Slade P, Bentall R
Department of Psychiatry, Liverpool University.
Br J Psychiatry Suppl. 1989 Nov(7):133-5.
Psychological training programmes for patients presenting with negative symptoms have developed from an environmentally based approach (the token economy) through interactive programmes (social and life skills training) to programmes which focus directly on facilitating and enhancing the cognitive skills of the individual patient (self-instructional training and problem-solving). It is clear that this sequence of research has generated a range of approaches which are probably undervalued in the management of patients suffering from negative symptoms. Problems remain with respect to the generalisation of some procedures but it seems likely that these problems may be overcome by tailoring treatments to the particular cognitive deficits of different groups of patients. This will obviously require a detailed analysis of the structure of negative symptoms and the deficits associated with them. The distinction between difficulties in initiating behavior and difficulties in organising behaviour may prove to be particularly important in this respect.
针对存在阴性症状的患者的心理训练项目，已从基于环境的方法（代币经济）发展到互动项目（社交和生活技能训练），再到直接专注于促进和提高个体患者认知技能的项目（自我指导训练和问题解决）。显然，这一系列研究产生了一系列方法，而这些方法在阴性症状患者的管理中可能未得到充分重视。一些程序的推广仍存在问题，但通过根据不同患者群体的特定认知缺陷量身定制治疗方案，这些问题似乎有可能得到克服。这显然需要对阴性症状的结构及其相关缺陷进行详细分析。在这方面，启动行为困难和组织行为困难之间的区别可能尤为重要。
