Results from our ongoing research program, together with a growing literature in clinical therapeutics, environmental and cognitive psychology, as well as psychobiology, have provided an empirical foundation which supports the hypothesis that there are distinct schizophrenic subtypes... with presumably different pathophysiologies... which require specific treatment interventions! Utilizing a group of trained, experienced and motivated clinical researchers who have functioned together as a team for the past six years, we propose to: 1) Refine and test new interventions thought to be relevant for operationally defined, diverse, high risk groups of schizophrenic patients identified in the current study of Environmental-Personal Treatment Indicators. Available data suggest that the course of schizophrenic subtypes is influenced by psychophysiologic and environmental processes which are mediated by the sex and age of the patient. Instrumental Role Therapy, a behavioral/educational intervention is proposed for cognitively vulnerable, multi-episode, primarily male, younger but typical schizophrenic patients who appear sensitive to criticism. In contrast, Expressive Role Therapy, an interpersonal/supportive intervention is proposed for affectively vulnerable, multi-episode, primarily female, older but atypical schizophrenic patients who appear sensitive to disregulation secondary to conflicted interpersonal relationships. Both treatments will be administered in the context of Family Therapy and Maintenance Chemotherapy; 2) Fully analyze and publish results from our continuing studies, one of the more extensive programs of clinical research in the aftercare treatment of schizophrenia.
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