Tov€er Nasr

Psychoeducation of&e Familie3 ofP.ti.otr with 

Schizopbrcaia in Rolldio to Rd.aplo Ptrv.atid 

Tov€er Nasr 

UniveBity of tho Punjab, 

I"rhoE, Patilh- 

2008

olrr|!tg-ll 

Itit qti6diL! MrTer'caNrrbiqldud.ry ry.wiirl E &Ed@oo 

?rr!t .itldardt bl!.oalaid$mrf&.Fdtirrl&rbdrF 

Fri,rddt r!dgnd6.dd-oi!irF-t@,-bd4ft Fli.l 

tu|flt!.d tu Do...cd. ofPtih.d. 

Pifr-.D. RdddXrE 

Dead of @b$r rd AdLdPqrt loAt 

tftr,rrdriofe lrnj$' trb.c P.brn

DET'ICATBD IO 

My frrt* sto ir Fr nt 6i. w.dd mP 

Il's ![ bc.e ofhn sbt I D b&y.

Psychoeducadon of the Fanilics ofPatienis with 

Schizoohrcnia iD Relation to RclaDsc Prevention 

A thesis submitted to 

Univcrsity oflhc Punjab, Lahore, 

lD partial fulfillmcr oflhe rcquirEmcnb for the 

degree ofDoctorate of Philosophy 

Trrveet N,ut 

Departrnent of Psycholos' and Appli€d Psycholos/ 

Univcrsity of thc Punjab, 

Lahore, Pakistan, 

2008

A.krowl.dg.rn$ 

Fi6t ol oll I u lhdrtful lo alniSbty Allab witn hb grtc. I hdve bed .bl. to mmplele 

I d v6y er:i.tu| 

c@peralion vahlbl. 6uggpsnoB and 8!id!trc.. 

io ny $4dvis.r Pbf@r Dr. Rul,hau K|w fd hd tind 

withoul hq help il w6 nol po$ible io rcconplish lhis work 

I N51 aFPBisl€ hd eliring .tfonr 

My +eial thsk3 ec du. to vie Checellor Ulivasly ol d. Pujtb ttol€sr 

Dr Mujbaid (,m fd f&itilrling lbe tm* of thi. s*, I suld als liL lo lhel 

th. Chaitp@ DPCC Pbf6$t Dr Shali.b Hl|lsir for being @opdtiv. ova lhc 

Than*s e aho du. !o d. cnan p€Mn ofpsrcholoSy md AFpli.d P3tcholocy, 

a Ch.ilFen DPC Poa.$r Dr NiE Najd for ll!@ spPort.nd @F!ti@ 

I u gdefin !o rh. .6don$ rt vrios hosPihts who .llow€d th.n piIidl! io 

tlke p.n in tlis Fledcb Bp@illly th€ Ntnorili.s !t Malo hosPrtrl who al$ Povided 

mc logidic n b b f&iln.r. dr€ 0rdrp@tic wo*. I wolld lite 10 lhot aU ltr. p.ticnt 

and olcir rclativ* wbo 8dftuly 

ard tircl*ly @p.tslcd fd sn IMtu, Th&t! to 

Dr, In@ lju md Dr. Ar6l$d Siddique for Ffding p.ti@ts &d fcilit tine thc pDcd 

of dar. colletior I pay my 0u*! to Dr. Atlb Aws ed Dr. Fmoq N@n for lh.ir 

suppon dd iLlluble advb. $reugho'rt ny Fsch wo*, 

My d..! gEdnrdc e dlc !o PDf@r LA K,T'tm &d K.l T.l@ fd .Uqiog &cs 

10 lhcn Fen l libnry .nd lo 6suh vllurbl.joudb. 

My spoid ltmli rc du to ny frisd N6hi Khm fd !d iffiF hclt ed 

suppon at diilerdt srdgps of thi! wort' Tn4k6 de ds to ny lii4dr Mohlin! Miu,

Nsin H!bi\ .nd M!l@n Aln d for th.n q4Dort I d dlo th.rtfrrl io ny 

@Uogu. Mis M!j..br &nd.!d Sobi. Qds for Udr h.lD i! Ii!.r.trc eeh. A 

Eqrcrdou @u,r of aditu

Ll llted@iio.................... 

L2 Sis!. ud SyqtoB of S.hiroptMn 

1.3 

t.a 

t,6 

1.2.1 PditiEStd o@......... 

1,2.2 Ncgniv. Syqtod,.,...., 

12.3 Diusrlizd Dimi@... 

Sub-tF of S.hiaPtlEi........ 

Eriobidr F.dd........... .. .... 

Itrp..r of lbd o! P.d6r....... 

Co@ .rd Oucodc of S.hi@hMi. 

lJ RcLF...,.,..,.,.,..........,.,....,.......................................,,,... 2. 

1.7.t f.rocof R!Lp...,.,.,,.,. 

vii 

1.7.2 llport e ofRdadc Prlr6lid 2E 

ll 

l3 

20 

2, 

25

ct.lrdNo 2 

vni 

1.8 Fdily r6d ScliaptMir...,,.,.,,...............,..,.,.,,.,.,..,..,..,., 30 

1.8.1 ltc.fratof Fhilyon&biaplMn...................... 3l 

1,8: IqaarofMcnLliUD..edFdi1i6,,,.,.,.,,.,..,..,... 34 

l J ldily PrJrho.dnrid..,,, 

l.8zl Pui|yButh.......,...,,.,,.,.,..............-. 39 

1,8.2.2 ldily&dTBtb.nr.....,,.,,,,,,,,,,,....,.,,...., 43 

1.9,1 P.)rto€drElid.,,.,....... 

1.9.2 Modeb of P3rtho.dE.riotr 

1.9,3 Otiedic of P!)aho.delir 

LI0 rurifqti@ of thc Std,,,, 

1.10.1 ObjFliv6 oflh. St'rdy... 

1.102 llrpolha6...-....,,.,...., 

2.2,1 P3lcho€d@rior Dd R.l+i. PEtdioo,,,,.,,,,,,., 6l 

4 

17 

49 

5l 

54 

51 

57

222 P.]rch..durri6.d TiqmtadlE4e E5 

zl Erliw.d Edtid.!d Co@ of llllB 

2.3,1 rly.bo.tu rdoo, ErFd.d B@t@.!d RelS6...-. 

2.4 scbaphMi.a&|FdilyBudm............ . . ..................-- ll3 

2,4.1 PrrhoduslidlndFhilyButd6....,.,......-....... 124 

M.ltodo|ogr.........,.,.,..,.,....,,.,,.,.,..,..,,,...,..,...............-...... 116 

3.1 Dai88ofR.ta.b............-.....,.,,.,..,.,.,.,,.,.,....-.-..........-. l3? 

3, Sql..-.......,.,.........,.,,....,.........,...,..,.,.,,.,....,....,..,..,., 13? 

3J A.s6!FtMq!6.,..,.,..,..,.,..,.,.,................................. l{! 

3A 

t.5 

rltlhocdqtiodrl Inl.dod06.,.,.,,.,,,..,.,.,.,..,.................... 146 

?rc.€dw,,,,.,,.,.,.,,,,.,,,,,,..,,,,,,.,,.,.,.,.,...............,...-....---. 152 

SufiDry,.,,.,,,,.,..,,,,,,,,.,..,,,.,,,,,.,.,..,.,.,.,..,.,.,....-....-........... 15? 

4,1 Srdisricr|^rdyrir,,,.,.,,.,.,,.,,.,.,..,.,.,....-...--.-....-....-..-.-.... lJ8 

9A 

l03 

lt5

4,1.1 U!6s Elsrld C!..rcldini 160 

1,12 PE n .darioo, Rde. R.t , od Stqtoii Sd6ty 162 

4.!3 Pqd..dqli@dS@iiF@li6i!9......-.......- 166 

4,1,4 tuy.ho.d!.tid&d F@nyBudd,.,.,...,,.,..,..,.,. l7l 

4.1.5 SuMroftb.Finding'................................ 181 

5,1 Pi}llbduc.tid ald RGlrp€! Rrt .,.,,...,.,.,,.,....,.,.,,.,.,..,..-. 183 

5, fttcto.dE tco dd Sy4oo SlEily ............,.,.,..,.,,.,.,.,. 185 

5.1 

5.4 

5.5 

foilyBuda&dPljrt.ds!io!........-.........,......,.......... 1E? 

