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Applied Research II 1 Running head: RESEARCH PROPOSAL Chapter One Komal Patel University of the Sciences in Philadelphia Applied Research II 2 Chapter 1 Statement of the problem Schizophrenia is a severe, chronic mental disorder that affects about 1.1% of Americans over the age of 18 in a given year. Both men and women are affected equally in all ethnic groups (National Institute of Mental health, 2007). The cause of this disorder is unknown; however genetics seems to play a role. Psychological and social factors may also play a role; researchers believe that events in a person’s life may trigger schizophrenia (Ballas, 2006). Schizophrenia has three major categories of symptoms, positive, negative and cognitive symptoms. Positive symptoms include hallucinations, delusions, thought disorder and disorder of movements. These symptoms are usually easy to notice and are not always present. Negative symptoms are a decrease in emotions and behavioral states. They include flat affects, lack of pleasure in everyday life and a decrease in the ability to initiate plans. Negative symptoms are harder to recognize. Cognitive symptoms include inability to sustain attention, poor decision making and memory problems. These symptoms are subtle and usually recognized through tests (National Institute of Mental health, 2007). Many approaches are available for treating the symptoms of schizophrenia; however, it is difficult to say which is most effective. Two popular forms of therapy are cognitive behavioral therapy and pharmacotherapy. Cognitive behavioral therapy (CBT) is based on the idea that thoughts control a person’s feelings and behaviors. “The cognitive therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to "not listen" to their voices, and how to shake off the apathy that often immobilizes them (National Institute of Mental health, 2007).” “CBT has been shown to produce large clinical effects Applied Research II 3 on measures of positive and negative symptoms of schizophrenia (Rector & Beck, 2001).” Pharmacotherapy is the use of medications such as risperidone, olanzapine, quietiapine, sertindole, ziprasidone and other antipsychotic drugs to control symptoms of the disorder (National Institute of Mental health, 2007). “Antipsychotic or neuroleptic medications work by changing the balances of chemicals in the brain and are used to control the symptoms of the illness. These medications are effective, but are also associated with side effects that may discourage a patient from taking them regularly (Ballas, 2006).” Pharmacotherapy does not cure schizophrenia however it allows persons with the disorder to live a some what normal life by alleviating some of the symptoms (National Institute of Mental health, 2007). The study proposed is designed to determine which form of treatment, cognitive behavioral therapy or pharmacotherapy, produces better results. This study will investigate how these forms of treatment are administered. Both the short term and long term effects will be looked at in determining effectiveness. The information gathered from this study will be beneficial for both persons with schizophrenia and those treating them. Purpose The primary purpose of this study is to determine whether cognitive behavioral therapy or pharmacotherapy is more effective in the treatment of persons with schizophrenia. Applied Research II 4 Research Question The proposed study is designed to answer the following question. Is cognitive behavioral therapy more effective than pharmacotherapy in treating persons with schizophrenia? Applied Research II 5 Reference: Ballas, P. (2006). Medline Plus: Schizophrenia. Retrieved on February 8, 2008 from http://www.nlm.nih.gov/medlineplus/ency/article/000928.htm Miyamoto, S., Duncan, G.E., Marx, C.E. & Lieberman, J.A. (2005). Treatments for schizophrenia: a critical review of pharmacology and mechanisms of action of antipsychotic drugs. Molecular Psychiatry. 10, 79-104. National Institute of Mental Health. (2007). Schizophrenia. Retrieved on February 8, 2008 from http://www.nimh.nih.gov/health/publications/schizophrenia/complete- publication.shtml Rector, N.A. & Beck, A.T. (2001). Cognitive behavioral therapy for schizophrenia: an empirical review. J Nerv Ment Dis. 189(5), 278-287. Sensky, T., Turkington, D., Kingson, D., Scott, J.L., Scott, J., Siddle, R., O’Carroll, M. & Barnes, T. (2000). A randomized controlled trial of cognitive - behavioral therapy for persistent symptoms of schizophrenia resistant to mediation. Arch Gen Psychiatry. 57(2). Turkington, D., Kingdon, D. & Weiden, J. (2006). Cognitive behavior therapy for schizophrenia. Am. J. Psychiatry. 163, 365-373.
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