Melanie E. Bennett

Evaluation of social problem solving in schizophrenia.

We examined social problem solving in schizophrenia. Twenty-seven schizophrenic patients in an acute hospital, 19 patients with bipolar disease, and 17 demographically matched nonpatient controls were tested on an empirically developed problem-solving battery that assessed the ability to generate solutions to problems, the ability to evaluate the effectiveness of solutions, and the ability to implement solutions in a role-playing format. Schizophrenic Ss were impaired on all 3 problem-solving domains compared with the nonpatient controls, but bipolar Ss were equally impaired. Several alternative explanations for these findings were considered. The most compelling hypothesis is that the deficits resulted from different factors: cognitive impairment for schizophrenic Ss and acute illness for bipolar Ss. However, longitudinal studies are required to determine whether problem-solving deficits in schizophrenic patients persist during periods of remission. Implications for rehabilitation strategies are discussed.

An empirical method for assessing social problem solving in Schizophrenia

The development of a multimethod social problem-solving battery for schizophrenia is described. The battery is unique in that empirical methods were used throughout its development. The battery includes components that tap skills for response generation and response evaluation. The behavioral components of social problem solving are assessed in an extended role-play format. Individuals with schizophrenia and bipolar disorder, as well as nonpatient controls, completed the social problem-solving battery and cognitive measures. Subjects in the schizophrenia group performed more poorly than controls on measures of the ability to generate and evaluate response alternatives, as well as on the role-play test. The two patient groups did not differ in performance on any of the social problem-solving components. Appropriateness of affect was the most powerful predictor of problem-solving effectiveness.

Subtype by comorbidity in young adult substance abusers

Comorbidity of psychiatric and substance use disorders is prevalent in adult substance abusers and influences the outcome of substance abuse treatment. To study the impact of comorbid disorders, adult subjects are subtyped into primary and secondary abusers. This study assessed comorbidity in young adult substance abusers involved in treatment, and evaluated the utility of the primary/secondary distinction in this population. Over half of the sample met criteria for at least one current psychiatric diagnosis. Subtyping resulted in 20 primary and 34 secondary abusers. The groups differed on gender, age of first problem due to substance use, depressive symptomatology, and reasons for use of alcohol. Secondary abusers reported more severe family and psychiatric problems than did primary abusers. The groups did not differ in the severity of alcohol or drug problems. These results indicate that comorbidity must be evaluated and addressed when treating young adult substance abusers.