Rromlrd.iiou,.,,,..,.,,,,.,,,,,,,.,..,.,.,.,..,.,.,,.,,,..,,,.,,.,..,.. 191 

Clioicd iqlicJi@,.,.,..,..,.,.,,.,.,....-.-...........,,.,.,..,.,,.,,. 191 

5,6 

LiDi..ti@&dosclddfdfrds1*{![..................... 195 

5,7 Ctrlui@,.,,,,.,. , ,,,,.,,.,,,,,,,.,.,.,,..................,...,,,..,.... 196

IJST OT TADLES 

3.1 D€mg.pbi. ch@tqistG of lh. p.tdis, 141 

3,2 Dcrcgrcphic ch@.ltristi€ of fmily n@b6. 143 

4.f llh6 cl.red cb.fu@i.tica. 162 

4.2 MulliEiare aDbsis of @vsi!@ of p6l irlavc iotr fdily 164 

4,1 Mch cfidt dd int@tiv. lfct of palid gadd ldFrtno 165 

cdualion on post-intmtion ryrPtotr 

4.4 Dilteroe! in two partrcip&t erolps on Pct inietr@tid 161 

rlmplo@ (PANSS) 

4,5 stnptoo wdity alpe.rd F.t s..!lM1in Fsy.ho edErion 168 

4,6 Sybplom waity !t F!.!d Fst |!gmt in @! Fycho 

.dE.tion so'D (F50) 

4.? Cotrpeison of t*o paniciper gr.!F on &cid nrotio.irg l?0 

v&iibl6 (pe-i.twsti@) 

4,8 Conpdsr of two parliciptul 8bup6 on locial tunctioaing 170 

vai.blq (Fst-interventior) 

4,9 Coo}ti$r of two pdticipet gFrpt on m* natu! (!E 1?l 

4.10 Coqriloooft*op.nicipdrtero'D.onm*iabs(F61 171 

4.ll Mullivdidc elb6is of@vdim. of post iot w@lion faDny 173 

169

4.12 M.i!€ff€t&dbterctiv..trotofp.fho!d&.ti@aldpdial 174 

gada @ fdily hrd6 (pod i!tdv@li@) 

413 coqdi@ of Flicip.lt i! t*! gFr+. @ ttsily tudd (pr 178 

414 C.@.rieofFdricipoaillsgow.onhilyhlih(lo6t 178 

4,15 Conpdi@off@ilyhldartF..ldlNtilid.,nidlml 179 

63y.ho!drati@ 8Mq, n=49) 

4.16 CoEld@ of fdily buda d pc ud port iltdoii@ lw.l 180 

(D! F}ltoduc.lim erorp, !-50)

Fom of DSM MR 6i1qiotr 

LIST Of APPENDD'ES 

D.!DCr@hi. infomltid qudioMiE 

Lmi$id !.tr6 for PANSS 

PANSS S.ale 

TEininC Cenirrcare for PANSS 

Ihily Burda lrt rvi* Schcdul. 

Fmily Buden Scnedul. (Urd!) 

Pmisior leftd for Fmily Burda 5ol. 

Prtdo.deatioa B@kld (Urd!) 

D.@g4hi. dd .linicll v&i!bl6 s p.Gdicto6 of faDny 

budc4 o'ted vdrbb nMcin O|!{ffiI 

to&l 

DotuCEphic ud oliniql vuilbld a prdidob of family 

burdcA olt oft ldiable Routinc (pFssc@@t, lotd .mtle) 

xiii 

247 

250 

E2 

253 

258 

259 

261 

262 

269 

279 

29n 

281 

282 

28t 

284 

245

Appordir-K-ii D@snplic.ld clinic.l vdi.bld s Fldiclon orfrnily 2E6 

bordq! odcoe vei$lct i@ (r.+|!5.{M1,lolrl s.ql.) 

Appadir-K-iii Ddegnphic.ld clinic.l vunb|6 a Fdicton off.Fily 2a7 

badal od.oe lairbb roldtim (Fqrl$|@l, iold 

$plc) 

App6dix-K-iii Dobgnp[tc.ld clini.d vsi|bld aF.dictdr offrnily zEE 

^!?ddn-K-v 

bultLll o{&om vd.bl. Plyricrl hattb (Dc.!t6.|@! tord 

s4l.) 

DqFs.qnjc.ldclili..1wi.U6lFldi.toaofftoily 2a9 

buda\ ouEor vriiblc P.rholosicd hal6 (tF!'6.t6! 

tool $npl.) 

App.idn-L DaDgnphic ld.liuical !{iau6 r pFdiclod of faily 290 

bu.dq! olr.om Ei.bl. Fin@id (pod .lldffiq 

FFHF.lbn u.l @ p.y.boda{i@ Eoup .?.r.lcly) 

App.dn-Li DsDgtrtbic rd clilicd vribL. ! F.di.ro6 ofnnily 2tl 

budlr, ou.oD Enbb Rouda (po.r .tldtmq 

p.rrlb.dqdd .!d M p.r.bodBlri@ goA). 

App.ltdir-Lii Dcmgnpeic.ld clinicd vd.Dl6.. FldictoD offrtrily 292 

hld.rq o|lcotuvdru.t i!w(F.t.a€!|Mt, 

p.y.lodulid ud @ Fy.ho.dF|ti@ 8Frp) 

APpodir-Liii D.lFsnp[ic aad curic.l vailbld ! Fdicb6 off.mily 293 

buiLa our@d vrirbl. bl.&lion G.Et rlgrsl 

p.y.!o.du!rid od @ p.Jeho.dud@ 8F p)

Alpor.tr-Liv lr@9.+licDdcliric.lwi.blc.rFldi.r.r.oftuify D4 

hd-, o|lmwi.I'b ltlrical hl|i (!d.r6.d, 

FFb.cd!.dir d m FrliGldo totD) 

Atpddn-Lv Ddo8.+licddclio&.lyri&L.rFdi.idoftuify 2t5 

hrd.4ord@Gwi.lLP.ypholoSic.llalll(!ort-!6d!.d, 

p!rbo.&..tm &d m F}t[oldqti@ g!'{) 

Nots AFodirgFt i!i!8io.rd @lct EDr 

b@.fEtd ro tbi. coty. If i!t!rd.d DL..6d..r |h..tur. 

(r!!95E@ l'diloo)

Ln d AbDnvi:dou ud.yEDo& 

APA A@ricu PstrholoSic.l Asdiltid 

p 

B.r.; .red.rdi4d Dliy'. EglwiD @6.61 

BFI Beh.viou ldily th@py 

BPIIS B.idD.ychirric irirSqt. 

CBT Cognitivc beh.vior rherpy 

CDCMD Chio4ir"giodtc ai@ for r6rd dierdd 

d/ Dese ofa6doD 

DSM-W TR Di.g@lic Strridiot Mau.l-T.d Rdi.i@ 

E.E BxpB.d @doB 

FBS Fdilyblrdcr shcduL 

rdny fo.u!.d turhr 

CAF cloh6l ass.d nbcdooitrg 

IIADS Ho.pit t Afiiety ed D.r.a,id Sc.L 

HSV ll€rp6lirqlq viFl 

ICD bradioorlct..li6cld@ofDird!6 

NAMI Natioul dlid@ of halat illBr 

NHS 

M€e (firhnetic ed.e€)

MSANS Modi6.d &.L for !.8.rirc ryqros 

N 

NIMH N.lioorl l!.dn te of Marl Hdfth 

P Alb.bitir'i.tett.Edpbtdliliryof.biEbidvrilbL 

PANSS 

toririve ald lcgaris ryld!9re $dc 

PORT Pad@r out com r.!*h LdE 

R2 

SANS 

5D 

ssT 

USA 

wHo 

Mdripl. @rq.!id !qry!4 ttE@ of rF g6 of rdldo@p 

D!lr. (cap)i ilF!!!kt of chd8. 

Sc.l.s fo..!6!sJ@r of nc8.tire srlprob! 

s..16 fo. .33*t@r ofpcitiE 3Fpto6 

Con4ukd EIB oft r*r 

Wodd tldth Org{izrfon

Abst.act 

Sohiapnmi. is r siour cnd d.bitirarine fom of !Ml'l jthes chei.riz.d by 

a v&'.ty orstnprdrc. Tne @lditim offcn heoc ohbnic win .chps orl 

rnissioru ard ! sendrl d@line i. $e caplcily ro lead b indepodeot lifs. D.spne rh. 

widc spl€ld ue ofefidtive dripltrhoriG, ranMl sijll Equi6 $rc &tdnionsl 

inl.ehtioB lik psFhocde.don ofrhc t&!iti6 ott[. p.ridE wjrh $hiaphmia. TXe 

pEsenr dudy wos doigned b cxmin€ th. emc&y ot p6ycho.ducarion with ftuiliq of 

ehiaphMia pdiats in El.rio! ro Et.p6r ppdnon, sr,rptom *vdiry Dd floity 

burd.D. Tr'is wa a betwd rulje|l lolgitudiMl study. S&lple ws ctuiLd toD $. 

out padent of rhe psFbi.rry uit Maro H6pil!l, LahoF. On. hbdEd ,d titi.o 

parialr {id $hizoptMia .nd th.i. fdity |Mbqs wft mircd sd @doDty 

all@rt d !o two gbw' One grcup r*jvld pslcho.de.td ,rd itc 0lh6 Srorp v6 

gdDg ounn fsrhr.nr, fte rDdel oflhd,py whicn n4 bd us.d i, this sludy is a 

psn ofpsFh@irl flDily inlqvorior p..bAc dcvelopcd by KuiFB, Lell md Ln 

(1992). 

