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Four of the 17 categories that are included in the ICF-CS for schizophrenia (b330 Fluency and rhythm of speech functions, b530 Weight maintenance functions, b640 Sexual functions, and b765 Involuntary movement functions) did not achieve consensus in the Delphi study (see S1 Table for more details). Schizophrenia is currently classified as a psychotic disorder. Antipsychotic drugs aren’t the only treatment people with schizophrenia need. For the 70 million people affected worldwide, please know, that it’s not your … This category belongs to chapter e1 Products and Technology, and it should be noted that the ICF-CS for schizophrenia already contains four categories from the same chapter (i.e., e110 Products or substances for personal consumption, e125 Products and technology for communication, e130 Products and technology for education and e165 Assets). Further information about the experts who formed part of this study is available as supplementary data (S2 Text). Is the Subject Area "Schizophrenia" applicable to this article? Schizophrenia is a severe mental disorder associated with impairment in functioning. All categories reported by at least 5% of the experts were listed and presented to the panel in the second Delphi round. Data curation, Schizophrenia is a neurodevelopmental disorder that involves a complex interplay between genetic and environmental factors that contribute to its clinical phenotype and the underlying endophenotype. https://doi.org/10.1371/journal.pone.0217936.g001. Schizophrenia - Psychology bibliographies - in Harvard style . Table 3 lists the categories that did not match in the two sets of data (the set of categories included in the ICF-CS for schizophrenia and the set of categories that reached consensus). A multidisciplinary approach to both assessment and clinical intervention is essential to support individuals with this health condition. However, there was a significant difference between these two groups in years of experience (p < .01), since the invited experts who did not respond were less experienced than those who did take part. A total of 175 psychologists from 46 countries covering the six WHO regions answered the first-round survey (78.5% of the 223 who were sent the survey material). Treatment is directed at ameliorating acute psychosis and reducing relapses. Yes Competing interests: The authors have declared that no competing interests exist. Aggregation of third- and fourth-level categories to their corresponding second-level category yielded a list of 223 second-level ICF categories. [2 *], over 60 randomised controlled trials (RCTs) have subsequently examined the efficacy of Cognitive Behavioural Therapy for psychosis (CBTp).These trials have typically looked at the effectiveness of CBTp in improving the core symptoms of schizophrenia … Journal of Abnormal Psychology Emotion Deficits in Schizophrenia: Timing Matters Ann M. Kring, Marja Germans Gard, and David E. Gard Online First Publication, November 8, 2010. doi: 10.1037/a0021402 Myth #1 Having schizophrenia is a sign of moral failing or weakness. Risperidone (oral forms) for people with schizophrenia 6 October 2017 | Cochrane Database of Systematic Reviews, Vol. This is a multistage process in which each stage or round builds on the results of the previous one in order to gather and provide information about a particular subject [15]. Increased repulsion of working memory representations in schizophrenia. For You ... Journal of Pediatric Psychology, March 25, 2020 . Section 1: Diagnosis and Classification of Schizophrenia . Personal factors were defined as the particular background of an individual’s life and living situation (e.g., age) [18]. There was a plan, a structure, and a method to my search. In order to be able to compare our findings with the ICF-CSs for schizophrenia, which comprise solely second-level categories, all third- and fourth-level categories identified in the Delphi process were aggregated to their corresponding second-level category. All categories included in the Brief ICF-CS for schizophrenia were selected by 75% or more of participating experts, thus supporting the relevance of the categories that form this ICF-CS. Original Article. The Journal of Abnormal Psychology ® publishes articles on basic research and theory in the broad field of psychopathology and other abnormal behaviors, their determinants, and correlates.. Analysis of microbiota in first episode psychosis identifies