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Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms

Lincoln, Tania M
Riehle, Marcel
Pillny, Matthias
Helbig-Lang, Sylvia
Fladung, Anne-Katharina
Hartmann-Riemer, Matthias
Published in Frontiers in Psychology. 2017, vol. 8, p. 2108
Abstract Although numerous interventions are available for negative symptoms, outcomes have been unsatisfactory with pharmacological and psychological interventions producing changes of only limited clinical significance. Here, we argue that because negative symptoms occur as a complex syndrome caused and maintained by numerous factors that vary between individuals they are unlikely to be treated effectively by the present "one size fits all" approaches. Instead, a well-founded selection of those interventions relevant to each individual is needed to optimize both the efficiency and the efficacy of existing approaches. The concept of functional analysis (FA) can be used to structure existing knowledge so that it can guide individualized treatment planning. FA is based on stimulus-response learning mechanisms taking into account the characteristics of the organism that contribute to the responses, their consequences and the contingency with which consequences are tied to the response. FA can thus be flexibly applied to the level of individual patients to understand the factors causing and maintaining negative symptoms and derive suitable interventions. In this article we will briefly introduce the concept of FA and demonstrate-exemplarily-how known psychological and biological correlates of negative symptoms can be incorporated into its framework. We then outline the framework's implications for individual assessment and treatment. Following the logic of FA, we argue that a detailed assessment is needed to identify the key factors causing or maintaining negative symptoms for each individual patient. Interventions can then be selected according to their likelihood of changing these key factors and need to take interactions between different factors into account. Supplementary case vignettes exemplify the usefulness of functional analysis for individual treatment planning. Finally, we discuss and point to avenues for future research guided by this model.
PMID: 29259567
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Article (Published version) (598 Kb) - public document Free access
Research group Psychopathologie clinique et expérimentale (987)
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LINCOLN, Tania M et al. Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms. In: Frontiers in Psychology, 2017, vol. 8, p. 2108. https://archive-ouverte.unige.ch/unige:111187

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Deposited on : 2018-11-21

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