The bekl€t ofpsttho.ducarion w$ uosl.rcd ed ad.pt€d jnlo t@at leguge 

Udll' & ir *ould tur b. djttcutt for th. p.rticiFlt! lo osrpr*ad i! As t[. obj*tirc 

ol $e trcnslaion ws to c@ale awsde$ mong rhc fmiliB ofoElc paiidls 60 siDplc 

la]lguge *a q.d iror..d olkchnicat l{gug€. Tt. iriddrion b.em vith.dqtion 

pDgm. Eduatio wq pDvid.d to rtc p.liats ,nd rhl pardcipalr fmny tjhb6 Drl 

to giv. thn a geoqal oridtdion of enizophqia, ebout rho biotogical mtur., etiologj/,

sybproG and co@ of illns .d trEtrenr plm, 

Th. fdily ofde gnup who r@cived t6ychoed@tion lfotled rotlt dG 

lt@p.ulic ssioB. Folow up w6 for 3n mdhr, Tte p6ri.n6 ofboth grcW6 vw 

g.ning cquivaldt dG of ncwlepriG, bd th. olc grcup h.d u rddjtiood ldvmrrg. of 

pstrnocdEalioral ssios. 

'Ir'€ patidB md l,h. Fnicipairg fmily !tMb6 w.rc 66s.d Mcej i.c prc 

irt dotion md anatn fouowwa1rixtu ns. P.riar wac s6€d or losiiiv. dd 

N.8div. SynploN Scalc (PANSS) ed rbe p.nicipating faoity llmbrD w@ $*€d 

on Fffiily Buden Sc.le (8BS). N@ry.dne palidk and tlen fmily Dcmbft .onplcr€d 

lrat cnr Tn r6d1s Eval.d rhat 1hc go|9 who Eiv.d p6'rhoed@rrioa h.d 0,t 

Flape rde d conFEi io l4olo in @n p€trho.du.niotr gbup. Fdjly plycno.duadon 

hrl d iqac. on srqtoN evqity, th. pdia& i! rle Fycho.du.:ti@ grelp show.d 

sigDillcmdy l€ls syrrpioG eqity at fotlow up .! codp@d b tnosc in rhe mn 

p€Fho.du{rion go'p. Patiors in Ftrcho.duria gDLp .le slF}Ed mrt d 

inpev.mal in scial incrionirg. Ttc fditier ofpsycn@ducation gDup also snowe.t 

low lacl olburdd posl irtdwnrioa B coqrftd ro rcr Fycho€duario gor+. 

Fmily psrno.duadonol inieflado!! h.ve proved effic&iob wilh pali.ntj ed 

n nili6 of slirPh|aia pori.nk.

Ov.niq of th. l}6tr 

The prMI study cxdircd .ffet of p6tdoedu..ti@ on rtrp6epevotio4 

synplo@ sveity ed feily buden ofpatiob witn Scni&phMh, Itc tist chapler 

povidB ddniiioD ofthor.rical @nc.prs und.r sludy. Tic s@nd ch,pls pDeids e 

ovq v'ev of thc EldM! r*Nn lnanus. 

The ftdhodolo$, is d.sdibc

S@!d.lrqta Ploidde o14iw of FlG@rlilE nE @ relq.. r.r., & 

ov@iw of pg'lho.tlustion.l inrtudoB, Ihl@ pi.6ts e ovditr of rcLps. 

F.varioD, io lowd .iFE5.d @ti@ Lv.t .!d !o r!d& 6nity buda 

IXjtd ch.pi.r crqbiu Detodolo8/ ofdF sldy. Ihc f€lG &d c!@tdndc, 

of th. suplc e d.6ib€d hails of rhe ftrlM u!.d fd .!@!nh! irfomiio 

FS.rdine inId@ti@ Gd ed f!.[y lh. Flccd@ u!.d to .tdiq dr,r irfo@lio tu 

Fod! ch.p1a pE6u d!r. .!.lyrix ed Edt. in idi,A both d.€ciptirc .nd 

infaati.l .!.lF€., l[n cbpta d6 ti!& s|t@rr of d. rodilg. h cn.p(a fiE, 

Iindines &o dieuld in lb. liShr ol didtilg liEBre ad 6&io cuhnal @ni!It. 

lini.!@ }!E hc@ lir€d ud $e8.di@ for nnw tw.rc[ l.rc b€6 Erde

Schiepluoia is ! srndt@ that afsts ognido$, @tionn FscplioN &d 

o$r 4pdrs ofb€hrvior (8.J. Srdak & v.A, tu ek 2OO5). Thi. iltn6 hs dii*& 

syhpioMloloF, .!d sftly disopliv. pGylhopaihology, Wide Mg€ of !tmpto6, 

qi0' iB .onesponding cna[cn8e to cxphin lh. .tivdity on a reMl leyel, i! wh.t nak.s 

SchizophFnia a c.prirzrinA mdicd disidq (tudr@r & Bt&lq 2OOl} 

x h rh€ msl debilir.ting ed dd!$.drg ittns rhlt p6rrhi{ris1 ftd (B.loo. 

K!u, Md*l, & Cadcnheo4 2OOr. Th. iftid€nc. ofshiz@hMja i, about 10,6 ofrh€ 

gdr.i Dopulalio! Worldwida Its synptoG @r oft@ .pp@ iD *ly ld,rlrtoo4 whjcn 

i3 the most d}lmic period ofone,s lite. Most of tn€ !tr@ted d€ iD lheir r..6 or @ly 

20s. Majonry of thd & Mbt. lo rcrh ro rcmal )oug adutl liv6t ro 8p lo lchool, lo 

nnd ajob, or to tufill rh€n dorBric rcspoDsibjliii6 (Aidlg6 & Blaatq 2OOl} t 

pobably osue6 mE suJfding ed distrels dd lmids moE liv6 ihe &y cecq. It 

.l$ caG ! ejor budd on halrh s.flic6. In th€ USA irs tleid 6t hs bc, 

stiml€d $ 2% ofihe src$ utioDal pedEt (JohGlon., Fenu4 & Zerlty,1998!. 

Cu@dy th. mst wid.ly us.d definilioc of Schiaph@i, al t*t for ccen 

pupos G ltre on6 pnvidcd by rhc Affiid psrchi.uic As@i.tid! DsM_ry TR 

(AP4 2005) crit .ia, ed ICD- lo (wHO 1992). Boln qitais stiputrie lbal .ff&tivc 

rtmptom mu$ rcl bc ploniM! n'. nilinM d@rjoa of iln4, is I .MrI for I CD_ 

l0 lrd 6 mltls fd DSM- TL 

r,2 Slgm md 3ynpiom ot S.btaphrcnis 

Tddnidilty Schizoplufri. is @nsid,!d . rrp. ofFFhoriq ,a rh. d.lhnion of 

p3r!hsi! itdfnA mt beo corcrBiv. In oldd de6nnj@ rhe e,phsis hld bd on

Itt€ slbj@tive dd int€mal psythotogicdl qpdince ed psycholk w6 defrcd s 

iqlilrMl b @|ity t6tii8. On d. orhd sidr of lhe +.cruD, prychGis h6 ha 

denn d obj*tiv€ly ed ops.tidally 6 tne @uencc ofdelsions ed n.Iuinrdons 

wirn ln. hlllEitutior rating ple wirhour .v&de ofrh.n padologicat otlE 

(Andre6cn & Bhck, 2001). 