preliminary associations with … Adapted from the Encyclopedia of Psychology. Schizophrenia is a devastating illness with an early adulthood onset and persistent course. For more information about PLOS Subject Areas, click The two ICF-CSs for schizophrenia are available for free download at: https://www.icf-research-branch.org/icf-core-sets-projects2/mental-health/icf-core-set-for-schizophrenia. All potential participants received an invitation with basic information about the study and what would be required of them. Clinical treatment of schizophrenia. Table 1 shows participants’ demographic and professional characteristics. Although a significant minority of the general public also believed them to be liable to commit violent and sexual offences against the person, on average they were not rated as dangerous. In this article, I shall focus on psychosocial treatments for schizophrenia and explore how the corresponding data aligns with theoretical concepts developed by Lev Vygotsky and Aleksei Leontiev. Change style powered by CSL. 1. Data regarding the categories presented to experts in rounds two and three and the degree of consensus reached are shown in the first two rows of Table 2. https://doi.org/10.1371/journal.pone.0217936, Editor: Eduardo Fonseca-Pedrero, University of La Rioja, SPAIN, Received: January 26, 2019; Accepted: May 21, 2019; Published: June 6, 2019. The research evidence for schizophrenia as a neurodevelopmental disorder. A multidisciplinary approach is essential to help individuals with this health condition, and psychological interventions are considered a priority. Our aim was to recruit a panel of experts as broad and heterogeneous as possible and to achieve consensus and common opinion despite and across this variability. With respect to the Body functions component, an agreement of 75% or higher was achieved for 14 categories. Supervision, The ICF provides just such a framework. The four journals that published the most studies of motivation in schizophrenia were Schizophrenia Research (46 published studies), Psychiatry Research (18), Schizophrenia Bulletin (12), and the Journal of Abnormal Psychology (8). Yes As this category also reached consensus in the validation study from the perspective of psychiatrists it clearly reflects a problem area for these patients [28,29], and therefore its exclusion from the ICF-CS for schizophrenia should be reconsidered. They were reminded that the aim was to obtain a final list that was both short enough to be applicable in clinical practice and sufficiently comprehensive to cover the most important needs of people with schizophrenia. The focus on recent advances in the neurobiology of schizophrenia has pushed aside the psychological understanding of the person with schizophrenia for several decades. J. Gómez-Benito was the author who received the funding. The categories included in the ICF-CSs for schizophrenia were also listed. It has a multifactorial etiology, with numerous individual variables interacting with several environmental factors [2]. There were no significant differences in age, gender, or years of experience in treating individuals with schizophrenia between the groups that responded across rounds 1 to 3. Angus MacDonald, III, PhD. Based on previous studies [14,20], consensus was defined as agreement among at least 75% of participants. The goal of the present study was to build on this by exploring content validity from the perspective of psychologists, another group of health professionals closely involved in the care of individuals with schizophrenia. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. (1995). Of the 1,555 health professionals who agreed to take part and who provided demographic and professional data, 223 were psychologists who met the eligibility criteria and who were therefore invited to begin round one of this study. The ICF is based on a multidimensional, biopsychosocial approach (see Fig 1) and considers a patient’s functioning as a dynamic interaction between the underlying health condition and specific personal and environmental contextual factors. Responses in the first Delphi round were logged using an online survey system (www.qualtrics.com). Indeed, we sought to obtain a sample of experts that, as far as possible, reflected worldwide variety in all the variables considered (e.g., gender, age, years of experience, and region). 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Can this blessed ‘Corona’ situation possibly have an upside?

