Randall L. Morrison

Handbook of family violence

I. Introduction.- 1. Overview.- II. Theoretical Models.- 2. Psychoanalytic Perspectives on Family Violence.- 3. Physical Aggression between Spouses: A Social Learning Theory Perspective.- 4. Sociological Perspectives in Family Violence.- III. Forms of Family Violence.- 5. Wife Battering.- 6. Physical Abuse of Children.- 7. Child Victims of Sexual Abuse.- 8. Incest.- 9. Marital Rape.- 10. Husband Battering.- 11. Elder Abuse.- 12. Family Homicide: When Victimized Women Kill.- IV. Special Issues.- 13. Violence among Intimates: An Epidemiological Review.- 14. Prevention of Wife Abuse.- 15. Neurological Factors.- 16. Alcohol, Alcoholism, and Family Violence.- 17. Domestic Abuse: The Pariah of the Legal System.- 18. Family Violence in Cross-Cultural Perspective.- 19. Research Issues Concerning Family Violence.- Author Index.

Social competence in schizophrenia: Premorbid adjustment, social skill, and domains of functioning.

The relations between premorbid adjustment, social skill, and domains of functioning (symptoms, social adjustment) were examined in a group of 107 schizophrenic, schizoaffective, and affective disorder patients. Premorbid sexual adjustment was moderately correlated with social skill in the schizophrenic and schizoaffective patients. Schizophrenic patients had the lowest premorbid adjustment and social skill, followed by schizoaffectives, and then affective patients. Within the schizophrenic group, social skill was significantly related to both current social adjustment and negative symptoms, but not positive symptoms. Similar but weaker effects were found for premorbid adjustment. The results suggest that deficits in social skill are correlated with poor premorbid and morbid social adjustment of schizophrenics.

The role of social perception in social skill

The literature on social skills has emphasized the behavioral response components necessary for competent interpersonal functioning. Little consideration has been given to the role of social perception. However, recent findings have suggested that the response skill model is inadequate to explain the complexity of interpersonal behavior. The ability to receive and process relevant interpersonal stimuli adequately is essential for effective social performance. The present paper reviews findings concerning sensitivity to emotional cues in specific child and adult populations. Implications for training social skills, conducting behavioral analyes which consider social perception skills, and developing techniques for the assessment and training of social perception are discussed.

Gender, social competence, and symptomatology in schizophrenia: a longitudinal analysis.

The relationship between gender and social skill measured by performance on a role play test was examined in a sample of 57 schizophrenics, 33 affective disorder patients, and 20 nonpatient controls. Female schizophrenics were more skilled than male schizophrenics, but no gender differences were present in the affective patients or the controls. Longitudinal analyses conducted on the schizophrenic group indicated that the superior social skill of women was stable over the year following a symptom exacerbation. Symptoms and social adjustment improved for both men and women over the year, but did not differ according to gender. The implications of the results for gender differences in the long-term outcome of schizophrenia are discussed.

Social competence in schizoaffective disorder, bipolar disorder, and negative and non-negative schizophrenia.

Social skill and role functioning were assessed in matched groups of patients with DSM-III-R schizoaffective disorder, bipolar disorder, and schizophrenia. Schizophrenics were categorized as negative syndrome or non-negative on the basis of the SANS. The negative schizophrenics were significantly more impaired on almost every measure of social functioning. The other three groups were not consistently different from one another. The results suggest that when patients are comparable on dimensions such as duration and severity of illness, schizoaffectives do not occupy an intermediate position between schizophrenics without negative syndrome and bipolar patients. Rather, the three groups exhibit similar degrees of social disability. In contrast, negative syndrome schizophrenics were more impaired even when they were similar in chronicity and severity.