Given lh. wide r&ec ofsFplom tnc clinic.l inv6dgaroE haw tti.d io sinptiry 

tlc @rc.r|ualiatioa otlbc di$rdd by dividi.g it irio rhE di|]fuioNi pdirive 

slnpioN! negativ. synptod .nd diloryuircd dimnrion!, Bscd or po6itivc ud 

n€gariv. dislidior ! ddd of Schiapbmi. ws DDposd by CDw (1980) ed 

An.lreienedOhen(1982)restivcly.Tn,rtti.tifteBio.,liryof &nizophHia 

pndoMology hld b€a supporl€d by ditr@l ,orhors; rh€ fou facrofuFdct concm, 

t[. gq.tic, n@biotogicd, omlogicol .!d plycn@i.t f6tuE of S.hizoDDdi., 

inclnding thoughr ed b.haviorat disturbtuoes, ne8anvc ,nd psilivc srrlProm tud 

sial witldrzw.l (HN.y, ClmI, lDt.nis, T.ytor, & Barn€s, 1996; l@nksa & 

r.2.1 P6ldv. Syhp.o@ 

The p6idv. lynplom rep@nt 6e dgsmLd or bizaft bcb6vio6 .rd 

lhoughls (Cond, 2001). It. psrthotic di@ioos Efs !o two cl6ic p6rrbotic 

.ynpt!@ rlDr Efler a pdiafs @.nsion abour rh€ 16 ofboundsi6 b€rwa hi@tf 

or hdclfmd the dtemol world. Oieo padd& wjd Schieph@i! show phobi. 

lwrloa lrd gct ubu b.c!e of t.n distutb.d $ou8hr plres dd srug. h.li.f 

drey hold, voiceg they h@. Aaau. oflh* odd *paitu.st lI* p..ians try beh!rc 

dilldqlly .r dj|ftul dfts. At tin6 thcy dnibit stqorr?ic b€h.vior lik shuming

ick dd fonh. ftey my san delrchcd or wialty d@f ed rc@nr p@ccupi.d in 

|}ctoq thouCls (circd aoh U.S Sl.gd Ca@ls RGpo4 199). H.ltEiE(ons and 

delsions, borh synpiom Enar . "tcs of.go boonddie. ItE patidr i! @ble !o 

dislingnish b.twd his or ncr oM rhoughis ed pweprios ed rhose h. or sh. obrains 

by obwila rh. qraml wld, 

Hallkinations c disrurbe@ of p@.Non, vhicn @u mnour ey 

c@arim to a Fsl dinulG (A[o, ac@I4 & BoEi!, 196} HaltEiEli@ 6 @u 

in ay of lt. five s€@ry nodditi6, Schibpl,dic Fiiors onm.ly r!!on ludiiory, 

visurl, racdl., gutarory or olfaclory h.Urci@iioN or conbin.rioD ofth*._ Audjiory 

bdlwiurio. ulualy t *6 rh. fm of . hic., .p@lin8 io d .boui rh. tubje! sm 

tic qled. lcrbal hdtwilliotr (Drid & Lucr.\ 1993).,Ih6c e @n)|ldy 

exp.r'oc.d as nois6, muic, or mrc ir?ielly voic!, Thc vorccs my b. MbEd or 

h€d cl@ly, ed rh.y @y sF.* rcds, pt|l"g or s!tu6. Th6e h.l@iudoB ,t$ 

i&lude cl@ly ,udiblc voi@s, uurly *ying n.8ariv., crirical or eighrclirg drilg. d 

comddne on o pqson\ &iioB, trguing wirh oie doihs .bour ! paiid! or &p..ling 

aloud the p.riors' dFlsnts (Aldl€3q & Bt c*, 2OOl). 

P6plc wi6 .udilory hrttrciorioB &iDltr podu@ itc 'de signrts of $uod ir 

the bdb wifi tu imrdsql riSht lempoQl oonic.l rsroDe io audrory p.rceptiod of 

sD€b tlo 'h* td@" &d b.li.vc rh.r *tem.l em* de reloEibl. (Keef€, Amot4 

Bayd, McEby, & Wit@ 2004 W6dtu4 wrig!! ButL&rc, B!fu, to*.d a .1., 

1991), 

Viul hallBin.rioM tuy b€ lirple or 6npr.x dd ielld. t sts, oI liehl

p@ni dimls or objdts, Olf&lory cri 8Blrlory h,luinalioft e onm 

€xpdierc.d logclhd, €speially s uqLagt i.stcs or odoB. Trctil. h.lluin.tioru 

@y !. dpqioccd a *aiIioE ofb.inS toEh.d tr pricto4 .lctric.l s..liod, or 

lhe s.tior of iDset @wlin8 ud6 th€ sbn, which is call€d fomi..dotr. 

In addilioo paticab dy be cxEa !4itive lo bekgeud noi64, lights, @lor dd 

diltrctioG. Lrboatory stldiB h8. r.peLdly fo@d preblm ofFcptim .!d 

atledjo! mns popl. witn Schiephmh (Gold & Thrkd, 2002),Th€ Eiou 

pdeplion ed dtention pobl.N in S.hidphffiir @y develop trs b€for€ $e oDsd 

of mtud disldlr (conblrn & K.lp, i 994} Suh pobl@ ale @!!ibure b ll]omry 

ord olhs .ogritive inprilrMlq mong individlalr wilh $e disordd (HaiD,rr S&.n€, 

Silvo, Lring, & Mcctu, 2001) TIis inrpriooi in nultiple domiB is . core 

ch@dsric ol Schi4phMi rd mr c.!s.d by .hDaiciy of jUIB (Mohe!e4 

P&lsd, Lcdy, Amdenr, And.@q t999). 

D.lsio, involve dtt{be@ h douen| r|thd rhm DqrQliolr th* e fidily 

held b€li.f! thrt d. fabe s wcll s coltrdy b r pclfu,. €dusdodl !d cultunl 

brck9o6d DeluioE my 1dL difieMr thcn6 (Cond,2oo4). Deluids oeqins 

in Scli?ophrcnj. pali@c tu, h.v. s@liq g@di@, Ftigiou, ninni$ic, surt or 

pmutory $d6, dd nt!@hondriasl idd. of vsiou ki!d! & .I mll@n, Mosr 

oha@lenslicr e a vdiely ofp6siviry pheroncn!, Ilre pari@t f.cl6 dEt he i! m longd 

in @nEol ofhis oM thoud6, tclings or will ud thlt ne is b.i!g il0uac.d or 

@nEDll.rt by &m. nysrqioE, dim foEd

IMUiN of petsecutiugie* b.li.v. th.y @ bcins plooed aeli6r spi.d 04 

slddd!4 disimiDrcd lgaict or rl'rannrd. 

D.lutio8 of reJere.e pî@ts 9ith s*h dcluios atr.ch lpoial .nd !@nd 

mminS !o thc r.ulrsl aclion6 olotn6 or evdrs, 

Del,sio$ ofetuhnat pztjaL.wirh such deluion! belide thrt ihcy @ 

q1@ly fms !n Powertul p.Ms. 

Dehsitu o{Nt.ol p*ia,6tAi4 $!t th.ir lhoudt5! acli@ ald f€lir8r @ 

.@tou.d by otha p@ple (Com, 2ma). Th* delcioG ,ls! iftlud€: 

?7,a!a}l ds,r,a, belGfdat thougft whict e not fien oM d pur inio rhen 

lroqht itr.ltuwal b.li.t t\^lJ)en dDugn|s @ b.ing br@ aw.y or rmv.d 

teo then nind! by othd p@de 

mougtt btuad@tirgL.lief $^ eRhow $.n rhougdrs bav. beoe @qjbt. 

lo olheB or $oughG !rc btuad.6Ld to thc oursid. world ed ev.ry orc ce h6 $am. 

They ftay b3 convinccd that sne one is tlyirg io ht?ioI'e ihd or itrrpolc ilen will on 

Inm (Alloy, A@lla, & BooEia 1996). 

1,2.2 N.8rdv. SyD!'toB 

Negativ. synptoN rcfld a dcfci@y of mnrd fidriming' d !!5d. of 

norml thoughtq b.haeioB &d @tb$ (Co@r, 2004). DSM- rV rR (AtA, 2OO5) 

lisls ihre negativo syhpiom s oherclqistics of S.hizophmia: alogia, dI€ctiv. 

bluling ed volitior Otnd regaliv€ strnplos rhrt @ col|mn in &hizophMit 

include siol vithdr.er, &!eddi. .!d idlPanld rnafol 

,.troa,a k $ndtu qucd Fvart of sp@n. n is cb.@rtized by . Educrion ir 

1

th€ @ut oa spontseow !p@h, If the s?.cch i! ad€qut ir mui th€ r€nddcy is to 

prcd@ cnpty or inpovdGh.d sp@b. In @y patif,ts rte inpoverishmal oftnoulht 

e6 in th. dpBsim of leguga Padals my hav. g@i difliculry pro

,,l,l.1a,,id Ef6 to {r. los ofor.\ oaplcity to qpdid€ djotndt aDd 

plcaure, Mey patid$ descdbe rhemelve! d f..ling motionolly eDpty. They e no 

loDSlr .ble to @joy mtviiie thal psioNly 8av. rh@ pLsw, lEh s pllyine Aorls 

or sing fmily or fri.id!. Ir fels lfte n ie nor mnn fi. .forr ro g.t out ed do lbjngs. 

