Difficulty assessing effort drives motivation deficits in schizophrenia, study finds

That is the title of this article I am writing about. “Individuals with schizophrenia often have trouble engaging in daily tasks or setting goals for themselves, and a new study from San Francisco State University suggests the reason might be their difficulty in assessing the amount of effort required to complete tasks.  The research, detailed in an article published this week in the Journal of Abnormal Psychology, can assist health professionals in countering motivation deficits among patients with schizophrenia and help those patients function normally by breaking up larger, complex tasks into smaller, easier-to-grasp ones.”  The tasks they set themselves up for maybe too large and they need to make them smaller and easier to grasp.  That makes sense if you have to clean house just start small and clean a little of a room or just one room at a time.
I wonder if that is easier to do. “This is one of the first studies to carefully and systematically look at the daily activities of people with schizophrenia - - what those people are doing, what goals are they setting for themselves,’ said David Gard, an associate professor of psychology at SF State who has spent years researching motivation and emotion. ‘We knew that people schizophrenia were not engaging in a lot of goal-directed behavior.  We just didn’t know why.’ In 2011, Gard received a grant from the National Institute of Mental Health to study the reasons behind this difficulty in goal setting.  An earlier article detailing other research from this study, published in May in the journal Schizophrenia Research, showed that when people with schizophrenia do set goals for themselves, they set them for the same reasons as persons without: to connect with others.  But motivation deficits are still common among these individuals, and his latest study set out to pinpoint the reason.” I haven’t set any goals for myself in a long time.  I have been thinking about it for some time.  I do feel a need to change some things in my life.  I have become to set in my ways again.
How did they figure out what might work? “Through a series of cognitive assessments and random phone calls, Gard and his colleagues at SF State and the University of California, San Francisco collected data from 47 people with and 41 people without schizophrenia.  Participants were called four times a day, randomly throughout the day, for a week and asked about their current mood, as well as what they were doing; how much enjoyment they were getting out of it; and what their goals for the rest of the day were.  The results were coded by variables such as how much pleasure they were getting out of their daily activities and how much effort was involved, then compared that with the results from the cognitive assessments.  Gard and his fellow researchers found that, while people with schizophrenia engage in low-impact, pleasurable goals - - such as watching TV or eating food for enjoyment - - as much as others, they have a greater difficulty with more complex undertakings or goals requiring more effort.”  That is what I have to do is stop watching so much TV and start reading again I haven’t read a real book in over five years.  Start my walks again get out of the house.
The article ends with: “There’s something breaking down in the process around assessing high-effort, high-rewards goals,’ Gard said.  When the reward is high and the effort is high, that’s when people with schizophrenia struggle to hold in mind and go after the thing they want for themselves.  The findings indicate that health-care providers who want to help individuals with schizophrenia set goals for themselves should break larger tasks into smaller, simpler ones with rewards.  For example, instead of guiding a patient specifically toward the larger goal of getting in physical shape, a provider could instead encourage them to gradually walk a little bit more every day. That’s something we would do for everyone else, but it might have been avoided in patients with schizophrenia because we thought they weren’t experiencing as much pleasure from their activities as they actually are,’ Gard added.  We can help them to identify things that are pleasurable and reward them toward larger goals.” I believe I will give it a try and just start smaller and walk around the lake to get my mail like I used to and build up my walking again and get out of the house.

Schizophrenia and Recovery

The experience of being schizophrenia is an empty and lonely one.  It’s easy to withdraw from the world, rather than to cope with the reality of it.  My perceptions remain unquestionable, there’s really no one to share what is real to me or unreal and be believed as an experience.  I was feeling very fragmented one day and being alone, I had to look inside the crazy feelings I was having.  There is no pain to be given, yet I know and realize that the delusions and paranoia do exist.  My brain isn’t getting the message through to the right people, and I am not separating the truths of who are the right people, to trust, to share with, and even to care about.  It’s difficult at times without an understanding person to meet with the real world.  I withdraw from the society and world around me, reality, simply because I don’t want to be misunderstood about what I am experiencing or feeling and as I try to hide my illness, I had no idea this secret was destroying me. 
I slowly gave up on everything I wanted to do and because of a promise I made with a family member, I began to reach into the basket of cornucopias delight and began to feel better about myself.  The pins and needles of negativity and doubt began withdrawing themselves and I could see a bit more clearly.  I do have my fears as I am becoming a part of a greater blessed part of life, working, keeping an apartment, being responsible to myself as well as others and I often feel I am normal, working towards Recovery, a part of the real outer world, not one that is hallucinated.

It has taken me sometime to completely understand what has happened to me and what I have done to myself, being dual diagnosed as well, yet I don’t blame the world for putting the cup in my hands.  Reading and listening to those I can trust and care about has brought me back to the realm of sanity, besides taking the medications I have, without having to resort to self medicating by using illicit street drugs and alcohol.  I had to learn to be patient and trusting and realize tomorrow is another day, not just a dream I can re-manipulate, which gets me closer to understanding that I have a contribution to make with the faith of others, an opportunity to become normal. 

Written by Donald S.