As a Life Coach, Steve feels a strong urge to help people not only to cope with this spell of uncertainty, but “hopefully to emerge from it stronger than we were before this crisis started; when, unfortunately, we took so much for granted. Like many similar global calamities before it, including world wars and pandemics, this virus-spread will change the world because mankind will make new discoveries and adapt new practices,” he tells me.

To make his points clearly, he starts by expressing a few basic – important – presuppositions, or concepts, about Life. Anyone who has ever attended his workshops, or talks, or even follows him on Facebook may find these familiar, even if somewhat controversial.

Why change? I ask. Change, he says, will always happen, whether we like it or not, whether we want it or not, and whether we’re ready for it or not. In fact, “change” is perhaps the only certainty we have during our lifetime.

When change happens externally—in our environment—we get affected too. Sometimes we are affected directly, at other times indirectly. Sometimes we are affected a lot, at other times, not.

“Since everything in life is connected, anything that happens anywhere in the world will affect everything else, even if perhaps in the minutest way, but a chain of events will have been precipitated. This is known as Cause and Effect. So, always expecting change is a good start. Accepting that certain events are inevitable because there is more in life that is out of our control than there is that’s within our personal power is another essential step. The past is what it is. The present is more within our control. Consequently, being able to expect, accept and even embrace change—whatever its form or outcome—is one of the most important life-skills anyone can have. The opening lines of the “Serenity Prayer” express this perfectly:

So, we have to accept that things go wrong, change our lives, shatter our dreams more often than not. Where do we go from here? His answer: “When things go wrong, what is ‘actually’ happening is that these events would not be going as we had planned or as we would have liked them to go. Here is a harsh truth: In the bigger picture, there is no ‘right’ or ‘wrong’ way for things to go. This may sound strange, perhaps even objectionable, but in Nature everything happens out of necessity, not for the advantage of anything or anyone. Birth and Death are normal, ongoing events that are equally necessary and interconnected. Our false sense of ‘self-importance’ as a species makes us (humans) believe that whatever happens in the Universe is ‘about us,’ when we are merely a miniscule particle in the vastness of the ‘Big Picture’. Nothing is about us! We are simply minor components of an infinite whole. Of course, some things will change because of our actions— such as ‘climate change’ for example—but it’s not so much because we are in charge of anything. It is rather because we are participants in an ecological environment where every action can prompt a reaction.”

He then quotes Khalil Gibran from his monumental work The Prophet to illustrate our place in the scheme of existence. “When he is asked to speak to the fold about children, the prophet Almustafa says,

Life’s longing for itself. We need the humility to admit that we humans are incidental rather than instrumental to Life. Events will unfold as they must—one way or another—and we can either stress ourselves because we wanted them to unfold differently, or do our best to adopt and flow, surviving in the process as best we can.

Because we are complex living beings, we may not be able to control our emotional responses to our surroundings, but we can often adjust our reactions; hence our conscious thoughts about them and, as a result, we change our feelings.”

We know that we are different from one another and therefore we inevitably react differently to circumstances. Says Steve: “Yes, our personalities have been layered over the years from a mix of different experiences, to say the least, so no two persons are identical. Our behaviour, therefore, will be different as will be our response to the current situation. For some it will be more stressful than for others.”

“Stress,” he says, is an emotional response. “It varies between individuals. Those who generally do not seek external factors to energize themselves, also known as “introverts,” may find it easier to be indoors for prolonged periods, engaging themselves and remaining calm in their own or in limited company. They are used to it. Those who generally need a lot of interaction with other people in order to keep themselves fully charged, also known as “extroverts,” will probably react to the need for isolation with more stress and might struggle to keep calm and engaged while at home alone or in very limited company. They are not used to it.”

Then there are the anxious amongst us. What about them? “Those who are prone to “high anxiety,” meanwhile, need to be kept in our focus. They may need to be reminded that this is a temporary state of affairs. It is a storm and all storms eventually subside. This, too, shall pass! But we all need to be responsible and patient, appreciating the shelter and safety of our homes. My heart bleeds most for the lonely and the homeless. I wish we could all afford them more solidarity during this winter of dull global health.” Anxiety is a natural response that is intended to protect us, he comments: “Do not be surprised if you feel more anxious or worried than usual, especially at times like these. We humans are hard-wired to notice even the first signs of danger and our brain immediately goes into overdrive to keep our bodies safe. The snag is that this “stress response” that we experience as anxiety, as essential as it is for our survival, may be too much for some people to handle in certain circumstances. Our brain does not know when the bad news is fake or exaggerated, so it produces the same response as when we are faced with real danger.”

What can one do to reduce stress? “Use rationale to reason with yourself, as much as possible, to lessen your “imagination” of what might go wrong. Since anxiety results from ‘physiological’ responses in the body, it helps to focus on your breathing to help your brain slow down and calm the rest of your body, releasing better-feeling hormones. If these measures aren’t enough, seek help, but be aware that you are not alone. There is always help for anyone ready to help himself.”