Th.n owodK lh.r lh.y hrvc lon rhe qpeily !o 6joy lnd&lv6 my b. s $lG of 

gr@i psrdolosicdl peir (Crow, 191). Inplir.d at6ti@ t @nd.d io rhe irobility to 

@ncalrare or Bpold !o ! srinulB thai paridi ce nol ptcs or 6llcr, vhicl blt€s 

lhh fel coDns.d o. cxFid@ nlgo@tcd douShE. Itr* pmbt@ of lndrion e 

d$ eiated wilh foml rbough di3orda (N.l$A Sq, & Str.towlE, | 998). Amlhd 

$p{l of lhe n€galive dimion is a Edeed inrcnsiry of emorional Espone lhat lerv6 

Schi&phrnia patienB inditlMq apathdic aad arledoojc. Siidcmt dcprsie 

r)dprotu @u ir up ,o 60?6 of scnizopbdic pad.nG. D@Bion is ond diticutt !o 

di.gn6e beaw sFproG ofschizophmja !d dcpr6sioo &eqMdy ov.dap (Sd, 

Strakoski. KeL Upadhylt!, \vs! & McElory, 1996), 

'Ihe negarive synplom d€ cml.led wilh per pe@6id .djudn{! @gnjtjyc 

drstuncion dd p@r EpoN ro r.stDdr (BDr. R S_ C.E & J. M, CIEA 

192).Th. n g1iv. synploB e als irn!o.r.!r i! pogncis, rh. p@ncc of n€g.liv. 

sj4hplom is a slrong pFdiclor ofpoor qulity of lif. md oocuprtion.l itrDaimol (pJ!e, 

T0urL Montlguc, & Moris, l99l). 

lJJ Disrg{itlg Dlm lo! 

This dimion iDcludd diersmizc

3'rnpron of S.N2ophMi. by Blculd (1908, citd tom CotE, 2001), 

S.hiaphrEi. on@ dl6lr . FM'3 $ility lo Ihiil !b.i8ht .!d cladt 

tlsughl!my@modgonpidl,{ED@Dmymtb.$L!o@n6t cfdlo!8 

lld my bG oily di5t&t!4 @.bL to bcu .natid ed n lllar. dsir oaEt 

pM6 (H.tuu4 Srtel, Sliq L!!si rt Mcc.la 2003), It tuy b. dificul fd lhrn 

!o c.rry on @nvmtion, pbn dad dd rolv. Fobl4. Th. p.ridt! h.virg rrr4loN 

ofdi&rysizlliod @ d'oE inp.ir.d tbe otld r!! goup6 (SFug. S.hotbd4 Vo6, 

Hox, & E!s.b4 2007). TrF of llousht

Th. veidy of s),rpbru md cou8c of Schiaphroio h6 led to *ve8l aherDts 

to d€line lnb CroL!!. 

Tbe lubttF! of S.hi6phFni. e defined by 1he ptdoniml 

srmptonololory al $o tim. of dalulion. Thc!. subtt?6 ao is follows: 

In peeoid Scni&phFni|' th. clioicll picturc b doniDlcd by w.ll orSpdzed 

pmoid delsion!, thought prccBld Dd nbod @ rchtivdy lpdcd ad th. p.1id1 my 

lpp€d nonnal util his abnonrd bcli.fs d. ucovd.d (APA, 2005). 

The pdtidrs {irh di$g&j2cd t}F on6 rpp6 rilly ed .hildbh in tleir 

h.hwioi Affcdv. syrnptm &d tholght di$der e pbminat. DdBioN e 

@I|llM ed higlrl' o4,'i4d. Hdl@ituiioN .le @ @n@n dd e mr €lr!obr.4 

C.robnic S.nizopbEDi! is ch@t rized by mlor 5FlPloE &d by.bdg6 b !.tivity 

v&ying bdwd dcildal .d rn4or. HallwiMtiou, dduiod ed |tr.ctis 

sytrrtoG @ but e suly le c,bvioE (APA, 2m5)- 

P6uli{iti6 of rcluidy mvdht @ diddi by po6ruiq (volut ry 

Gsutrption of i,appDpri{. d bizm postuB) si@typcd mvlool p.ooi@t 

MdiMq or pbnincnt gri@ir8. 

Tne Nmli.l leaturc of ttc udiff.Fntiatcd rypc of Schi&phmi. is $. plt3a. 

of !'mplo@ llBt n*l criterion A of Schi@phrmia but rhrt do et nd cnbic for lh. 

rarmoid, disore@i4d, or ca&ionic lr?. (APA, 2005). 

ll

Thc R6idurl typc of ..r'i-pnhb sledd be us€d wbd ih.F bs her !1 l*t 

oft Ailod. of S.hjzophtr .ir bln rh. ctmr clinicsl picrre is withour premi@r 

posiiive prFholic srnpt!ru (..e. deluions, ballucinotioN, disrgoizat spe{h ot 

b€hlviot. ft@ is cdriluing evid€G of thc dtrurbdce 6 indicaicd by rhe p6@c of 

n g.riv. s'trptoN (€.& nr .lla! poy€rry ofspdh, or. voliri@) or rrc q mE 

.nenutd pcitive s,rrpro@ (..9. @aLic b.havior. nitdly di$r8diz.d sp@h, or 

odd belicfs). If delusiorr or hrlucinrtioB @ pGdnr, they N not plonindt ed q. 

@l a@onpdied by srora.ffer (Ara! 200t. Ndr thc bn€fd..djption is siyq a!ou! 

epid.miolog/ dd iftid.rc. of S.hizopbmi! i! diflmr cutftc rd si.t golp' 

Tte wmld wiilc pr.vdace of S.hjaphFni. hs b@ 6timr.d I about I % 

(Aid@n & Bl@L, 20{) | ) lxl d. r4ons 6!n Ud[.d 51!16 ct.id 2.5 niti@ p6pt. 

sundinS with lln disorLr (APA, 2000t Co@, 2O0t ). IE sigritice{y ligta nl., of 

SchiephFnir e Eponcd molg diflqor eihnh goup€ living in legc cili€s (IeNn, 

Kirkbridc, Moryr!, D@!L & Lloy4 a d., 2006). The 6tes of Schjz.lkelia @ rhc 

hi8h6t in a6 whG lh* .rlnic grcw6 G v.ry .m[ in llmbd rhD leol Fpul.rion 

(VeUrg, Sellon, Vffi, Le, Btoq & Eock, 2006; ,&ob!, 2OO2). 

Schiaphmi! ha b.cn d*ib€d in lll culru$ .nd sdo@nomjc li.tus dd 

incidac. r.16 dc I€|Mh!|, siDile ir eid.ly djft@r ptG (hbldlty, 2OO3; cir.d 

frcm G.ldcr, lieis, & Cov.a 2@6), b irtqrialiad natioN r di.preponiomr. 

nmhlr of snizophMic patimts re in low sioeollmic eroup!,.Iindine m$ tik ly 

duc !o th. dowad drit rBulrirg t@ impair.d !@irt dd occuprrional fiBtionilg 

An .ll.mtive qphD.rio! p6poe &.r mE dE ir6s re dFlidccd by de low 

t2

sio4onomic greups $e mr it cofi.iburcs io lng d*.lopndl of s.htophMia (8. ,. 

S.d@l & v. A. Srdoclq 2005), 

Hieh inctune of Schizophhi! lmng 861 itMigtull (sbol 6 p6 lom in 

Afo4dibba6) ed alnpt cuh@ cheg. hs bd r?ond 6 dc @itr cae involvcd 

in lh. dewlopndl ol Sc[i@phmi. (Csror & S.ltd, 2005). Ihe prwdm. of 

Schi@phdir h$ b*n corcl.ted wnn |c.l popllltion d.Gity in ciri6 wirh popularion 

of noe the I milli@ p@pl.. fte efld ofpopulatio doity is couist nt wiih thc 

obscn.rjon tut dre incid ! ofSchiaplucnic in.hild&n oler.hq o@ ortwo 

Schihphrni! p.tiols is Mce 6 hiSI in ciiic! s in @l @muid6 (P.d6or & 

Montuer! 2001). fto* obsd.ti@ dugg.st th.r sial eE6sE in ub{ sdtirgs @y 

!0@r th. dlveloplMr of S.hi4phMic i! p@s !l ri5k (8. J. Sidoct & v. A. S.doctc 

2005). 

Ih. bel@ sivo setior @ntliB iifomdon oo c.Gal f&r6 of S.hizpbMia. 

FiEt . very bri.fdesiprid is siva lbout pr.rcdid p€@nrliry, n is ldy irqaltiv. io 

dicss lbi! heaE dis contaic rh. ihp.ndi.8 nlk f&!o6 conrrfturile in developnot 

of SchibpbHio. I$e d. dd6ib.d heE bri€0y. 

S.hiaplwnia cd d€velop h p.@uliti6 of.ll Ljnds. SoDe lddrs wirh 

&hizophMi. e odd s cbildEr. Mo6r oftd rh* FNB hav€ p6oality eli|l litc 

si.l isl.tion. ftey m be @lrl mtioDdly ed la qF6iv€ Fe@tbidlr Th6. 

