Catana Brown

The relations between cognition and the independent living skill of shopping in people with schizophrenia

A great deal of interest has developed regarding the impact of cognitive deficits on the everyday functioning of people with schizophrenia. This study examined the relationships between cognitive functioning and the performance of a specific independent living skill (grocery shopping) in a sample of 73 individuals with schizophrenia or schizoaffective disorder. Cognitive variables included tests of verbal memory, executive functioning, verbal fluency, sustained attention and visual motor skill. Functional outcome was measured with the Test of Grocery Shopping Skills, which is an ecologically based performance measure that requires participants to shop for 10 items within an actual grocery store. Accuracy on the shopping task was significantly associated with fewer perseverative responses on the Wisconsin Card Sorting Test, better verbal memory and faster processing speed. Shopping efficiency (i.e. less redundancy) was associated with better performance on several cognitive tasks, including verbal memory, verbal fluency, sustained attention and executive functioning. Results of this study extend previous research by examining the relation between cognition and the actual performance of daily living skills under natural circumstances.

Sensory processing in schizophrenia: missing and avoiding information

The possible coexistence of supersensitivity and overinhibition (Schizophrenia: Origins, Processes, Treatment and Outcome (1993) 335-350) in schizophrenia was studied using the Adult Sensory Profile as a measure of Dunns (Infants Young Children 9 (1997) 23-25) model of sensory processing. The quadrant model describes sensory sensitivity, sensation avoiding, low registration and sensation seeking as behavioral responses to sensation. Individuals with schizophrenia (N = 27), bipolar disorder (N = 30) and mentally healthy controls (N = 29) were compared using the Adult Sensory Profile. When compared to the mentally healthy group, the results indicated that both the schizophrenia group and the bipolar disorder group had higher scores on sensation avoiding. The schizophrenia group also had higher scores on low registration and lower scores on sensation seeking than the mentally health group. There were no differences between the schizophrenia and bipolar disorder group. According to the findings of this study, individuals with schizophrenia tend to miss available sensory stimuli. When stimuli are indeed detected, they are often avoided.

The effect of an oral health promotion program for people with psychiatric disabilities.

Oral health programs for people with psychiatric disabilities are rare. This study examined the feasibility efficacy of an oral health intervention for people with psychiatric disabilities. Fifty individuals were recruited and randomly assigned to receive education, reminder system and mechanical toothbrush or just the mechanical toothbrush. 42 completed the study. Plaque index scores recorded at baseline and after 4 weeks indicate a statistically significant improvement for both groups but those in the enhanced intervention improved significantly more. The results suggest the mechanical toothbrush improves the oral hygiene of people with psychiatric disabilities. The combination of mechanical toothbrush, dental instructions and reminders result in additional improvements.

A psychiatric rehabilitation approach to weight loss.

Obesity is a major problem nationwide and even more prevalent among people with psychiatric disabilities. This study examined the efficacy of a psychiatric rehabilitation weight loss program. Twenty-one individuals participated in the 12-week intervention. Another 15 individuals served as matched controls. Results indicate the intervention group improved more than the control group for weight, body mass index, waist circumference and physical activity. The intervention group lost 2.7 kg (6 lbs) and the control group gained 0.5 kg (1 lb). A weight loss program incorporating psychiatric rehabilitation principles was effective for people with psychiatric disabilities at a community based program.

The prevalence of night eating syndrome and binge eating disorder among overweight and obese individuals with serious mental illness

The prevalence of night eating syndrome (NES) and binge eating disorder (BED) was assessed among overweight and obese, weight-loss-seeking individuals with serious mental illness (SMI). Sixty-eight consecutive overweight (BMI > or = 25 kg/m(2)) and obese (BMI > or = 30 kg/m(2)) individuals with SMI (mean age = 43.9 years; mean BMI = 37.2 kg/(2); 67.6% Caucasian, 60.3% female) who were enrolled in a group behavioral weight loss treatment program were assessed at baseline for NES and BED with clinician-administered diagnostic interviews. Using conservative criteria, 25.0% met criteria for NES, 5.9% met criteria for BED, and only one participant met criteria for both NES and BED. This is the first study to find that obese individuals with SMI, compared with previously studied populations, are at significantly greater risk for NES, but are not at greater risk for BED. Stress, sleep, and medication use might account for the high prevalence of NES found in this population.

Doing daily life: how occupational therapy can inform psychiatric rehabilitation practice.

