implementing spiritually-oriented psychotherapy for individuals with schizophrenia are delineated to assist providers in carrying out spiritually sensitive care. Keywords: religion; spirituality; schizophrenia; psychotherapy; culture; rehabilitation; recovery; religious delusions 1. Introduction The topics of spirituality and psychotherapy have often been controversial in the literature on schizophrenia treatment [1,2]. Some practitioners have argued that religion had no space in the Religions 2012, 3 83 psychotherapy setting given a need to be grounded in science. -
The Effect of Delusion and Hallucination Types on Treatment
Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2016;29:29-35 Research / Araştırma DOI: 10.5350/DAJPN2016290103 The Effect of Delusion and Esin Evren Kilicaslan1, Guler Acar2, Sevgin Eksioglu2, Sermin Kesebir3, Hallucination Types on Ertan Tezcan4 1Izmir Katip Celebi University, Ataturk Training and Treatment Response in Research Hospital, Department of Psychiatry, Izmir - Turkey 2Istanbul Erenkoy Mental Health Training and Research Schizophrenia and Hospital, Istanbul - Turkey 3Uskudar University, Istanbul Neuropsychiatry Hospital, Istanbul - Turkey Schizoaffective Disorder 4Istanbul Beykent University, Department of Psychology, Istanbul - Turkey ABSTRACT The effect of delusion and hallucination types on treatment response in schizophrenia and schizoaffective disorder Objective: While there are numerous studies investigating what kind of variables, including socio- demographic and cultural ones, affect the delusion types, not many studies can be found that investigate the impact of delusion types on treatment response. Our study aimed at researching the effect of delusion and hallucination types on treatment response in inpatients admitted with a diagnosis of schizophrenia or schizoaffective disorder. Method: The patient group included 116 consecutive inpatients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV-TR in a clinical interview. Delusions types were determined using the classification system developed by Gross and colleagues. The hallucinations were recorded as auditory, visual and auditory-visual. Response to treatment was assessed according to the difference in the Positive and Negative Syndrome Scale (PANSS) scores at admission and discharge and the duration of hospitalization. Results: Studying the effect of delusion types on response to treatment, it has been found that for patients with religious and grandiose delusions, statistically the duration of hospitalization is significantly longer than for other patients. -
Understanding the Mental Status Examination with the Help of Videos
Understanding the Mental Status Examination with the help of videos Dr. Anvesh Roy Psychiatry Resident, University of Toronto Introduction • The mental status examination describes the sum total of the examiner’s observations and impressions of the psychiatric patient at the time of the interview. • Whereas the patient's history remains stable, the patient's mental status can change from day to day or hour to hour. • Even when a patient is mute, is incoherent, or refuses to answer questions, the clinician can obtain a wealth of information through careful observation. Outline for the Mental Status Examination • Appearance • Overt behavior • Attitude • Speech • Mood and affect • Thinking – a. Form – b. Content • Perceptions • Sensorium – a. Alertness – b. Orientation (person, place, time) – c. Concentration – d. Memory (immediate, recent, long term) – e. Calculations – f. Fund of knowledge – g. Abstract reasoning • Insight • Judgment Appearance • Examples of items in the appearance category include body type, posture, poise, clothes, grooming, hair, and nails. • Common terms used to describe appearance are healthy, sickly, ill at ease, looks older/younger than stated age, disheveled, childlike, and bizarre. • Signs of anxiety are noted: moist hands, perspiring forehead, tense posture and wide eyes. Appearance Example (from Psychosis video) • The pt. is a 23 y.o male who appears his age. There is poor grooming and personal hygiene evidenced by foul body odor and long unkempt hair. The pt. is wearing a worn T-Shirt with an odd symbol looking like a shield. This appears to be related to his delusions that he needs ‘antivirus’ protection from people who can access his mind. -
Quick Lesson About
