Abnormal Psychology

Schizophrenia and Other Psychotic Disorders 563

FEEDBACK LOOPS IN TREATMENT: Schizophrenia

To be effective, treatment for people with schizophrenia must employ interventions

that induce interactions among neurological, psychological, and social factors (see

Figure 12.6). When successful, medication (treatment targeting neurological

factors) can reduce the positive and negative symptoms, and even help improve cog-

nitive functioning. These changes in neurological and psychological factors, in turn,

make it possible for social treatments, such as social skills training and vocational

rehabilitation, to be more effective. If patients are not psychotic and have improved

cognitive abilities, they can better learn social and vocational skills that allow them

to function more effectively and independently.

12.6 • Feedback Loops in

Treating Schizophrenia

Figure 12.6

Treatments that target psychological factors (CBT and cognitive rehabilitation)

address steps 1, 3 and 4 of treatment: decreasing positive symptoms and cognitive

defi cits (psychological) and improving overall functioning and quality of life (social

factor). Moreover, even when CBT may not decrease psychotic symptoms per se

(step 1), it teaches patients how to function (step 4) despite these symptoms. In

turn, as psychotic symptoms become more manageable, stress levels—and cortisol

production—should decrease and thereby have fewer effects on brain functioning.

Similarly, treatments that target social factors, such as family therapy and

psychoeducation, social skills groups, and vocational rehabilitation, also address

TT

g

Treatments Targeting

Neurological Factors

Medication: traditional

and atypical

antipsychotics

ECT

Changes neural

activity

Changes thoughts,

feelings and

behaviors

Decreases family

conflict and family

members’ critical

behavior

Improves social

interactions and

ability to work and live

more independently

Treatments Targeting

Social Factors

Family therapy and

education

Social skills training

Residential treatment

Vocational rehabilitation

CBT

Cognitive rehabilitation

Motivational

enhancement

Treatments Targeting

Psychological Factors

P S

N