Everyone seems to think that after this trying time our lives are going to change – some say radically, others in small ways. So, what does he read in his crystal ball about this? “These new circumstances are forcing us to change our ways of working, our daily habits and our attitude towards life. How lasting these changes will be remains to be seen. Some of us have had to adapt to working from home. Most of us have limited our movement outside the house to an absolute minimum. Some are in strict quarantine. At the moment, we are not buying clothes or gadgets, except perhaps online. Streets are quiet and entertainment outside the home is on hold. For the most part, we became more conscious about the need to economize on our consumption, realising that we need to keep our homes stocked perhaps for longer periods than originally thought. Hopefully, waste may also be greatly reduced as a result of our predicament.”

Steve continues and says that we seem to be returning to the Past in some ways. “This includes a renewed awareness in the need for public hygiene. During the Second World War, the British Ministry of Health issued posters with the catchy phrase, Coughs and Sneezes spread Diseases. This education was particularly important since people would often be huddled in bomb-shelters for extended periods. Evidently, this is still a good axiom for us to keep in mind too, now that we face such difficult times. The pendulum seems to be swinging toward the other extreme. Thanks to our greatly reduced transport by motor vehicles and an extensive suspension in air travel and tourism, even Mother Earth is having a break from our incessant fuming and polluting.”

We know only too well that the threats facing us are not small. They are economic as well as health- and wellbeing-related. “Let us not underestimate how this can affect us and others in our country, to what extent and for how much longer. What is lacking, perhaps, is a sense of urgency amongst many whose habitual irresponsible nature compels them to abuse their freedom, breaking rules and increasing the risk for others. That said, let us not exonerate ourselves from doing our part.”

Steve emphasises that everyone is connected. While some of us are more prone to certain consequences, no one is exempted. He gives a few examples: “Some people may be more financially stable than others yet have much more at stake economically in these perilous times. Some have the security of a pension but are more at risk healthwise. Some of us have relatives living abroad and may be worried, while others may have elderly parents whom they cannot visit So we are all pretty much in this together. Especially in times like these, it would be very unwise for us to compare ourselves to others. We simply need to do our bit and count our blessings.”

He points out that we all depend on other people to get through this difficult time. “But soon enough we may be looking back and perhaps we’ll have difficulty remembering the detail of this bleak reality, because we shall have won the war against the darn virus and moved on.”

But this is not the first threat to humanity’s survival, and it won’t be the last. “Dire situations tend to bring changes and progress too. Action and reaction often go hand in hand. World War II brought a huge leap in air travel, a dramatic development in other means of transport and advances in communication. Previous epidemics forced nations to improve health services and caused advances in medicine. There is always an upside, even in this crisis … whether or not we are able to see it yet. For one thing, petty differences seem to fade in the background and, so much that we believed was important before the crisis has been overshadowed.”

What qualities do we need to get through this bleak episode as quickly as possible? “The first is discipline. Without discipline there will be chaos. With discipline there will be progress. The second is patience. I remember having an MRI scan a few years ago. I am rather claustrophobic so my tendency would be to panic but knowing that it would be over soon and because I was kept occupied (by the earphone music provided to me) it seemed like a short dream that was over before I knew it.” The third requisite is to have a plan. He explains: “Your emotional wellbeing depends on making the most of your time at home. Prepare lists of activities you need to get done. This could be the time you’ve always dreamed of to (finally) sort out those drawers, or mend stuff, or spend time enjoying your pastimes. Be prepared. Make contact with friends without getting together physically. Share ideas and resources with others.” He emphasises that we need support for one another. “Let us find ways to stay connected, to reach out – especially to those who find it hard to be indoors for too long or who suffer from depression, and not assume they should be the ones reaching out to us if they need help. If you can think of anyone, especially of the elder generation or who suffers from unpleasant emotional conditions, use the phone or any online means to make contact regularly.”

