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For several years, the choice of a treatment has been based on the subjective judgment of clinicians driven by their scientific knowledge and experience, and focused towards the selection of the most appropriate therapeutic strategy. The awareness of providing treatment grounded on the latest scientific evidence, the difficulty to follow the increasing number of data […]
ReAttach is a therapeutic method characterised by Paula Weerkamp (Weerkamp-Bartholomeus 2015). She points out that, “‘individually’, there are many differences in psychological functioning. ReAttach is focusing on the similarity in cognitive processing of information, emotions and events. The underlying structure of ReAttach is based on ortho-paedagogical influencing, obstructing factors and facilitating optimal conditions for cognitive […]
[:it]The Schizophrenia Proneness Instrument has its origins in the basic symptom concept first described by Gerd. Basic symptoms are subtle, subclinical self-experienced disturbances in drive, stress tolerance, affect, thinking, speech, perception and motor action, which are phenomenologically clearly distinct from psychotic symptoms. They can be present before the first psychotic episode, between and after psychotic episodes, even during psychotic episodes themselves. They were thought to be the most immediate psychopathological expression of the somatic disturbance underlying the development of psychosis – thus the term ‘basic’.
Basic symptoms are phenomenologically different from mental states known to the patient/subject from what s/he considers his/her ‘normal’ self and thus are clearly distinguishable from subtle disturbances described as traits in those at genetic high-risk. In addition, basic symptoms are phenomenologically clearly distinct from attenuated or frank psychotic symptoms – employed in the ‘ultra-high risk’ (UHR) criteria of an imminent risk of first-episode psychosis – as they are not necessarily observable by others as are odd thinking and speech, negative symptoms and formal thought disorders. They are regarded as having originating in the subject, unlike schizotypal perceptual disturbances and hallucinations, and do not primarily affect thought content as do magical thinking, ideas of reference, paranoid ideation and delusions.
Download Schizophrenia Proneness Instrument-Adult Version Score Sheet.
Download Summary of basic symptom criteria.[:]
[:it] I disturbi schizofrenici rappresentano un problema centrale di sanità pubblica. Prevenire, attenuare o ritardare la comparsa di tali disturbi costituisce un compito essenziale per un’assistenza psichiatrica moderna. Questo volume esplora un insieme di strategie preventive non limitate al riconoscimento precoce degli esordi schizofrenici ma rivolte anche alle situazioni di rischio remoto. Indice: Towards a comprehensive model of schizophrenic disorders and specific vulnerability for preventive strategies by Alessandro Grispini. Cognitive deficit and vulnerability in schizophrenia by Silvana Galderisi, Eleonora Merlotti, Armida Mucci. Preventing schizophrenia: is a genetic counselling possible? by Alessandro Serretti. Meaning of and possibilities for familial prevention of schizophrenia by Karl-Erik Wahlberg. Risk factors for schizophrenia and prevention by Nigel Bark. A general theory on the promotion of mental health and prevention of mental disorders by Michael Murray. A preventive strategy for schizophrenia: from primitive drives to the development of a new society by Ramhan Haghighat. Obstetric and delivery complications as risk factors for schizophrenia: neurodevelopmental perspectives by Hiroshi Kunugi. The neuromotor, behavioural and cognitive predictors of schizophrenia by Paola Dazzan, Eugenia Kravariti, Paul Fearon, Robin M. Murray. Families where a parent has schizophrenia: opportunities for prevention by Duncan McLean, James Scott and John McGrath. Implications of schizotaxia for the prevention of schizophrenia by Ming T. Tsuang, William S. Stone, Sara I. Tarbox, Stephen V. Faraone. School and schizophrenia by Graham Murray, Matti Isohanni, Irene Isohanni and Peter Jones. Basic symptoms in the early detection and intervention in schizophrenic disorders by Joachim Klosterkoetter and Frauke Schultze-Lutter. Early detection and intervention in psychoses: implementing a program by Angelo Cocchi and Anna Meneghelli. A critical review of early detection and intervention in schizophrenia by Richard Warner. Does Schizophrenia Still Exist Today? by Giuseppe Martini. Early intervention in psychoses: road to recovery or dangerous illusion? by Germana Agnetti. An hypothetical attempt to define the number needed to treat to delay the first hospitalisation for schizophrenia by Mark Weiser, Haim Knobler, Itamar Grotto, Michael Davidson. Prevention of de-humanisation: Towards the concept of “rehabilitative psychoanalytic psychotherapy” in the treatment of schizophrenia by James Grotstein.
[:it]In questo volume, in accordo con la tradizione cognitivista, la sfida lanciata dagli autori è proprio quella di utilizzare, nel modo più raffinato possibile e migliorandola, la psicologia intuitiva o ingenua della mente, nel tentativo di estenderla anche alla risoluzione di problemi che tradizionalmente la psicologia del senso comune ha avuto difficoltà ad affrontare, come ad esempio il fenomeno del paradosso nevrotico, o della resistenza al cambiamento, ovvero: come è possibile che un individuo persista in una condotta per lui fonte di infelicità e nociva, nonostante le informazioni di cui dispone, i suoi strumenti cognitivi e i suoi scopi rendano possibile ed opportuno un cambiamento? l’intento è quello di coniugare la psicologia del senso comune con le conoscenze della psicologia di base per spiegare, più in generale, la bizzarria delle condotte psicopatologiche.
