Abstracts
Résumé
Les approches classiques de traitement des personnes présentant une schizophrénie s’accordent pour reconnaître que réussir à soigner cette condition requiert davantage qu’une simple réduction de fréquence, d’intensité et de durée des symptômes positifs tels que des hallucinations. En fait, une approche plus complète, dont le but est de réduire l’incapacité s’avère indiquée dans la plupart des cas (Silverstein et al., 2000). Il a été récemment proposé que les nouvelles approches en réhabilitation cognitive de la schizophrénie requièrent la reconnaissance de l’importance de 1) systématiquement aborder la motivation, l’estime de soi, et les facteurs affectifs au moment de concevoir des interventions qui augmentent la cognition ; 2) la nécessité d’aller au-delà des interventions « à taille unique » et de développer des traitements spécifiques à l’individu ; 3) la nécessité d’aborder les anomalies de l’expérience du soi lors de la conception même des interventions d’optimisation des accomplissements cognitifs et comportementaux. L’étude de cas présentée ci-dessous est un exemple d’une approche de la réhabilitation cognitive de la schizophrénie qui tente de promouvoir le processus d’intégration de soi par le recours à une gamme d’interventions spécifiques, en relation avec les trois caractéristiques notées plus haut. Les résultats préliminaires suggèrent que cette approche pourrait être grandement profitable aux patients souffrant de schizophrénie.
Abstract
Classical approaches of treatment of people with schizophrenia recognize that successful treatment of this illness requires more than simply reducing the frequency, intensity and duration of positive symptoms such as hallucinations. In fact, a more comprehensive approach aimed at reducing disability is indicated in most cases (Silverstein et al., 2000). It has recently been proposed that new approaches to the cognitive rehabilitation of schizophrenia need to recognize the importance of 1) systematically addressing motivation, self-esteem, and affective factors when designing cognition enhancing interventions ; 2) the need to move beyond one-size-fits-all interventions and develop individual-specific treatments ; and 3) the need to address abnormalities in the experience of the self when designing interventions to optimize cognitive and behavioural performance. The case study presented here is an example of a cognitive rehabilitation approach of schizophrenia that attempts to promote the self integration process by means of a range of specific interventions and addresses three issues noted above. Preliminary results suggest that it could be very beneficial for patients suffering of schizophrenia.
Resumen
Los enfoques clásicos de tratamiento de las personas que presentan esquizofrenia reconocen que tener éxito en sanar esta condición requiere más que una simple reducción de la frecuencia, intensidad y duración de los síntomas positivos como las alucinaciones. De hecho, un enfoque más completo, cuyo objetivo es reducir la incapacidad, se revela como indicado en la mayoría de los casos (Silverstein et al., 2000). Recientemente se ha propuesto que los nuevos enfoques en la rehabilitación cognitiva de la esquizofrenia requieren reconocer la importancia de 1) abordar sistemáticamente la motivación, la estima de sí mismo y los factores afectivos en el momento de concebir las intervenciones que aumentan la cognición; 2) la necesidad de ir más allá de las intervenciones “de talla única” y de desarrollar los tratamientos específicos para el individuo; 3) la necesidad de abordar las anomalías de la experiencia de sí mismo, en el momento de la concepción misma de las intervenciones de optimización de los logros cognitivos y comportamentales. El estudio de caso presentado a continuación es un ejemplo de un enfoque de rehabilitación cognitiva de la esquizofrenia, que intenta promover el proceso de integración de sí mismo por medio de una gama de intervenciones específicas, en relación con las tres características arriba señaladas. Los resultados preliminares sugieren que este enfoque podría ser de gran provecho para los pacientes que sufren de esquizofrenia.
Resumo
As abordagens clássicas de tratamento das pessoas que apresentam uma esquizofrenia reconhecem que conseguir curar este estado requer mais do que uma simples redução de freqüência, de intensidade e de duração dos sintomas positivos, como as alucinações. De fato, uma abordagem mais completa, cujo objetivo é reduzir a incapacidade, é indicada na maioria dos casos (Silverstein et al., 2000). Foi proposto, recentemente, que as novas abordagens em reabilitação cognitiva da esquizofrenia requeiram o reconhecimento da importância 1) de abordar sistematicamente a motivação, a estima de si e os fatores afetivos no momento de conceber intervenções que aumentem a cognição; 2) da necessidade de ir além das intervenções “de tamanho único” e de desenvolver tratamentos personalizados; 3) da necessidade de abordar as anomalias da experiência do “eu”, na concepção mesmo das intervenções de otimização das realizações cognitivas e comportamentais. O estudo de caso apresentado abaixo é um exemplo de uma abordagem da reabilitação cognitiva da esquizofrenia, que tenta promover o processo de integração de si pelo recurso a uma gama de intervenções específicas, em relação às três características anotadas acima. Os resultados preliminares sugerem que esta abordagem poderia ser muito benéfica para os pacientes que sofrem de esquizofrenia.
Appendices
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