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Reducing delusional speech in chronic, paranoid schizophrenics.

R P Liberman1, J Teigen, R Patterson

  • 1Center for The Study of Behavioral Disorders.

Journal of Applied Behavior Analysis
|April 1, 1973
PubMed
Summary

Social reinforcement significantly increased rational talk in schizophrenic patients with delusions. Terminating interviews and rewarding rational speech proved effective, with lasting results in most participants.

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Area of Science:

  • Psychiatry
  • Behavioral Psychology

Background:

  • Schizophrenia is a chronic mental disorder often characterized by delusions.
  • Long-term hospitalization is common for patients with persistent paranoid and grandiose delusions.

Purpose of the Study:

  • To investigate the effectiveness of social reinforcement contingencies in modifying delusional talk in hospitalized schizophrenic patients.
  • To assess the impact of contingent reinforcement on the duration and frequency of rational speech.

Main Methods:

  • A multiple baseline design was employed with four long-term hospitalized schizophrenic patients.
  • Intervention involved terminating interviews upon delusional talk and rewarding rational speech with extended social interaction.
  • Rational talk duration during daily interviews was the primary outcome measure.

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Main Results:

  • A 200-600% increase in rational talk was observed across patients following intervention.
  • Treatment gains were maintained in three patients even with reduced reinforcement.
  • Direct confrontation of delusional ideas led to a decline in rational talk.

Conclusions:

  • Social reinforcement contingencies are a viable method for increasing rational communication in schizophrenic patients with delusions.
  • The study highlights the potential of behavioral interventions in managing persistent psychotic symptoms.
  • Generalization of improved communication was limited to specific social contexts.