[:it]La nozione di ragione pratica è uno snodo fondamentale in cui convergono diverse discipline filosofiche. Fra le linee intellettuali che hanno attraversato questa materia, una delle più originali e feconde è stata quella elaborata da Derek Parfit. A partire dalla prima metà degli anni Ottanta del secolo scorso, Parfit ha sostenuto che i problemi che riguardano la domanda “che cosa abbiamo ragione di fare” hanno significato soltanto all’interno di una indagine generale sull’ontologia degli agenti, cioè sulla natura delle persone e della loro identità nel tempo.
Questo saggio vuole sostenere che Parfit presenta una teoria convincente della razionalità pratica che ha implicazioni importanti per l’etica filosofica.[:]
[:it]
The Schizophrenia Proneness Instrument, Child and Youth version (SPI-CY) has its origin in the basic symptom concept first described by Gerd Huber.
Basic symptoms are subtle, subclinical, self-experienced disturbances in drive, stress tolerance, affect, thinking, speech, perception and motor action, which are phenomenologically distinct from frank or attenuated psychotic symptoms. Basic symptoms can be present before, during and after psychotic episodes. The term “basic” reflects the belief that they are the first specific psychological manifestation of the neurobiological disturbance underlying the development of psychosis.
Basic symptoms are phenomenologically different from normal, non-pathological, fluctuations in mental state. In other words they are different from what a young person considers his or her normal self, and in this way may be distinguished from those subtle disturbances that occur as long-standing traits in children at genetic high-risk.
Generally speaking, the SPI-CY can be used to assess young people of 8 years and above, with the caveat that some basic symptoms require a higher cognitive-developmental state and should not be assessed before the age of 13. Whilst, as for adults, the elicitation of subjective experience remains critical to identifying basic symptoms, the SPI-CY may also utilize information from parents and other carers. However, such third-party information may only be used to help explore what the young person is experiencing, and cannot act as a substitute for directly elicited information.
[:it]Das Schizophrenia Proneness Instrument hat seinen Ursprung im Basissymptomkonzept, das als erstes von Gerd Huber beschrieben wurde. Basissymptome sind feine, subklinische und selbst wahrgenommene Störungen des Antriebs, der Stresstoleranz, des Affekts, von Denk- und Sprachprozessen, der Wahrnehmung und der Motorik, die sich phänomenologisch deutlich von (attenuierten) psychotischen Symptomen unterscheiden. Sie können vor der psychotischen Erstepisode, zwischen und nach psychotischen Episoden sowie auch während der floriden Phase vorliegen. Da angenommen wurde, dass sie den primären psychopathologischen Ausdruck der der Entwicklung einer Psychose zugrunde liegenden neurobiologischen Veränderungen darstellten, wurde der Begriff ‚Basis’ gewählt.
Basissymptome unterscheiden sich von Befindlichkeitsstörungen, die das Kind bzw. der Jugendliche seinem ‚normalen’ Selbst zuzählt, und differieren dadurch von subtilen Störungen, wie sie für Kinder mit genetisch bedingtem Psychoserisiko beschrieben worden sind. Die SPI-CY kann generell ab dem 8. Lebensjahr erhoben werden, doch erfordert die Beurteilung mancher Basissymptome eine höhere kognitive Entwicklungsstufe, so dass diese erst ab dem 13. Lebensjahr erhoben werden sollten. Obwohl generell die Subjektivität der Beschwerden eine Hauptcharakteristik von Basissymptomen ist, wurde für ihre Erhebung in der SPI-CY bei Kindern und jüngeren Adoleszenten auch die Möglichkeit der Integration von Informationen von Bezugspersonen berücksichtigt, wobei diese die Exploration des betroffenen Kindes nur begleiten und stützen, nicht aber ersetzen soll.
The Schizophrenia Proneness Instrument, Child and Youth version (SPI-CY) has its origin in the basic symptom concept first described by Gerd Huber. Basic Symptoms are subtle, subclinical self-experienced disturbances in drive, stress tolerance, affect, thinking, speech, perception and motor action, which are phenomenologically clearly distinct from (attenuated) psychotic symptoms. They can be present before the first psychotic episode, between and after psychotic episodes, even during psychotic episodes themselves. They are thought to be the most immediate psychological expression of the neurobiological disturbance underlying the development of psychosis – thus the term ‘basic’.
