Applications of experimental psychopathology in psychiatric rehabilitation

Persons with schizophrenia show deficits in basic psychological functions such as attention, perception, and cognition. Remediation of these deficits by direct training may facilitate the effectiveness of neuroleptic medications, social skills training, and family therapy. In the vulnerability-stress model of schizophrenia, persons with schizophrenia may have lower thresholds for disorganization that contribute to vulnerability. Stress increases arousal, which brings many competing responses to the same strength, leading to intrusion of inappropriate responses. Interventions that reduce arousal and lower the strengths of competing responses should reduce psychological deficits. Arousal-reducing, attentional, and cognitive interventions are appropriate for the prodromal, acute, and chronic stages of schizophrenic disorders. Laboratory-based assessment and ongoing measurement of basic psychological deficits in schizophrenia are keys to the development and validation of multimodal psychiatric rehabilitation.