The effectiveness of narrative group therapy on resilience, functional disability and psychological distress of patients with chronic schizophrenia

Document Type : Original Article

Authors

1 MSc in Clinical Psychology, Faculty of Educational Sciences & Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

2 Professor, Department of Psychology, Faculty of Educational Sciences & Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

3 Technical manager of the treatment and rehabilitation center for chronic patients, Dar al-Shifa, Ardabil, Iran.

Abstract

This study aimed to investigate the effectiveness of narrative group therapy on resilience, functional disability, and psychological distress of patients with chronic schizophrenia. The current research method was quasi-experimental with pre-test, post-test, and follow-up with control and experimental groups. The population of the research included men aged 20 to 60 with chronic schizophrenia in Ardabil in 2023 who were hospitalized in treatment and rehabilitation centers for chronic psychotic patients, and their number was estimated to be around 250. Convenience sampling was used due to the impracticality of gathering patients from other centers for group therapy. One treatment and rehabilitation center for chronic patients was selected through this method based on the availability of the required sample size and the level of cooperation. After reviewing the psychological files and considering the inclusion criteria, 30 participants were selected and randomly divided into experimental (n=15) and control (n=15) groups. Both the control and experimental groups answered the Connor-Davidson Resilience Scale, the WHO Disability Assessment Schedule, and the Psychological Distress scale before, after, and one month after the intervention, and their data were compared with the use of descriptive statistics and analysis of variance with repeated measurements analyzed in SPSS22 software platform. The results showed that resilience, functional disability, and psychological distress (anxiety, stress, and depression) have a significant difference from the pre-test stage to the follow-up stage. Therefore, it can be concluded that narrative therapy leads to the improvement of resilience, functional disability, and psychological distress of chronic schizophrenia patients.