QUICK Delusional Disorder: Grandiose Type LESSON ABOUT Description/Etiology Delusional disorder is characterized by the presence for at least one month of delusions and the absence of other symptoms associated with psychotic, mood, or personality disorders that usually include delusions. Delusions are fixed beliefs that persist despite objective evidence that they are not true. Whether a particular belief is considered delusional varies from culture to culture; to be considered a delusion the belief cannot be accepted by members of the believer’s own culture or subculture. Delusions are categorized as either nonbizarre or bizarre. Nonbizarre delusions are beliefs that could conceivably be true (e.g., a life partner having an affair, being the object of unspoken love, being spied on by a government agency), whereas bizarre delusions have no possible basis in reality (e.g., having all of one’s organs replaced without surgery, being controlled by messages received from the CIA through a hat made of aluminum foil). The primary change in criteria for diagnosis of delusional disorder in the Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition (DSM-5) from the fourth edition of the manual is the removal of the requirement that delusions are nonbizarre. The criteria for delusional disorder are delusions of at least one month’s duration; criterion A for schizophrenia has never been met (nonprominent hallucinations that are related to the theme of the delusion may be present); functioning is not noticeably impaired and behavior is not odd (except possibly for the direct impact and ramifications of the delusion); symptoms of mood disorders, if any, are brief relative to the duration of the delusion; and the delusion is not directly due to a general medical condition or the physiological effect of a substance. -
Early Identification of Psychosis a Primer
Early Identification of Psychosis A Primer Mental Health Evaluation & Community Consultation Unit TABLE OF CONTENTS Introduction...............................................................................................................3 Psychosis and Early Intervention........................................................................4 Why is Early Intervention Needed?...................................................................5 Risk and Onset..........................................................................................................6 Course of First-Episode Psychosis 1. Prodrome........................................................................................................7 2. Acute Phase....................................................................................................8 3. Recovery Phase..............................................................................................9 Summary of First-Episode Psychosis...............................................................11 Tips for Helpers......................................................................................................12 More Resources......................................................................................................15 Acknowledgements...............................................................................................16 2 INTRODUCTION Psychosis is a condition characterized by loss of contact with reality and may involve severe disturbances in perception, cognition, behavior, -
De-Rationalising Delusions
De-Rationalising Delusions Authors: Vaughan Bell,1,2 Nichola Raihani,3 Sam Wilkinson4 1. Research Department of Clinical, Educational and Health Psychology, University College London 2. Psychological Interventions Clinic for outpatients with Psychosis (PICuP), South London and Maudsley NHS Foundation Trust 3. Department of Experimental Psychology, University College London 4. Department of Sociology, Philosophy and Anthropology, Exeter University 1 Abstract Due to the traditional conceptualisation of delusion as ‘irrational belief’, cognitive models of delusions largely focus on impairments to domain-general reasoning. Nevertheless, current rationality-impairment models do not account for the fact that i) equivalently irrational beliefs can be induced through adaptive social cognitive processes, reflecting social integration rather than impairment; ii) delusions are overwhelmingly socially-themed; iii) delusions show a reduced sensitivity to social context, both in terms of how they are shaped and how they are communicated. Consequently, we argue that models of delusions need to include alteration to coalitional cognition – processes involved in affiliation, group perception, and the strategic management of relationships. This approach has the advantage of better accounting for both content (social themes) and form (fixity) of delusion. It is also supported by the established role of mesolimbic dopamine in both delusions and social organisation, and the ongoing reconceptualisation of belief as serving a social organisational function. -
Bipolar Disorder Mania and Hypomania Prepared By: Dr
Bipolar Disorder Mania and Hypomania Prepared by: Dr. Anvesh Roy Psychiatry Resident, University of Toronto This is a review of Bipolar disorder focusing primarily upon its defining phenomena of Mania and Hypomania. The following text is envisioned to help case based learning of Bipolar Disorder by providing a background context (the video case). This is designed to show how the scenario may present in real life when you are faced with a similar patient rotating through the ER or in an inpatient unit. Click on the following hyperlinks to arrive at each section with pertinent examples from our video case (commiserate to enabling objectives): . What is Mania and Hypomania? Definition and meaning. Differential Diagnosis . How to get a history and pertinent information . Objective evaluation: Physical Exam and MSE . What are the investigations? . Management . Short Term, including addressing safety concerns and acute agitation . Long Term . References and further reading (for the so inclined) Bipolar Disorder - Mania and Hypomania Prepared by Dr. Anvesh Roy for HUB Psychiatry, Faculty of Medicine, University of Toronto Page 1 of 18 What is Mania (and Hypomania)? An extremely disabling and potentially harmful behavioral syndrome that indicates an underlying central nervous system disorder. Mania can lead to harm to self or others, and may be accompanied by features of psychosis. Hypomania is a less severe form of mania, see later on in the text how to differentiate between the two. Usually, by definition they denote affliction by one of the various forms of Bipolar Disorders or ‘Bipolar Spectrum’ of disorders. They can be secondary to other causes, but then they are not referred to as such, as will be explained. -
Psychological Characteristics of Religious Delusions
Soc Psychiatry Psychiatr Epidemiol (2014) 49:1051–1061 DOI 10.1007/s00127-013-0811-y ORIGINAL PAPER Psychological characteristics of religious delusions Robel Iyassu • Suzanne Jolley • Paul Bebbington • Graham Dunn • Richard Emsley • Daniel Freeman • David Fowler • Amy Hardy • Helen Waller • Elizabeth Kuipers • Philippa Garety Received: 30 May 2013 / Accepted: 16 December 2013 / Published online: 31 December 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract (OR 7.5; 95 % CI 3.9–14.1), passivity experiences, having Purpose Religious delusions are common and are con- internal evidence for their delusion (anomalous experi- sidered to be particularly difficult to treat. In this study we ences or mood states), and being willing to consider investigated what psychological processes may underlie alternatives to their delusion (95 % CI for ORs 1.1–8.6). the reported treatment resistance. In particular, we focused Levels of negative symptoms were lower. No differences on the perceptual, cognitive, affective and behavioural were found in delusional conviction, insight or attitudes mechanisms held to maintain delusions in cognitive models towards treatment. of psychosis, as these form the key treatment targets in Conclusions Levels of positive symptoms, particularly cognitive behavioural therapy. We compared religious anomalous experiences and grandiosity, were high, and delusions to delusions with other content. may contribute to symptom persistence. However, contrary Methods Comprehensive measures of symptoms and to previous reports, we found no evidence that people with psychological processes were completed by 383 adult religious delusions would be less likely to engage in any participants with delusions and a schizophrenia spectrum form of help. Higher levels of flexibility may make them diagnosis, drawn from two large studies of cognitive particularly amenable to cognitive behavioural approaches, behavioural therapy for psychosis. -
ICD-11 DIAGNOSTIC GUIDELINES Schizophrenia Or Other Primary Psychotic Disorders
Internal WHO Document for research use only; not for citation or distribution 1 ICD-11 DIAGNOSTIC GUIDELINES Schizophrenia or Other Primary Psychotic Disorders Note: This document contains a pre-publication version of the ICD-11 diagnostic guidelines for Schizophrenia or Other Primary Psychotic Disorders. There may be further edits to these guidelines prior to their publication. Table of Contents SCHIZOPHRENIA OR OTHER PRIMARY PSYCHOTIC DISORDERS ..................... 2 6A20 Schizophrenia ....................................................................................................... 3 6A21 Schizoaffective Disorder .................................................................................... 10 6A22 Schizotypal Disorder .......................................................................................... 14 6A23 Acute and Transient Psychotic Disorder ............................................................ 17 6A24 Delusional Disorder ............................................................................................ 21 6A2Y Other Specified Primary Psychotic Disorder ..................................................... 24 Qualifier Scales for Symptomatic Manifestations of Primary Psychotic Disorders ........... 25 © WHO Department of Mental Health and Substance Abuse 2021 Internal WHO Document for research use only; not for citation or distribution 2 SCHIZOPHRENIA OR OTHER PRIMARY PSYCHOTIC DISORDERS Schizophrenia or Other Primary Psychotic Disorders is a grouping of disorders characterized by significant -
Naughty Or Narc? the Frequency of Narcissistic Traits in Child Psychiatric Disorders