!E ond cdle

.djbtrbcnt ta b@ snoM io coel.t will dy di!@c orct, For ova all prognosi5, 

oerativc synrptoft, cognidve deficir., dd poor social itunolins. A history ofgood 

sial ldjs1rl6t !r vort plac prior to ilb6! tods io bc Mirr.d with ! b€td 

outcotu (tudrM & BhcL, 2001). ft. tu6 ot S.hiephmia @ d tuny 

ulddtood .nd lne deiritiv. crE l f&rors e ycr to bc idatifc4 Thft e G* cld 

cut &d tnoM rist f&toa vhich iMce on€'3 pr.disposirion b d€ dis@. 

R€sach on bioloeical pr.dbposilion clons ibe role of hqeditary h casation of 

SobiDphr.ni!.Tn disorda il p@ipitaied h cponsc lo sr6s in vdn@ble individurl! 

(Cons, 2004).I!e Elati* oI SchizophMia p.1i.ot @ al bighd nsk for tle*loping 

Schiaphmi. lrd ehi2lttlll di$dq lbA $. rclaljvs ofbiF|f prn@t (Ko.nd, 

M6l@D. & tuvis, 1935; Mij, r989),Th. chDcs ofa Fts 

dw.lopinA rh. di5ord6 

e grdtq if o. or botb pamts or siblilg sull6 rh. dis.e,rhe cb,6 ofddal@ile 

Schiephmia in twin studiB t 304 in mnozygotic dd tlcPlo in di-zl8oric 

((tinslcr, 2001). 

ClMt rppDrch6 in go.tica @ diBt d tovdd ide irying lne. pcdigees of 

afict d peBos ad iNstigalilg lhc &nilie for driclid filgnat laglh 

polymorptim 6n regegat€ with dF dis. ph@tt!. (K&yiorsou A Cogos, 2006). 

Thc mledr biolog tehriqB hav. iForl.d .ftng .5silriN betwa s!@i6c 

cnon@nd sns dd Schiz.ptmi.. Mo& thd hrlf of th. cnmmsB hlvc bcn 

B@iat d witn scntuphmi. i! lho* vrbs epoft (Cntdoot, Donove, & Ow.4 

2005; Norion, willim, & Owen, 2006).

Reml rhrdi* indi@r€ rhr adopie€ .r hid genetic .i!k d€ 6ieni6c6tty mor. 

ss'tv. ro ld!@ @ing P8r&rD io adoFivc fditiG thd .l fmilid rr tow gderic 

risk (Ti.mn, Wynne, Sori, lj&i, & Laesy, 2004). Al llE m. time! how€v.r, ron- 

gdetic feio6 alo ploy s siifi.er ol€, q did.rc.d by E@! wbich hq shoM 

lh.t in th€ cs of mno4godc rwiB shding idmrical ga6, rhc chdc of boo ofrhd 

getdne &hiaphrdia de l€$ ths fifty pdccnt (Cardo & Colt@m, 2O0t ), Rufter 

(2005) Eports lh. impoftae of oviloll|Mll t&ros @nhjburing fd Flrhologicjl 

.nd pdhologjcll our .one d .vid.nce{t by vdioE rwin &d .doPte ltudi6. 

ltrd e hghs nl6 of fi6r adoi$ion for &ntophMia in twiN a @opaEd 

to gn.nl populariotr (X,lanio& Moftnq, & Ktritq 1996), Orc h ra paliar! wnh 

&hi&phMia ha e afieled fmily mer$cr, In 8en@1, ihc .hk incEs, song closc 

Elatva of tlr F@n airh SchizopbrEir. r|on. p€mr is afc!o,t, thc ch,!c6 ofih. 

child dd.lopiig Schiaph@id @ $our 5%. 

Abm@.liric in bhi! sEuci@ hs. bcD fo@d in src p€ridts of 

Schiephenia (Coftr, 2001). Thi6 imludc! rhc .nhrSed v6t icl.s in foo of caviries in 

rhc inlerior of tlc bnir 6rll ofc@bcpiEt nuid. Sieilely th@ tu be a r.dlcriotr ir 

s'a i, ene p!rr. of bnin (Ow, L.wist Robin, & Mway, t989)_ 

Strdje h!v. rugg6ld c@bnt coriicd btuG (t&ry, RoI, Dgod.x 

Wiotq LAii & M!ny, 193; Ziphky, Liir & Sulive, 1994) d. ftde.t ed lone 

hrvc indicotcd Fniculd irrclvc@t of rcDpoDl tobe siErrEs. A trra_sltdrli, ot 

MRI nudi6 @ncludcd thar lh@ ra Elirbl€ Md si8nilror dill.|!l@ i! rtE vd!ft of 

t5

whol. b6ilt laleral ud Oird v@nicl6 md hippoc!trpB in schizophMi! (wngnl & 

Cneg.! in rcgiool cdebEl blood flow 

hgv{ ud Flwm (1974) d.mBrst d rhar padnB wilh Sc[Lophhi! had 

rcktivdy Gduo€d blood flow h lhc iobl LobB. Tnis b4bfron$riy ws cdfmcd in 

6 edl ner&us\!,s {Hiq M.!r! a L!ft, 2004). 

TIE dopdin htTolh6is, suesgll ltrr syDplom ofschizphhir @ duc 

pn@ily b . nDdiooal hFer&tivily in dE doplmim sysron, Much oflbe 6wpon for 

thedopMin ht?o66is re Aom rh. ob@atior 6!r ln..tfic&y of my of rhc 

dripsycbotic dogs lsed lo heat SchiaphEnia wb hiehly codelaled wiit rh.i. .bihy !o 

bler dopdi!. (Dr) @crro6 {Mctoy & Mctar4 r 993), This n}?olhais is 

subsuntiat€d by illlrd 5Mi$ which shor thal d@dire Ec.p!06 dd dopdire 

comdturion lscl @ inde.s€d in prriatr wiih Schjzoph@a 6 @trp.d b @!nar 

conlrol gluP (But hcr,2m0), 

Pr€Mcy dd BinI Coopliqrion! 

F.ral daelolmor, pre dd pdi,Mral binh conplicarions ar t!.liv!ry, yinl 

jnfstiotu, &d toxis e Fponed $ lle nor c.se of SchizophrDia by sme Esehe6 

(Kadld, Mdmy, JBaaIq & Bsi., 2000)_ Thi! *i

@ond 1em of pcgMcy @npd.d to @ihcts of p@ple yilhoui S.hi@phrdi! 

(W.d,li,gto4 1993; Bowa B.gs, & cEv@r.itr 2004)- 

Oae nodcl fd the i.i.sEti6 ofbiologicrl fo.!o6 Dd Flchosiat ed 

.nvioMdd f&to6 is thc sdrs diath6is rb.!.I. Th€ mod€l F!tutal6 tlEt r ptur 

may have a speific ro|@biliiy or biological prcdisposition $.t, wna .ct d on by 

sne rEeful dvnomd flciors5 ![o* rh. synlptoG ot S.hjaphMi. to &rclop 

{Gon6nDr! & R.illct 2003i cir.d fon Coher, 2004; Zubin, M€uin6, & Srcinhdd, 

1983). In the @si 8d.El l|16 dial[Bb rFdcl, Oe diorbai! or $. sr..s ce b! 

biological or dviomtal o. borh. Thc dlio!fulll orFn.or @ bc .irh6 

biolosical (fo. cxdpl., o infecrion) or !6y.holosical (tu qmple a sfe$tu fdily 

silu.tor or rh. dalh of. cloe iladv.)_ 

Allho!8h the twin dd .dopli@ stldis indicai! thar Schi&phhi! j! gcnctic.Uy 

ltiDmftrs1 thc did.@ ale slDs lhar ovnoD|M|lt intmc6 hBr ptay | @jd 

ole $ well In tlc lel 40 F4 rhe po$ibility d.t pathological el.riorlhip or p.tim 

of comuicdion wilhin th. nsl* fsbny @y lod ot t6r in gd€ticaly wtrcdll. 

childrd, to ln. adud dd.lophear of arhizlphmi4 ba b6 nis.d R.ichM 

( 1940) {3 cnen fom Beks, 1986) coiled $e ph'!!e Schi2.phMic mlhd &d taler 

wortds srpponcd thc @m.l)! wilh tt claift dr rt @ibd of S.hiaphdiq wft 

botn overpDt€lirc &d hoslil. lo rh€n cbnd.d, IrF SctjaphMogeic @rh6, 

d.t&h€d ald idifiercnt Elariotuhip brrym ih. chitd\ ddclop@rrt ed ei.t shls 

l1

Erp6ed €mlio$ studi6 have shoM rhar p@t! of patiot with 

S.hiephhia havc I tddetuy lo cxlibit mG coniic! nlvc comui{tion tEblm 

Mltowilz, Gold$.in, & Ndhtal.i4 l9l; 195) dd @ oH diti.at or shov mE 

conc.med beh,vioi tove.ls lbei. childreo (Boyc, Bdtsd, & Mslt, 2002; H@ley, I998), 

E\pBi.d cmdoa cfd b d. ld.l of diticisnl nostiliry, srxl ov6 invdvmdr niSh 

colmunic.tior d.visce! negaiv. alfstive siyl6, md high E.E ce p@ipirir. |he otu.r 

of SchibpbMj. $ w.ll 6 6 i'l:@e relale sl€ (Mison ,1993). 