Basic symptoms are phenomenologically different from normal, non-pathological fluctuations in mental state known to the child/adolescent from what s/he considers his/her normal self, and thus are clearly distinguishable from subtle disturbances described as traits in genetic high-risk children. Generally, the SPI-CY can be assessed from the age of 8 onwards, yet some basic symptoms require a higher cognitive-developmental state and thus should rather not be assessed before the age of 13. Although their subjective perception is generally a main characteristic of basic symptoms, particularly for their assessment in children and younger adolescents, the SPI-CY offers the possibility to integrate information of parents or carers. Such third-party information, however, should only support the exploration of the child/adolescent and is not meant to replace it.
L’Outil d’Évaluation du Risque Schizophrénique (version Adulte) (OERS-A) (Schizophrenia Proneness Instrument ou SIP-A) tire son principe du concept de «symptôme de base» décrit pour la première fois par Gerd Huber. Les symptômes de base sont des perturbations discrètes, d’intensité infra clinique, que le patient/sujet* éprouve subjectivement et qui affectent l’énergie, la tolérance au stress, l’affectivité, la pensée, la compréhension du langage et la motricité. Leurs caractéristiques phénoménologiques sont manifestement différentes de celles des symptômes psychotiques. Ces symptômes ont été opérationnalisés pour la première fois dans la Bonn Scale for the Assessment of Basic Symptoms (BSABS) et le Frankfurt Complaint Questionnaire (FCQ). Ils peuvent être présents avant le premier épisode psychotique, entre et après les épisodes, et même au cours des épisodes eux-mêmes. Ils ont été considérés comme l’expression psychopathologique la plus immédiate du désordre somatique sous-jacent au développement de la psychose – d’où le qualificatif «de base». Sur le plan phénoménologique, les symptômes de base sont différents des états mentaux que le patient/sujet identifie comme étant ceux émanant du soi «normal», et ils peuvent donc être clairement distingués des anomalies discrètes décrites comme des traits chez les sujets à «Haut Risque Génétique». De plus, les symptômes de base sont phénoménologiquement nettement distincts des symptômes psychotiques atténués ou francs, utilisés comme critères de «Très Haut Risque» pour prédire l’imminence du premier épisode de psychose dans la mesure où ils ne sont pas nécessairement observables par les autres comme le sont les pensées et le langage bizarres, les symptômes négatifs et les troubles formels de la pensée. Ils sont considérés comme s’étant développés dans l’intimité du sujet, ce qui les distingue des troubles perceptifs et des hallucinations schizotypiques.
Comment l’évolutionnisme peut aider dans sa prévention et son traitment
[:it]El Instrumento de Vulnerabilidad a la Esquizofrenia, Versión para Adultos (SPI-A), evalúa un amplio rango de alteraciones auto-vivenciadas sutiles definidas inicialmente como síntomas básicos. Está fundamentalmente diseñado para contribuir en la predicción de primeros episodios psicóticos, así como para facilitar el abordaje de una gran variedad de cuestiones clínicas y de investigación relacionadas con diferentes estadios de la enfermedad. El SPI-A proporciona importantes elementos para comprender los déficits y quejas subclínicas que a menudo preceden episodios psicóticos francos y permanecen durante la remisión. Por tanto, está principalmente dirigido a psiquiatras y psicólogos con un interés clínico y científico en las psicosis, aunque también podría ser relevante para otros profesionales, estudiantes, pacientes y familias implicados en el cuidado de personas con psicosis. Los mismos pacientes podrían sentirse ayudados por el SPI-A a la hora de expresar sus experiencias subjetivas, que a menudo resultan muy difíciles de describir espontáneamente.[:]
[:it]O Instrumento de Propensão a Esquizofrenia tem suas origens no conceito de sintoma básico descrito primeiramente por Gerd Huber. Sintomas básicos são distúrbios sub-clínicos sutis auto-experimentados da motivação, da tolerância ao estresse, do afeto, do pensamento, do discurso, da ação motora e da percepção, os quais são claramente distintos fenomenologicamente dos sintomas psicóticos. Eles podem estar presentes antes do primeiro episódio psicótico, entre e após episódios psicóticos, e mesmo durante os próprios episódios psicóticos. Pensava-se que eles eram a mais imediata expressão psicopatológica da alteração somática por trás do desenvolvimento da psicose – assim o termo “básico”.
Sintomas básicos são fenomenologicamente diferentes dos estados mentais conhecidos pelo paciente/sujeito do que ele/ela considera seu eu “normal” e assim são claramente distinguíveis dos distúrbios sutis descritos como traços naqueles com alto risco genético. Além disso, sintomas básicos são claramente distintos fenomenologicamente dos sintomas psicóticos atenuados ou francos – empregados no critério de “risco-ultra-alto” (Ultra High Risk − UHR) para risco iminente de um primeiro episódio psicótico – já que não são necessariamente observáveis por outros, como pensamento e discurso estranhos, sintomas negativos e alteração formal do pensamento. Eles são considerados como sendo desenvolvidos no próprio sujeito, contrariamente aos distúrbios de percepção esquizotípicos e alucinações, e não afetam primariamente o conteúdo do pensamento como o fazem o pensamento mágico, as idéias de referência, a ideação paranóide e os delírios.
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