Using Drugs and Mental Health

The outlook in the Mental Health System today tends to differentiate as to the knowledge and attitude of the mentally ill in the system about illegal drug use and those who are of authority in dealing with illicit drugs. People with only a slight knowledge or no experience with Mental Health whom have a mental health problem are usually frightened, afraid or uncomfortable about the subject of illicit drug use. On the other side of the coin, consumers or clients who have a mental health problem or family members who are sufferers often believe this is a subject of stigmatization and usually feel they are being cast aside or are in need of further support because of their drug use or the illicit use by family or friends. Knowledge of the mental health system as far as mental health is concerned is also a matter of the media of which the youth of today and those whom have never been exposed to the mental health system find it both fearsome and are often awe stricken at the same time, having not much knowledge as to what causes mental illness and how such illness’ are controlled in consumers. Many people today only have the Media’s ideas of the practices and conditions to base their knowledge on and with this, some mental health problems such as depression, anxiety and stress are seen as common, rather than something which may be debasing or life threatening to and individual, consumer or client. Other conditions such as schizophrenia, bi-polar or psychosis are seen as extreme, especially when associating with people with such illness’, or those who have experienced drug use or are currently using. Most people do not seek help or treatment when they begin to experience symptoms of these particular illnesses until their experience becomes a serious problem requiring professional help as seen by family members or friends. The different drugs used today seem to equate to different mental health illness’, such as schizophrenia and depression which always been seen to be caused by certain illegal drugs. Much of the understanding in one aspect deals with mental health problems and the influences on people and their usage of drugs, yet this will vary by the kinds of drugs and the influence of acceptance or rejection of the used substances by users. There are long term symptoms and short term symptoms which result in the side effects from the use of illicit drugs as with any medication. Be aware your choice is a part of your health, where you can find a better life with fewer problems without self destruction or hearsay. Written By Donald S.

Cognitive Behaviors Justification

Cognitive Behaviorism is called CBT or Cognitive Behavior Therapy and is a general term for similar therapies which are, Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy and Dialectic Behavior Therapy. Most of these therapies are based on the idea that our thoughts cause our feelings and behaviors and can be changed so that we can feel and become better. Specific ideas are taught during therapy; the client’s goals, what they should tolerate, how to think and behave and how to obtain what they want. Clients are not told what to do, they are taught how to achieve what they wish to obtain.
Cognitive therapy helps reduce severity of distress among psychotic patients | Science Codex "Authors from several UK universities (Birmingham, Glasgow, Cambridge, Manchester and UEA), led by the University of Manchester, set out to determine whether cognitive therapy, combined with monitoring, is effective in preventing the development and worsening of psychotic symptoms which can lead to schizophrenia." Risk factors included having intermittent or very mild symptoms suggesting psychosis, or schizophrenia-like personality problems. Although cognitive therapy is not effective in preventing the development of first episode psychosis for those few that transition, it does significantly reduce the severity, frequency and intensity of psychotic symptoms in this help-seeking population. This leads authors to believe that many patients recover naturalistically, or with minimal intervention. The study also found that the effects of the sessions were greater than originally expected, mainly because they provided regular contact for the patients.
Being diagnosed with a schizoaffective disorder with psychosis, I tend to think that I may have missed out on something which is being researched with the clients in the UK. That is the amount of time that is spent by therapist with these clients being researched to circumnavigate the possibilities of the clients slipping further into the abyss of psychosis and possibly becoming schizophrenic. Yet the time I have spent without supervision has been used in thought concerning how to make changes in my own life, especially the emotional aspects, which causes trouble in my thinking and enacting with other peoples concerned. The idea of the use of medications to curb psychotic episodes or even schizophrenic episodes may be necessary for many who have a lack of control of themselves and to those who work in the mental health field, yet the answer for clients of such illness’ who strive to control themselves’ is to begin to think clearly for themselves with guidance and with a clearer understanding than being medicated and therefore construed in their thinking. I personally do not readily accept what I am taking for a medication, due to the many side effects, yet it does help me to control my reactions to what I observe of life so that I can place situations in a perspective where I can tolerate reality, instead of being seen as rebellious and misconstruing of other people’s ideas and emotions.

Written by Donald Sammons
April 14, 2012

Schizophrenic Recovery

I was doing some reading of articles this week and came across a website with the following article about “Schizophrenia Subtypes.” The author of this article has schizophrenia and writes about different subjects of schizophrenia. It is also a place where you can ask questions or comment on article she has written. This article I am talking about today list the five subtypes of schizophrenia and tells their symptoms. It surprised me to learn that paranoid schizophrenics respond to treatment better and have a better outcome. Of course she also mentioned that with all statistics there are exceptions. I have been thinking why do we do better? As I have mentioned in prior blogs, being ill was hell on earth for me. I never want to go through that again! I was sick in jail since April to November, when they finally took me to the State Hospital. I hardly knew anybody while I was there in jail. I had money while I was there. Although I was too paranoid to spend it, I thought if I signed my name to the papers to buy commissary. They would just steal my name. I was a smoker at that time but I did not buy cigarettes for about six of the months while I was there. That is not the only reason it was so bad. I was not of a sound mind to hold a conversation with nobody. I kept to myself and also my delusions. To have paranoia in jail is hard. I know that is one reason I recovered. I would never want to go through that again. Just having delusions was hard enough if I would have heard voices I do not know how hard that would have been.

Life

It is not too bad living this life. Even when you are having a bad day and life keeps throwing more bad stuff at you. I had one yesterday, I will not go into details of everything that went wrong. It just seemed that I had to work twice as hard to do regular duties. I almost canceled my hair appointment after work. It was too close to the appointment time and I could not do that to my brother. After all he cuts my hair for free. I thought I will go to my appointment, and then go home and relax. I still had bad luck on the bus home. I said maybe I should have just stayed at home today. I went home finally and thought, life is not that bad after all. I have a lot to be thankful for. I do not have bad days that often. In fact this is a first. I probably made it worse by thinking about all day. I have beautiful and good grandchildren. I have a good job. There is a lot to be thankful for when things are going bad. I am a paranoid schizophrenic. I am usually upbeat, so it is hard for me to understand otherwise. That is why I do not understand depression or when others do not bounce back like I do. I always just change my outlook to the better when I feel down. I try to look at how others are affected when the same things happen to them. I know it is hard sometimes, although I feel it cannot be bad forever. There is always tomorrow!