Bmta ed Skded Fdilies 

Lidz md Lidz ( 1949; cihtd lion Bdtq, 1986) dMibed rwo ab&mal pr6tu 

of fmjly b.bwioi In deqF offd t ln@ b r Fonjndr divide bdscn rhc p!@r, 

dd one prst g.$ overly closc io i ohnd ofrhc opposile sox, ln othd tlF of&nily, a 

s**.d r.lari@Np witl de p€dt irvol!6 . poM slDgalc bctwa p@r. od tn 

Esdtin8 donjnm. of or€ pMis &d rhis ihcy sugg6Ld w6 ecior€d with 

dd.lopned of Schizopbhja. 

PsFholosjcd pdrpc.liv€ 

Sienud FGud posnrlatd thal SchjephMio roulk fbm 6xalion! in 

devclopMt lhrl @uEd anid $o lnoe l|i.r 6d|l jr rh. &velopMt of IIcllIIB. 

Fieud regffd€d S.hibpiMia d . Ege$ive Gponse !o oveNhclming tia.tarior ed 

co.nict with pq$B in 6e avilomar. Thr rs|xid ilvotre ! *ithdrNd of 

m$onal invdmd Siving thc apPeddcs ofrutiltic wirh&lwil. Freud ht r rd

6 , @Mruace of djslortic i. dE Eip|ul El.lid$jp b.rwd ln. infel dd ihc 

miher, Sorc p6t€ho-&aly!r, ht?orhesize tn.r rhe dcf4t in rudimenlary .go fiuctios 

p€mit inre@ b6tiliry .nd aggBiotr lo dilbn lhe mt[6 infdr €laiio8bip, lddjlg 

to a peEonalily orBmianion tlul is rIlndble ro srres. Th. oDla of sldpiom duiDg 

odol€sac. @E ar . im vid thc p€mn rcquiE . sLone €o io deat wnh rh. !.cd 

lo fuction indepddddy. to s.!r.c ton lh. pamls lo id.ntitt &sll, ro control 

incrsed inteBol drivc!, and b coF wirh intcns. dnrDsl limuhtid (cit d tm Cotu, 

2Vt4). 

Sullivu ( 1951, cned 6on Coher, 2004) derg€d Schiepheric pa$ds in 

intcniirc lEFbo.Elysb &d omluded Ihd $. i[6s Eultr fion rtc ely 

inteQs$Dal dilll.ulii.s and sial retalionship6 p.niculdly rhoe Ebtcd ro *h,t h. 

@6idd!d f.dry ovdly diou mthdtug' A@ding lo 4irl temi.g thdi6, 

cnild@ who h&r hav. SchizophMi. led imrional @rio ed w.ys oftbintingby 

inilar'Dg p,mr wno my hBv. thcir oM lignj,icdt @riord pmbl@, Tn p@r 

in!€rp@nel rchtionrhip of S.ni2.phMic p6on! Mding b tnis dEory, .bo 

d\*elopr bsa@ ol poor trF{kls fbh rdich !o l.d duilA childnod 0,c, Sllen & 

fdrb (196) hb s886Ld rhd n is rD$ibt. 1o dpltjtr th. slrqr.N {d sigc of 

Schiepbrcni! io lft! of abnomdiri6 of lb@ mir m8nitive pnes6, N.Salivc 

r)dprom ard s{re irrpprcpdir. Unis, a&, pasenrion, qhich ir thc Gu[ of 

inrbi|ny to eoe.ale sFnr.n@s (wilted) &rior. Soft poritiv. syrplom, ..& pejviry 

t9

expsiflcs, auditory md so@lic hdl@iialios my b€ .onsid@d thc r.!ul8 olr let 

oraw{.lB of the prior inLriion rh.t a@r'pei6 ! delibdr. ftr. 

Dcluiom of ps!@ulion dd EleMcc ny be mdctstood s rhc cull of u 

idbility !o @@dy ilfd th. intclrioB of othcr p6ple Simihly rhci! inftuB lboul 

{hal olhs people e $inking my be inco@lly pdeiv.d s infomrion coming fen 

e stmal slE. This @uld pDvidc d dplmlid for 6ird Fsn ldirory 

hd@iDlims (Bat!ll, FemylDud\ MoFisor, Lewir, & Cororu, 2OOt\ 

whil. wc h.vc d@iibd dtl th. ctiniclt farG of ilhs dd iG qu..t tadoE 

now bdeoy the inp4l of illnss on patiot is dilcBed, hoN h./ eh. fcct! ed qpcrieoce 

l5 Imp!.r of tth.s on prd.lt 

P.eMl qpdime of h.ving SchiaphMia &d |lmrcd uout ,bout itb6 

e uvryinslyneg4ivalh* p.tidr ond liv. in a wo d of mstainry md tn.y fel 

tn@t6ed mrinry dE lo thei. srrPlo@iotogl, f.t& tury p€rc@rioB (h.IeiturioE) 

and utru. lixcd beli€fs (del6ior!) 6pei.lty when lh€y f*t $sl b rh.i. life 

(Fneutory dcluior). All€Ed p@Fi@ e v.ry disiBlina od p.ti.nr f*b 

agoriz€d !o d€sibe lh.* espei.lty du€ to 3n.rp pq!€ptu.I .xpaicer dd atleErl 

slmudile3 (Clniry & Dunne, 1989; Harfel.!, 1989; rei., 1987). Isp&r or @pilirc 

lbiliti6 i! de rEporr.d, Difficdrid in doueht ed s!@h oigaM!@ e v€.y 

tuk d.Th. .biliry io Mebbq ihing. dd concdrEc sl$ der€s. plMilg ed 

3e9@ciD8 abilitiB e allo afel.d; rim b@om disioncd dd doi. gcr juDbtcd ed 

.ll this is v.ry dilEesiDg ror lhe patidt AI rh!$ ulEul qpqiace inc@e srce of 

rhe pahol (culti.a & DMq r989i H.lfiel4 l9E9). fte p.riat, pirh schiephdi. 

20

Epon very n.g|tiy€ expdi.G ofrE fi6r hoElirdizlior Gpeialy ifit &qui.cd 

solsion or phtlical @t$inq tht irdu6 lo$ of *lflulorcmy and f*ling of 

h.lplse. Loss oIp.Eon l id@tity a . mmal p@n r.ponedly i. Uc e@t6r 

suce ofprin for tn€ paijqt yith Schiaphqh, CEdunt lbjl h@$ng f*lirg jr.lta 

whd lhe lab.l ol "Scniapnmi!" o! ttraral prtimf is lcqlired (BouicE, t989; 

BEkt , Lvin, Wo&on, Sobel, & Stod., 193), 

Arlol.lc@t suec is . paiod of pq ecc!'id@ mtt it bons vqy djfi.ul md 

crucjd for ihe p6d !o acquiF ml. of ! naLt plri@L Thc be.baviont srnploE . 

patimr exhibits le.ds lo inc@€d pd rcjalion, This sjdl sluion lId aloohcs nom 

!@udings colpl€d with ilM Epoe to rFplo6 @y jrr.!.ify rhc sufrdilg in Ihe 

pee$ of th. tr4ilioo !o de tolc ot schi2lphmic d .lMlll prticDf (hFz, l9l). 

Plin . porial wilh Scnizotldi. Ick L d.saiH in his oM words: 

t4re 0 98?) oots, "duing ny llt. lcds ond 4rty iwoti.s, whd ny |ge den.dcd 

lhll I dar€ sd doelop 5ei.t skilh, n, iI!4 lcquir.d thrr I spdd my adotesag otr 

psFnirdc w!rd5, to rhis d!y, r noM fte lo$ of rho6e yaB'i, !o rhk d.pi.rs dE aSony 

& indiyidul lcls sla hc los nir iddfty s a mIMt p.Fn. p6pt. ,irh md 

i Un s .xp.ricno. a lot of obslactd iD geiting a job .d fscc sligm in eso oI 

.mplotrlqi Msjonry ofrh@ pridrs d. Epon disimiorioa in inrap4o..l 

rcl.lionshiD€ Md in enrplotmdt (Bicli & Cahnht, 2OO7), Abo th. lubja$vc 

dFtrc orni8D dd di*riminrion in p{ti.n|l wirb Schtoph@i. plliac tivirg id 

ube @ lend b bid. th.t illr6s ed frce disrinimdon in drylormot whitc th€ 

ruEl p'timtr .eo[l.d ro b. ndiculc

In lh. fouowilg lation, o pari!{r spal Flar.d io this illne, d€ cow of 

illne$, lhe oul cone ofschimphEnil rlap* tud lhe f&ioE vhich aD qu. r.lape 

r.6CouBe.!do conc ol Schlrophrc.tt 

SchjaplMi! h llpicany vided 6 s chbnic disd6 dr b.giB @ly i. lif.! 