He emphasises that we also have to be aware of what he calls ecology, meaning that we are in the same boat. “Actually, we are much like the crew of a submarine, where anything you do affects the rest of us, and vice versa. Let us exercise respect and selflessness, as opposed to panic buying, breaking quarantine, scaremongering or anything that affects society negatively. A truly civilized society should not require laws to keep its members in check, but alas we are not all civilized enough in our behaviour.” He cautions us about using words because without realizing we may be affecting others negatively instead of spreading calm and hope. “Avoid words that are loaded with drama. Catastrophizing, exaggerating and over-thinking are ways of creating anxiety. Without letting our guard down, let us share kind words and respectful humour. Let us consider how we speak to ourselves and to others.”

What lessons can we learn from this? “There is so much more that we ‘cannot’ control than there is that we can. What we ‘can’ control involves what relates to us, especially our words, our thoughts, our actions and our reactions. Assume responsibility for your actions and for your wellbeing. Avoid blaming others unnecessarily. Accept that the situation is the way it is and we need to make the most of it while it lasts. .As the old song goes, “I can’t stop the rain by complaining.” But I can avoid getting wet (feeling depressed or bored) by taking steps to remain dry (to do what I can to avoid hardship for myself and others).”

How can this awful situation possibly affect us in a positive way? Is there a proverbial ‘silver lining’ here? Steve is ever the optimist. “More than one, actually. Recapping some of the points made earlier, we have the following: Because of the fear of dying this situation has spiked religiousness in a lot of people, although this may have been spurred by the wrong motives in some because to turn to one’s God only when one is afraid points to a devotion of convenience. In my books “Gratitude is the only form of prayer,” so I prefer being grateful for all that is working in my life, rather than praying for protection, prompted by fear of a present threat. On the plus side, this made many people reflect and not take their life for granted.”

He points out that we have seen an increase in solidarity and even witnessed support being offered to complete strangers. “We experienced extraordinary human kindness in sharp contrast with the selfishness demonstrated by those whose actions jeopardized the stability of the nation.”

Another silver lining? “There is the fear of running out of rations. While fear may be irrational and ill-founded, in recent weeks we found ourselves curbing waste. A need to reduce and control our consumption makes us more human than machine. Such a situation also makes us realise what truly matters in life. Many people may have needed this jolt in order to realize that needs and wants are not the same thing and that you cannot eat possessions.”

Those of us who weren’t aware that security is a myth soon realised it. “Seeing how such a misfortune – that was out of our control to begin with – could reach us in a flash from the other side of the globe and how it forced us to close shops, cancel events and stay at home – risking our livelihood in some cases – may bring us to our senses before we pass judgement on socially emarginated people. Losing one’s job is enough to render a person homeless from being unable to pay rent. Let us refrain from labelling homeless people as addicts or lazy. Our own security is a fragile as the leaves on a tree. On a personal note, my life and career were going splendidly a few years ago, or so it seemed on the surface but in a flash – in just one moment – my whole world crumbled. It felt like my success story was cut short and coupled with a horror movie so there I was, in total disbelief, having to start over in my mid-fifties. My safety (“luck” if you will) lay in the fact that I did not have to pay rent and we had a second income, but I learned at that moment that security is a myth.”

Another silver lining is the practice and importance of washing our hands as a vital necessity. “Let us hope this practice stays with us for a couple of generations.” Then the need to cover our mouths. Steve comes up with some interesting facts: “The University of Bristol’s 2019 research indicates that “the airborne transmission of diseases, including the common cold, influenza and tuberculosis, is something that affects everyone with an average sneeze or cough sending around 100,000 contagious germs into the air at speeds of up to 100 miles per hour.” We should all be very aware of this, rather than casual about public hygiene.”

He reminds us that this is a unique occasion to have time to ourselves. “Rather than struggling with it why not actively think of ways to interact with friends remotely and look up online or other resources related to their interests. If you are working from home, don’t become sloppy. Keep yourself in top form.

This is an opportune time to interact with your family, discuss topics of mutual interests, watch movies together, or do other activities… together. We must not forget that we are in this together.”

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