Naughty or Narc? The Frequency of Narcissistic Traits in Child Psychiatric Disorders Kendall D. Moore The University of North Carolina at Chapel Hill Spring 2013 A thesis presented to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the Bachelor of Science degree with Honors in Psychology Committee Chair: Eric Youngstrom, Ph.D. Committee Member: Jennifer Youngstrom, Ph.D. Committee Member: Guillermo Perez-Algorta, Ph.D. NAUGHTY OR NARC? 2 Acknowledgments I would first like to thank Dr. Eric Youngstrom for all of his support and encouragement to motivate me to complete this Honor’s Thesis as well as to fulfill my goal of attending graduate school in Clinical Psychology. I have truly enjoyed having you as my undergraduate mentor. From our first-semester discussions on a certain “measure,” to not “monkeying” around with Tamarin business, I am looking forward to continuing our collaboration throughout our careers. I would also like to thank Dr. Perez-Algorta for being such an influential part of my first step into the MECCA Lab during my junior year Independent Study course. Thirdly, thank you Dr. Jen Youngstrom for being an awesome member of my defense committee! Also, to the rest of the MECCA Lab that I have had the privilege to work with (Jacquee, Graham, Coty, and Anna), thank y’all for being such great lab-mates! To mom and dad, I don’t think there are words to express the amount of thanks I have for the both of you. Y’all have always supported me in school and in life, and part of my goal in completing this thesis as well as attending graduate school was to make both of you proud. -
Grandiose Delusions: a Review and Theoretical Integration of Cognitive and Affective Perspectives
Clinical Psychology Review 31 (2011) 684–696 Contents lists available at ScienceDirect Clinical Psychology Review Grandiose delusions: A review and theoretical integration of cognitive and affective perspectives Rebecca Knowles ⁎, Simon McCarthy-Jones, Georgina Rowse University of Sheffield, UK article info abstract Article history: Grandiose delusions (GDs) are found across a wide range of psychiatric conditions, including in around two- Received 24 August 2010 thirds of patients diagnosed with bipolar disorder, half of patients diagnosed with schizophrenia, as well as in Accepted 23 February 2011 a substantial proportion of patients with substance abuse disorders. In addition, over 10% of the healthy Available online 5 March 2011 general population experience grandiose thoughts that do not meet full delusional criteria. Yet in contrast to other psychotic phenomena, such as auditory hallucinations and persecutory delusions, GDs have received Keywords: little attention from researchers. This paper offers a comprehensive examination of the existing cognitive and Grandiose ‘ ’ Grandeur affective literature on GDs, including consideration of the evidence in support of delusion-as-defence and ’ Delusion emotion-consistent models. We then propose a tentative model of GDs informed by a synthesis of the Bipolar available evidence designed to be a stimulus to future research in this area. As GDs are considered to be Mania relatively resistant to traditional cognitive behavioural techniques, we then discuss the implications of our Schizophrenia model for how CBT may be modified to address these beliefs. Directions for future research are also Psychosis highlighted. © 2011 Elsevier Ltd. All rights reserved. Contents 1. Introduction .............................................................. 685 2. What are grandiose delusions? ..................................................... 685 3. The epidemiology of grandiose delusions and beliefs .......................................... -
Khat Induced Psychotic Disorder: Case Report Elias Tesfaye1*, Wolfgang Krahl2 and Selamawit Alemayehu1
Tesfaye et al. Substance Abuse Treatment, Prevention, and Policy (2020) 15:27 https://doi.org/10.1186/s13011-020-00268-4 CASE REPORT Open Access Khat induced psychotic disorder: case report Elias Tesfaye1*, Wolfgang Krahl2 and Selamawit Alemayehu1 Abstract Background: Khat (Catha edulis) is a stimulant leaf khat comes from a tree which grows in countries bordering the Red Sea which are along the east coast of Africa and in west Asia. The psycho- active component within these leaves is cathinone. In Ethiopia, Khat is chewed routinely by users for its euphoric effects and as a recreational drug, and chewing khat has an important role as well in both traditional and religious ceremonies. In this case report, we describe the case of a 33-year-old male patient presented with psychotic symptoms after prolonged and heavy khat chewing. Case presentation: Findings on psychiatric evaluation encompassing detailed history and mental state examination suggest khat induced psychotic disorder severe in full remission; khat use disorder, severe, in early remission. Conclusions: This case demonstrates that the use of excess khat above 2 bundles for prolonged duration can manifest with psychotic episodes. A small number of case studies had supported a causal relationship between heavy khat use and psychosis or psychotic symptoms. There have been suicidal attempts and homicidal acts in those who used excess and prolonged use of khat. In our case, the improvement attributed to stopping the khat rather than taking antipsychotics. Therefore, we recommend an urgent social intervention to change the community norms regarding Khat use through psycho-education in media, institution and in person about the relationship between khat use and mental illness.