Keywords

References

Akhavan Far, M. (2021). Mental disorders, impact of event and psychological well-being based on the source and duration of social media during the corona pandemic. Journal of Research in Psychopathology, 2(5), 21-27. doi:10.22098/jrp.2021.1399
Barbotte, E., Guillemin, F., & Chau, N. (2001). Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature. Bulletin of the World Health Organization, 79(11), 1047-1055.
Basharpoor S, Amani S, Narimani M. The Effectiveness of Narrative Exposure Therapy on Improving Posttraumatic Symptoms and Interpersonal Reactivity in Patients With Cancer. jrehab 2019; 20 (3) :230-241. doi: 10.32598/rj.20.3.230
Bergmann, N., Hahn, E., Hahne, I., Zierhut, M., Ta, T. M. T., Bajbouj, M., Pijnenborg, G. H. M., & Böge, K. (2021). The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders. Front Psychol, 12, 708808. doi:10.3389/fpsyg.2021.708808
Bouvet, C., Naudin, C., & Zajac, J. (2019). The concept of narrative insight in schizophrenia: a systematic review. L'encephale, 45(3), 256-262.
Buckley, P. F., Miller, B. J., Lehrer, D. S., & Castle, D. J. (2009). Psychiatric comorbidities and schizophrenia. Schizophr Bull, 35(2), 383-402. doi:10.1093/schbul/sbn135
Buonocore, M., Bosia, M., Baraldi, M. A., Bechi, M., Spangaro, M., Cocchi, F., Bianchi, L., Guglielmino, C., Mastromatteo, A. R., & Cavallaro, R. (2018). Exploring anxiety in schizophrenia: New light on a hidden figure. Psychiatry Res, 268, 312-316. doi:10.1016/j.psychres.2018.07.039
Chae, Y., & Kim, J. (2015). Case study on narrative therapy for Schizophrenic adolescents. Procedia-Social and Behavioral Sciences, 205, 53-55.
Charlson, F. J., Ferrari, A. J., Santomauro, D. F., Diminic, S., Stockings, E., Scott, J. G., McGrath, J. J., & Whiteford, H. A. (2018). Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull, 44(6), 1195-1203. doi:10.1093/schbul/sby058
Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety, 18(2), 76-82. doi:10.1002/da.10113
Correll, C. U., & Schooler, N. R. (2020). Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatr Dis Treat, 16, 519-534. doi:10.2147/ndt.S225643
Cowan, H. R., Mittal, V. A., & McAdams, D. P. (2021). Narrative identity in the psychosis spectrum: A systematic review and developmental model. Clin Psychol Rev, 88, 102067. doi:10.1016/j.cpr.2021.102067
DeLuca, J. S., Rakhshan Rouhakhtar, P., Klaunig, M. J., Akouri-Shan, L., Jay, S. Y., Todd, T. L., Sarac, C., Andorko, N. D., Herrera, S. N., & Dobbs, M. F. (2022). Psychosis-like experiences and resilience: A systematic and critical review of the literature. Psychological services, 19(S1), 120.
Edwards, C. J., Garety, P., & Hardy, A. (2019). The relationship between depressive symptoms and negative symptoms in people with non-affective psychosis: a meta-analysis. Psychol Med, 49(15), 2486-2498. doi:10.1017/s0033291719002381
Fernandez, K. T. G., Martin, A. T. M. B., & Ledesma, D. A. S. (2023). The Use of Narrative Therapy on Paranoid Schizophrenia. Psychological Studies, 68(3), 273-280.
Galderisi, S., Kaiser, S., Bitter, I., Nordentoft, M., Mucci, A., Sabé, M., Giordano, G. M., Nielsen, M., Glenthøj, L. B., Pezzella, P., Falkai, P., Dollfus, S., & Gaebel, W. (2021). EPA guidance on treatment of negative symptoms in schizophrenia. Eur Psychiatry, 64(1), e21. doi:10.1192/j.eurpsy.2021.13
Ghavami, M., Fatehizadeh, M., Faramarzi, S., & Nouri Emamzadehei, A. (2014). The effectiveness of the narrative therapy on the social anxiety and the self-esteem among the girl students. Journal of school psychology, 3(3), 61-73.
Gürcan, M. B., Yildiz, M., Patir, K., & Demir, Y. (2021). The Effects of Narrative and Movie Therapy on the Theory of Mind and Social Functioning of Patients with Schizophrenia. Noro Psikiyatr Ars, 58(2), 108-114. doi:10.29399/npa.27291
Jafari, F., heydarnia, a., & abbassi, h. (2019). The effectiveness of group narrative therapy on depression in divorced women [Applicable]. Rooyesh-e-Ravanshenasi Journal(RRJ), 8(5), 217-222. http://frooyesh.ir/article-1-942-fa.html
Jauhar, S., Johnstone, M., & McKenna, P. J. (2022). Schizophrenia. Lancet, 399(10323), 473-486. doi:10.1016/s0140-6736(21)01730-x
Kane, J. M., Schooler, N. R., Marcy, P., Correll, C. U., Achtyes, E. D., Gibbons, R. D., & Robinson, D. G. (2020). Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry, 77(12), 1217-1224. doi:10.1001/jamapsychiatry.2020.2076
Karibwende, F., Niyonsenga, J., Nyirinkwaya, S., Hitayezu, I., Sebuhoro, C., Simeon Sebatukura, G., Marie Ntete, J., & Mutabaruka, J. (2022). A randomized controlled trial evaluating the effectiveness of narrative therapy on resilience of orphaned and abandoned children fostered in SOS children's village. Eur J Psychotraumatol, 13(2), 2152111. doi:10.1080/20008066.2022.2152111
Kart, A., Özdel, K., & Türkçapar, M. H. (2021). Cognitive Behavioral Therapy in Treatment of Schizophrenia. Noro Psikiyatr Ars, 58(Suppl 1), S61-s65. doi:10.29399/npa.27418
Krynicki, C. R., Upthegrove, R., Deakin, J. F. W., & Barnes, T. R. E. (2018). The relationship between negative symptoms and depression in schizophrenia: a systematic review. Acta Psychiatr Scand, 137(5), 380-390. doi:10.1111/acps.12873
Llewellyn-Beardsley, J., Rennick-Egglestone, S., Callard, F., Crawford, P., Farkas, M., Hui, A., Manley, D., McGranahan, R., Pollock, K., Ramsay, A., Sælør, K. T., Wright, N., & Slade, M. (2019). Characteristics of mental health recovery narratives: Systematic review and narrative synthesis. PLoS One, 14(3), e0214678. doi:10.1371/journal.pone.0214678
