Schizophrenia: Innovations in Diagnosis and Treatment

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Overview

In Schizophrenia: Innovations in Diagnosis and Treatment, Dr. Colin A. Ross - founder of the Colin A. Ross Institute for Psychological Trauma - presents a new theory outlining a previously unknown dissociative subtype of schizophrenia related to psychological trauma that can be treated with psychotherapy as opposed to medication. This book explores his concept, supported by an extensive bibliography, case studies, and numerous tables. This one-of-a-kind volume is a must-read for psychiatrists, psychologists, and other professionals involved in researching or treating schizophrenia. Its comprehensible text makes it useful for people with schizophrenia and their families as well.
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Editorial Reviews

Doody's Review Service
Reviewer: Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description: This book purportedly covers schizophrenia, but it is primarily about the author's proposal to expand the dissociative disorders into the domain of schizophrenia and establish a dissociative subtype of schizophrenia. He makes, what I believe to be, an unsubstantiated claim that 25-40 percent of individuals in treatment for schizophrenia actually have a dissociative disorder. Indeed, patients with so-called dissociative identity (DID) disorder are reported to have Schneiderian first rank symptoms and other psychotic symptomatology, but they also have more of these symptoms than do individuals with schizophrenia; they have more depressive symptoms than do individuals with major depression; they have more manic symptoms than individuals with bipolar disorder; and they have more anxiety symptoms than individuals with anxiety disorders. The problem is that DID does not meet the validity criteria (Robins E, Guze SB Am J Psychiatry. 1970 Jan;126(7):983-7) for psychiatric disorders. Therefore, the "disorder" has no boundaries and could potentially expand to cover every psychiatric disorder. (For further discussion see Multiple Personalities, Multiple Disorders: Psychiatric Classification and Media Influence by North et al. (Oxford University Press, 1993)). The book is written by a well-known author in the field of dissociative disorders. I do not believe this book adds to the psychiatric literature or to our understanding of psychiatric nosology.
Purpose: The purpose of the book, according to the author, is to "attempt to define a subgroup of individuals within the DSM-IV-TR category of schizophrenia who are more likely to respond to psychotherapy, who are more likely to report severe childhood trauma, and who have more extensive comorbidity." (As if psychotherapy has been shown to be an effective treatment for DID.)
Audience: The book is aimed at clinicians and psychiatric researchers. According to the publisher's description of the book "...a must read for psychiatrists, psychologists, and other professionals involved in researching or treating schizophrenia."
Features: The first of the book's five parts covers the author's description of a dissociative subtype of schizophrenia. Part 2 covers psychosis and schizophrenia in reference to definitions, genetics, efficacy of antipsychotics, and psychological trauma as an etiology. Part 3 reviews DID. Part 4 summarizes the author's conception of the overlap between schizophrenia and DID. Part 5 focuses on treatment with chapters on outcome data, principles of psychotherapy for "dissociative schizophrenia," and lastly, a chapter on "talking to voices." There is a bibliography at the back of the book and the index is useful.
Assessment: I certainly believe that patients with DID suffer. It has been known since antiquity that patients with hysteria can have what appears to be epilepsy, paralysis, blindness, and multiple unexplained medical illnesses. They also can have "psychosis." Should we develop a dissociative subtype of epilepsy, stroke, and myocardial infarction?

2 Stars from Doody
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Product Details

  • ISBN-13: 9780789022707
  • Publisher: Taylor & Francis
  • Publication date: 12/28/2004
  • Edition description: New Edition
  • Pages: 318
  • Product dimensions: 5.90 (w) x 8.30 (h) x 0.80 (d)

Table of Contents

Preface
Acknowledgments
A Statement of the Problem

PART I: A DISSOCIATIVE SUBTYPE OF SCHIZOPHRENIA

Chapter 1. Assumptions and Logic Underlying the Dissociative Subtype of
Schizophrenia
A Model of Gene-Environment Interaction
Implications of Monozygotic Twin Data
The Triangle of Recovery

Chapter 2. Characteristics of the Dissociative Subtype of Schizophrenia
The Spectrum from Nondissociative Subtypes of Schizophrenia to Dissociative
Identity Disorder

PART II: PSYCHOSIS AND SCHIZOPHRENIA

Chapter 3. Definitions of Psychosis and Schizophrenia
DSM-IV-TR Definitions of Psychosis
DSM-IV-TR Text and Criteria for Schizophrenia

Chapter 4. The Genetic Model of Schizophrenia
The Genome As a Minor Contributor to the Causes of Schizophrenia
Evidence for the Toxic and Protective Effects of the Psychosocial
Environment

Chapter 5. The Efficacy of Antipsychotic Medication

Chapter 6. Psychosis and Trauma (John Reed and Colin A. Ross)
Childhood Trauma and General Psychopathology
The Base Rate of Child Abuse Among Psychiatric Inpatients
Childhood Trauma and Psychosis
Failure of Most Research on Schizophrenia to Consider Psychological Trauma

PART III: DISSOCIATION AND DISSOCIATIVE IDENTITY DISORDER

Chapter 7. Definition and Scientific Status of Dissociation
Errors of Logic and Scholarship Concerning Dissociation
Diagnosis of Dissociative Identity Disorder
General Errors of Logic and Scholarship

Chapter 8. Dissociation and Trauma
A Continuum of Dissociation Versus Discrete Pathological States
The Trauma-Dissociation Model

Chapter 9. Dissociative Identity Disorder
Reliability and Validity
Etiology
Epidemiology
Phenomenology

PART IV: DISSOCIATIVE IDENTITY DISORDER AND SCHIZOPHRENIA

Chapter 10. Bleuler’s Description of Schizophrenia
Analysis of Bleuler’s 1991 Text on Schizophrenia
The Fundamental Role of Dissociation in Schizophrenia

Chapter 11. Positive Symptoms in Schizophrenia and Dissociative Identity
Disorder
Distinction Between Schizophrenia and DID in the Schizophrenia Literature
Data on the Overlap Between Schizophrenia and DID
A Prospective Study of the Dissociative Subtype of Schizophrenia

Chapter 12. Case Examples of Dissociative Schizophrenia
From August Hoch, MD
From Sheila Cantor, MD
From Patricia J. Ruocchio
From Barbara A. Turner
From Janice C. Jordan
From Leslie Greenblat

Chapter 13. Hysterical and Reactive Psychoses

Chapter 14. Proposed Diagnostic Criteria for Dissociative Schizophrenia
295.40 Dissociative Type
Diagnostic Criteria for 295.40 Dissociative Type

PART V: TREATMENT

Chapter 15. Treatment Outcome Data
Subjects and Treatment Provided
Methodological Limitations of the Study
Limitations of the Literature
Treatment Outcomes

Chapter 16. Principles of Psychotherapy for Dissociative Schizophrenia
Principles of Trauma Therapy

Chapter 17. Talking to the Voices
Bibliography
Index

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