Perception of emotion among schizophrenic patients

The relationship of problems in social perception to the social dysfunction of schizophrenic patients has not been adequately addressed. The present study compared the responses of patients diagnosed as schizophrenic and affective disorder and nonpatient subjects on a measure of perception of emotional cues. A measure of general attention/perception was also administered. Schizophrenics exhibited selective deficits in perception of emotional stimuli in relationship to control groups. They differed in their perceptions of negative emotion, but not positive or neutral emotion, in comparison to affective disorder and control subjects. This selective distortion in social perception was apparent even though schizophrenics also performed poorly on the general attentional measure. A number of alternatives are discussed as possible explanations for the specific deviations which schizophrenics exhibited in perceiving negative emotion.

Positive and negative symptoms in schizophrenia. A cluster-analytic approach.

The relationships between positive and negative symptoms of schizophrenia and between negative symptoms and social dysfunction were investigated using cluster analysis. Clustering across schizophrenic subjects produced three distinct groups, each characterized by some mix of positive and negative symptoms. Clustering across symptoms and behavioral variables produced a cluster comprising negative symptoms and measures of social adjustment and an additional cluster comprising only measures of social skill. A series of correlations revealed a positive relationship between positive and negative symptom measures. X2 analysis revealed a significant relationship between the cluster solution across subjects and classification of patients according to negative symptoms based on previously published criteria. Results are discussed in terms of the implications for the further development and refinement of subclassification schemes for schizophrenia.

Assessment of assertion and problem-solving skills in wife abusers and their spouses

The present study provided an assessment of assertion and problem solving skills in couples characterized by wife abuse. A role play test and problem solving interaction task were administered to couples who were (a) physically abusive, (b) maritally discordant but nonviolent, and (c) satisfactorily married. Results indicated that members of abusive dyads exhibited deficits on selected behavioral components of assertion. However, few differences were observed between these dyads and the maritally discordant, nonviolent condition. Findings are discussed in terms of (1) the need for further evaluation of interpersonal skill variables in physically abusive males, (2) issues in selection of measures and subjects, and (3) the need to consider the possible interactive effects of multiple factors in family violence research.

SOCIAL SKILLS TRAINING IN THE TREATMENT OF NEGATIVE SYMPTOMS

Deficits in interpersonal functioning have been associated with schizophrenia since the disorder was first described. These deficits can be pervasive and often persist even when the more disabling psychotic symptoms have been pharmacologically controlled [1]. Although overt psychosis is generally the most salient and disturbing feature of schizophrenia, the importance of social dysfunction cannot be overemphasized. The results of several large-scale investigations have demonstrated that poor premorbid functioning, especially in the area of social relationships, is prognostic of poor long-term outcome [2-4]. In addition, studies have consistently found that schizophrenic patients whose family relationships are characterized by hostile interpersonal interactions are especially likely to require rehospitalization within nine months of discharge [5,6]. In view of these findings, treatments aimed at teaching schizophrenic patients more effective social skills have become a standard component of many psychiatric rehabilitation programs [7]. Indeed, the combined application of neuroleptic therapy to control psychotic symptoms and social skills training to remedy chronic interpersonal dysfunction is now regarded as one of the most promising approaches to the overall treatment and management of schizophre

Drug-Related Cognitive Impairment: Current Progress and Recurrent Problems

This chapter reviews recent research on drug-induced cognitive impairment, focusing primarily on global cognitive disorders, delirium and dementia, occurring as adverse effects of pharmacological agents used in clinical practice. Our primary interest is cognitive toxicity occurring in the elderly, but because there are major gaps in the literature on adverse drug effects in the aged, the discussion is supplemented with findings from other adult populations. We are concerned with cognitive toxicity as a clinical problem rather than with the use of drugs as probes for elucidating the neuropharmacological mechanisms underlying learning and memory. The primary focus will be on agents that affect the central nervous system directly rather than those that give rise to cognitive symptoms via demonstrable effects in the periphery. The emphasis is on recent studies on agents used in therapeutics; we have excluded articles on both occupational or environmental toxins and substances of abuse. The literature includes articles on both prescription and over-the-counter drugs. The strategy for retrieving the relevant papers was based primarily upon a search of the Medline data base for studies on humans published in the period from 1983 to early 1988 under the subject headings “dementia,” “delirium,” or “cognition disorders,” and the subheading “chemically-induced.”