schizophrenia; negative symptoms; apathy; anhedonia; psychological intervention; motivation; pleasure; recovery
Favrod Jérôme, Nguyen Alexandra, Frobert Laurent, Pellet Joanie (2017), Anhédonie et psychologie positive, in Santé mentale
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Nguyen Alexandra, Frobert Laurent, Pellet Joanie, Favrod Jérôme (2017), On était scotché de voir leurs capacités, in Santé mentale
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Nguyen Alexandra, Favrod Jérôme, Frobert Laurent, Pellet Joanie (2017), Impact of self-disclosure of professionals on empowerment of patients: a conversational analysis, in Eur Arch Psychiatry Clin Neurosci
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Favrod Jérôme, Nguyen Alexandra, Golay Philippe, Bonsack Charles (2017), Positive emotions program for schizophrenia: a randomized clinical trial, in Eur Arch Psychiatry Clin Neurosci
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Chaix Joséphine, Golay Philippe, Fankhauser Caroline, Nguyen Alexandra, Goodin Diane C., Favrod Jérôme (2017), Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale, in Front Psychol
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Favrod Jérôme, Maire Agnès, Rexhaj Shyhrete, Alexandra Nguyen (2017), Intervenimet për anhedoninë, in Rexhaj Shyhrete, Favrod Jérôme, Maire Agnès, Alexandra Nguyen (ed.), 147-156.
Favrod Jérôme, Nguyen Alexandra, Frobert Laurent, McCluskey Iannis, Fankhauser Caroline, Rexhaj Shyhrete (2016), Programme Emotions positives pour la schizophrénie (PEPS), in Franck Nicolas (ed.), 127-142.
Nguyen Alexandra, Frobert Laurent, McCluskey Iannis, Golay Philippe, Bonsack Charles, Favrod Jérôme (2016), Development of the Positive Emotions Program for Schizophrenia (PEPS): an intervention to improve pleasure and motivation in schizophrenia, in Frontiers in psychiatry
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Nguyen Alexandra, Frobert Laurent, Favrod Jérôme (2016), Schizophrénie : réduire l’anhédonie et l’apathie, in Santé mentale
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Background: The core features of schizophrenia include negative symptoms, which manifest themselves as absences or decreases in normal emotions and behaviors, and positive symptoms, which reflect excesses or distortions of normal functions. Drug-based treatments are highly effective on positive symptoms, such as hallucinations and delusions, but have limited efficacy on negative symptoms. Nonspecific psychosocial treatments have also shown few clinical effects on negative symptoms. Just as the psychosocial treatment of positive symptoms has improved by focusing more closely on delusion or hallucination, perhaps the psychosocial treatment of negative symptoms should also address specific targets. Recent literature has distinguished the negative symptoms associated with a diminished capacity to experience (apathy, anhedonia) from symptoms associated with a limited capacity for expression (emotional blunting, alogia). Anhedonia, which is defined as a reduction in the ability to experience pleasure, and apathy, which is related to a difficulty in anticipating the future, are good candidates for the development of a more specific psychosocial approach. Studies have shown that individuals with schizophrenia experience similar consummatory pleasure to controls, but less anticipatory pleasure. The combination of all these aspects led us to develop an intervention based on training the emotional and cognitive skills specifically needed to increase anticipatory pleasure in patients complaining of anhedonia or a lack of desire to engage in activities. A pilot study for the Positive Emotions Program for Schizophrenia (PEPS) demonstrated the intervention’s feasibility. Preliminary results indicated that participation in PEPS was accompanied by a significant reduction of anhedonia, apathy, and depression in a group of patients diagnosed with schizophrenia or schizoaffective disorders. Aim: Using a randomized clinical trial (RCT), the proposed study will compare the efficacy of using PEPS to reduce symptoms of anhedonia and apathy against treatment as usual (TAU). Methods: Eighty participants diagnosed with a schizophrenia spectrum disorder will undergo one or the other intervention for eight weeks. The study’s main hypothesis is that patients who have attended 8 one-hour sessions of PEPS will have lower total apathy-avolition and anhedonia-asociality scores on the Scale for the Assessment of Negative Symptoms (SANS), in comparison to the control group. The secondary hypotheses are that PEPS will increase patients’ capacity to savor pleasure, anticipatory pleasure, and consummatory pleasure. The study will also monitor the sustainability of PEPS’ potential benefits at a six-month follow-up. The necessary sample size was estimated using the results of the pilot study. Socio-demographic and clinical data will be collected using validated psychometric instruments, as will levels of psychotic symptoms, depression, and ability to savor, anticipate and consummate pleasure. Between-group differences in pre- and post-test values will be examined using an analysis of covariance (ANCOVA) for each outcome variable. Cohen’s d effect sizes will be calculated: between subjects at post-test and follow-up and within-subjects between pre- and post-tests in correcting for dependence among means in order to directly compare the effect sizes from other studies. Expected results and impact: This RCT will test the clinical efficacy and potential sustainability of PEPS. Increasing the ability of individuals with schizophrenia to experience pleasure may have an impact on key elements of their recovery process, such as hope and motivation. The short duration of the training needed for professionals, and brief intervention itself, make PEPS quite easy to implement in a variety environments.