TOPIC This paper provides an overview of occupational therapy in the context of psychiatric rehabilitation and mental health recovery. PURPOSE The paper delineates practical aspects of occupational therapys involvement in the mental health field with a discussion of occupation and the elements of conceptual models that guide the practice of occupational therapy. SOURCES USED CINAHL, Psych Info, Medline. CONCLUSION Occupational therapy is a key discipline in the field of psychiatric rehabilitation and brings to the field a strong theoretical and knowledge base along with unique procedures and practices. It is important for the psychiatric rehabilitation field to learn from all disciplines, including occupational therapy.

The Role of Sensory Processing in the Everyday Lives of Older Adults

This study investigated whether there are age-related differences in sensory processing within daily life. Participants included 404 community-dwelling adults divided into three age groups: 19 to 34 years old (127 individuals), 35 to 64 years old (126 individuals), and 65 years and older (151 individuals). Each participant completed the Adolescent/Adult Sensory Profile. There was a difference in sensory processing between the three groups (p = .000), with the older adults noticing sensory input less than the young and middle aged adults (p = .002 for both groups). Both middle aged and older adults engaged in less sensory seeking behaviors than did young adults (p = .012 and p = .000, respectively). In an additional analysis, the older group was subdivided into four age groups (65 to 69 years, 70 to 74 years, 75 to 79 years, and 80 years and older). There was an age-related difference between the four groups (p = .000). Those 75 to 79 years old and those 80 years and older noticed sensory input less than did those younger than 70 years (p = .002 and p = .001, respectively). Those 80 years and older were also less apt to seek sensory experiences than were those younger than 70 years (p = .011). The authors propose hypotheses about the meaning of these findings and provide recommendations for the application of this knowledge to support older adults to age in place successfully.

Learning proficiency on the Wisconsin Card Sorting Test in people with serious mental illness: What are the cognitive characteristics of good learners?

Although it is widely accepted that schizophrenia and other serious mental illnesses (SMI) are associated with neurocognitive difficulties, there is great variability in neurocognitive functioning across individuals. In recent years, a growing number of schizophrenia studies have utilized the concept of learning potential to explore individual variation in cognition. Learning potential refers to the ability to benefit from instruction and is measured by assessing test performance before and after training. The present study was intended to explore the cognitive characteristics associated with learning potential in people with serious mental illness. Sixty individuals with schizophrenia, bipolar or major (unipolar) depression completed a learning potential assessment using the Wisconsin Card Sorting Test (WCST) and a battery of standard cognitive measures. Based on established criteria for WCST learner subgroups, participants were categorized as high achievers, learners or non-retainers. There were several significant cognitive differences among the three learner subgroups. Most notably, individuals who were categorized as learners on the WCST showed significantly better verbal and working memory compared to non-retainers. Secondary analyses revealed that the three SMI diagnostic groups (depression, bipolar, schizophrenia) were similar in learning potential and did not differ on any of the standard cognitive measures. This study provides support for learning potential classification in schizophrenia as well as other serious mental illnesses, and indicates that learning potential may specifically be related to verbal and working memory abilities.

What Is the Best Environment for Me? A Sensory Processing Perspective

Abstract This paper describes the process of evaluating and designing interventions for sensory processing preferences using the Adult Sensory Profile. The measure is theoretically based on Dunns Model of Sensory Processing (1997) which describes the intersection of neurological threshold and behavioral responses resulting in the following four quadrants: sensory sensitivity, sensation avoiding, low registration and sensation seeking. The compatibility of this model and recovery is discussed along with specific strategies for matching environments and sensory processing preferences.

Effectiveness of Cognitive Rehabilitation for Improving Attention in Patients with Schizophrenia

Many patients with chronic schizophrenia who are treated in traditional occupational therapy programs demonstrate lower level deficits involving cognition and, more specifically, attention. This study examines the applicability of the cognitive rehabilitation treatment modality to patients with schizophrenia as compared with the traditional one-to-one task-oriented approach. Results indicated no significant difference between the two treatment methods. Overall, the subjects from both groups did show improvement in scores on the shell sort task of the Bay Area Functional Performance Evaluation (BaFPE). Scores for self-confidence, motivation, and efficiency improved for the subjects in both groups in at least four of the five task scores of the BaFPE. Significant improvements also were noted in five psychological tests of attention and memory for both groups. This study supported the importance of hierarchically arranged crafts and cognitive rehabilitation in an environment with reduced sensory input. Treatments that were structured, concrete, and visual were most effective.