Lopes, R. T., Gonçalves, M. M., Fassnacht, D. B., Machado, P. P., & Sousa, I. (2014). Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy. J Affect Disord, 167, 64-73. doi:10.1016/j.jad.2014.05.042
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther, 33(3), 335-343. doi:10.1016/0005-7967(94)00075-u
Millan, M. J., Andrieux, A., Bartzokis, G., Cadenhead, K., Dazzan, P., Fusar-Poli, P., Gallinat, J., Giedd, J., Grayson, D. R., Heinrichs, M., Kahn, R., Krebs, M. O., Leboyer, M., Lewis, D., Marin, O., Marin, P., Meyer-Lindenberg, A., McGorry, P., McGuire, P., . . . Weinberger, D. (2016). Altering the course of schizophrenia: progress and perspectives. Nat Rev Drug Discov, 15(7), 485-515. doi:10.1038/nrd.2016.28
Mizuno, Y., Hofer, A., Suzuki, T., Frajo-Apor, B., Wartelsteiner, F., Kemmler, G., Saruta, J., Tsukinoki, K., Mimura, M., Fleischhacker, W. W., & Uchida, H. (2016). Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study. Schizophr Res, 175(1-3), 148-153. doi:10.1016/j.schres.2016.04.047
Moritz, S., Schmidt, S. J., Lüdtke, T., Braunschneider, L. E., Manske, A., Schneider, B. C., & Veckstenstedt, R. (2019). Post-psychotic depression: Paranoia and the damage done. Schizophr Res, 211, 79-85. doi:10.1016/j.schres.2019.06.022
Mosolov, S. N., & Yaltonskaya, P. A. (2021). Primary and Secondary Negative Symptoms in Schizophrenia. Front Psychiatry, 12, 766692. doi:10.3389/fpsyt.2021.766692
Naziri, G., Ghaderi, Z., & Zare, F. (2011). The effectiveness of narrative therapy on depression in women Marvdasht city in 2009 year. Socio Women (Women Socio), 1, 65-78.
Oud, M. J., & Meyboom-de Jong, B. (2009). Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care. BMC Fam Pract, 10, 32. doi:10.1186/1471-2296-10-32
Percudani, M. E., Iardino, R., Porcellana, M., Lisoni, J., Brogonzoli, L., Barlati, S., & Vita, A. (2023). The Patient Journey of Schizophrenia in Mental Health Services: Results from a Co-Designed Survey by Clinicians, Expert Patients and Caregivers. Brain Sci, 13(5). doi:10.3390/brainsci13050822
Rezapour-Mirsaleh, Y., Talebiyan, E., Azizpour, s., & Hatamian, F. (2023). The effectiveness of Rogers's client-centered therapy on resilience and hope of women who committed suicide. Journal of Research in Psychopathology, 4(14), 37-45. doi:10.22098/jrp.2023.13098.1180
Rosenberg, A. R. (2020). Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic. JAMA Pediatr, 174(9), 817-818. doi:10.1001/jamapediatrics.2020.1436
Salehi, R., Shakhi, K., & Khiavi, F. F. (2016). Association between disability and quality of life in multiple sclerosis patients in Ahvaz, Iran. Materia socio-medica, 28(3), 215.
Shakeri, J., Ahmadi, S. M., Maleki, F., Hesami, M. R., Parsa Moghadam, A., Ahmadzade, A., Shirzadi, M., & Elahi, A. (2020). Effectiveness of Group Narrative Therapy on Depression, Quality of Life, and Anxiety in People with Amphetamine Addiction: A Randomized Clinical Trial. Iran J Med Sci, 45(2), 91-99. doi:10.30476/ijms.2019.45829
Shamsi, S., Lau, A., Lencz, T., Burdick, K. E., DeRosse, P., Brenner, R., Lindenmayer, J. P., & Malhotra, A. K. (2011). Cognitive and symptomatic predictors of functional disability in schizophrenia. Schizophr Res, 126(1-3), 257-264. doi:10.1016/j.schres.2010.08.007
Sharma, M., Nischal, A., Nischal, A., Agarwal, M., Gupta, B., Kar, S. K., & Pahuja, E. (2020). Disability in clinically stable patients of schizophrenia. Ind Psychiatry J, 29(1), 61-67. doi:10.4103/ipj.ipj_82_20
Shinjo, D., Tachimori, H., Sakurai, K., Ohnuma, T., Fujimori, K., & Fushimi, K. (2017). Factors affecting prolonged length of stay in psychiatric patients in Japan: A retrospective observational study. Psychiatry Clin Neurosci, 71(8), 542-553.doi:10.1111/pcn.12521
Stainton, A., Chisholm, K., Kaiser, N., Rosen, M., Upthegrove, R., Ruhrmann, S., & Wood, S. J. (2019). Resilience as a multimodal dynamic process. Early Interv Psychiatry, 13(4), 725-732. doi:10.1111/eip.12726
Sugawara, H., & Mori, C. (2018). The self-concept of person with chronic schizophrenia in Japan. Neuropsychopharmacol Rep, 38(3), 124-132. doi:10.1002/npr2.12016
Ungar, M., & Theron, L. (2020). Resilience and mental health: how multisystemic processes contribute to positive outcomes. Lancet Psychiatry, 7(5), 441-448. doi:10.1016/s2215-0366(19)30434-1
Upthegrove, R., Marwaha, S., & Birchwood, M. (2017). Depression and Schizophrenia: Cause, Consequence, or Trans-diagnostic Issue? Schizophr Bull, 43(2), 240-244. doi:10.1093/schbul/sbw097
Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry, 72(4), 334-341. doi:10.1001/jamapsychiatry.2014.2502
Wambua, G. N., Kilian, S., Ntlantsana, V., & Chiliza, B. (2020). The association between resilience and psychosocial functioning in schizophrenia: A systematic review and meta-analysis. Psychiatry Res, 293, 113374. doi:10.1016/j.psychres.2020.113374
WHO. (2008, 2012). The Global Burden of Disease. https://www.who.int/publications-detail-redirect/9789241563710
Xie, M., Zou, X., Xie, Y., Hu, L., Tang, Y., Cai, J., Kuang, Y., Zhu, L., Zou, M., & Wang, Q. (2023). Childhood trauma and suicide risk in hospitalized patients with schizophrenia: the sequential mediating roles of pandemic related post-traumatic stress symptoms, sleep quality, and psychological distress. Front Psychiatry, 14, 1221529. doi:10.3389/fpsyt.2023.1221529
Zadeh-Mohammadi, A., Abedi, A., & Moradi-Panah, F. (2013). Group narrative therapy on self-esteem and self-efficacy of male orphan adolescents. Practice in Clinical Psychology, 1(1), 55-60

Files

Share

How to cite

Statistics