uudlly fBt appeB h $. l.te tesE t\r ni

S.hidpt@ia CIoGy, 2001; McCuE, 2000). A tull Eov.ry is hoo likcly in p.M 

who tu clior.d quik w.ll bef@ lhc disordd or *h6. dbordd wa inidrlly ti88E d hy 

rrt*, @nc on $tuptlyi or dlvclopcd duii! niddlc !8. (M!mv@, Lykoa&!, Odis, 

TXc mF .pi6od6 | p.tial hE hr4 od tlF rbF iaidjouly d.vcloPins atd 

lorgd li6tilg lh* h!v. h6, dE tuE [r.ly ir b tltlt &ft Gidlrl d.r!8e will 

tmh {st@hdBolr 2000), Moc th. illi6 gd! chrelic mF O. n&$otrirg of th. 

p.li6r Cet! idpair.d .nd ft Lrd! io pc pbgdir (Libdlul} Sh.itu4 Cb.Io., 

robiM!, & S.b@ld, 1998). Rchivcly &v@ p3y.hoi. i. @ntiD@B &d unldtirg 

in sm t timrs. h rh. long M it i. . fd n@ siou p6blai, hd.e t[6 @ 

FtM61 chag€s in th. F$ndity 

which hE

@jority (60-70el") ofp.tiaL {it! Schizophr.nia ndd nnry or hnv. chjldrd, .nd mo61 

h.vc lry f4 tiads or social @lllcls (Maglioo, M@o, Fionlq Mahgonc, 

Gumsi, & M.j, 2002), Mey paliars with S.hizopbqis will 1tsrc r rctdriy.ty good 

outcon !d do nor exp*idc. tn sc\@dcilri@ton@Eid@dby$m.rob.a 

nanrErk oflic disrd.r (rrn Srnorju, t bt4ky, Kon€n, & Enbdg, 199; Sdrqios, 

CulbiE! Hei$A Lal4 & Si.g.l, 19 ). t! gdeEl rh. ouico@ for fcDal€ 

S.hiapl@ic palial3 ir b.dE lb4 $€ outco@ for n&lc p.liars (cDldaa Hmw, 

Relap* i! g@lly def!.d !4 .,r.he fsturg bet ilto ! pdioE srare or i.io & 

eelidbeh.viorpfi.o (R.6d, t995). Th€wod i5 u.dGtnsrAelyin nomnlne ol, 

ph,sical ald drdicd ce_ 

Kalafi (2003) ha d.foed rwo i)!6 of El.p3eq Gadrnilsion ro rh. hospibl due ro 

.eanalioi of Fldonc syDpiom, or !€d fd dr.a &cdiclrion dr 6 woej,g 

oonditi@ from the

situation. Thir !@nug. is coBid.ed vay high by se prefesiod. .nd $cy lugg6t 

lor 6dha nngovemsts in lEalbdr to Diliniz lLis Et. (BelL.k & Mu*r, 1993; 

Robi@n, Wodd, Alvir, Bldcr, & coldM, ct d. 1999; M.ijil, I

Kul8. w.la B&mal ud Kjlsling @006) al$ Eporrcd lh.t mE thrn 50r"4 Flapc6 {@ 

du. lo no. rdhd€rce to eliFrrhotic tudic0tion. 

Hieh dprss.d .mlio4 

cert in.'yirellMirl f@roBi 6eh 6 high levele of fmiti.t.xp6sed arctioB 

e @in @Eibutory tutoB of EhFe (BDh, BiEt, & Wing t972; VaughD & IrfI 

l97q Chag, 2002; Hoole, 20o?). Th. inpoltarc€ of sial cont xt oi dorio.l sial 

clidlc ha be idedriiicd by W6lmE q 0989) wtD forid rn,i sFh jnErFM.l 

facbB a dgulMls, cndc.l ed hodjle bebavior of fanity llMbc6, !@iat Ej4rion dd 

lcs of si.lly sqpodiv. ElarioBhips wft lit ty b ir.lle rhd.he6 of chF. 

d.n in p*ieDr wirh slhdloe rbe ed Schj2lphMia (UMilbe, Gos@, & Smlg, 

1992),Tn emoriorol qulitie olfmily avireMd md inter&dor p.n@ s. 

siif'cmt prcdcro6 of th. @@ ofvriou p6ychiaric cotrdirioB, cm for i[! 

disordd for which rhe biologicat ad gdetic veiabl* pDvide p.wdtul €tiologic.l 

dpletioB (v.rgha Stldd, & F6r@, | 984). 

Pari€hb whos Elariv6 @ 6rod hieh on expr.s.d emtio!! &.1€ e muoh 

mrc lit€ly ro El.p* eilhin . f* @nrhs aftd di$h,rg. (BDya Bnbr, & Wins, 

1912i VaAt & tJA, t976i l9at). Krva&gn ( 1992) t'on d ed 6&ciared crilic.t. 

hctil. or emtidlly ovd iwotv.d .nnud6 of tey EtariG 6 tn. mh fero, of 

Ehpe in pad@i! Mlh Schiapbqi4 Mrh d€p*bn ed biFokr diordd. 

Rclalis ofparidc aitn nigh dF€sld dorioG blam tnc paridl for hig 

bchavioEl di.turbuc6, whib tn Ghtiv6 of p.tieat! wiih low qp6.d @tioro 

rtuibur. 116. distui@.s !o ilrn* .nd oosid.r rh6e h.ron

{B@wolougL Jon61o4 & Tdid, | 994). MNn\ Mwir, tone.! Wcitu $d 

Hem.n i2002) rctoned lhal nieh criticism in fmily ed poor @oplidc6 ro n dic.no! 

i! thc sE!trget pr.diclor ofElap6c {d raddisior ir pdiors wirh ..hiapl,6j!. 

Tte slretul lifc dot @ el.r.d !o incMs€d EhA€ Dtc in plriots wirh 

Sohizophr@ia, Bcbbinglon tud @U..g!6 (BlbbinCroa Wiftns, Iorc6, FoErior, & 

Mmx i93) rcDorted selng ard sigiifitut @tario! b.{w@ tif. .vo|! .d on*r 

ofpsrlhosis s wcll s ercerbatio. ofp6'€horic ayipiotu du. 10 sioedent !!6sfin 

Mt!, SEsstul lile €vdts @y er oBe sonon lo d*top Scni@phrdi. bu rhey 

ruy trlggd new .pi$de in p@pte who @ {lltrd6t. lo q.hnôhaia or my crw 

Fldps in patidq Mrh S.hiephMi.. 

The &grtiv€ lifc cvdr mr oid pBlding . rEllpe seh e d.ait of I chrive 

lhe br.*up of. Fktionslip or thc tos ofajob, dy mjor chege in pork or lifc 

rodioAnightpGipi|lt lhe Et.p.!. pmr pFmrbid .d{rltior &r &n@t ant F+ 

molbid soci.l qirh&$l d. .te Mdat d wi0r edlid Elspde (RobiMn, Wodd, 

Arvir, Bild.r, & Coldbrn, d .t_, t99)_ 

In I'jgh €xp6ed @orjo6 prtidlr'tifc cvhIl dc ,ol tu6lary 6 prcvox. 

rcrap&, b6au. high €xpEs!.d dori@ ir etfis , sufrciot sE6s. (BiFly & Bm*q 

1970; L.lI & Vaughn, I980; Falts4 1984; cit.d ton Migorc, 1993), Lik*i!c. 

negar's verlal inrcra€rioBl bet vio6 b€r*@ plrian ud plmr r!fr.d n gltire 

afe(ve styl. (Doee, Fal@a coldlreia & Milr 1985) ud disnd.d @Il]|Miedor 

patlcB rl$ caD@ olaps ofscniaphEni. (Doe., w*r, Cold.Lii, Rondich & Ion$, 

r98l). 

21

Substancc .b@ in pdidts with S.ldaptMji is r risk f.clor for rclaFe. 

C.Mbis e @ !@ipit t. Elaps. h p.tinr! with Schizoph@ia (Ilomicrft, 1990; 

Cerweu, Bwib, C!6ta, CLzb@t , Dlltir, & Fox !r !t,, 1999). Jeren .od 

BiEhwo.d ( 196) in q dicw nod elicitcd polcibl. o.rributing t&roE for r.tap6. a! 

plMc of dly Ngrtiv. ltilproD, d.pBioD ad noFl6$c., bigh qp6s€d 

emdon in clce .clrtiv*, poor adher6c. ro mdicalior s

allaiale comity ldi€ty, ir is re.!@y tc' irtddq Moreovs, if tnc dise6. is ml 

rrotcd ir c& b. d.ng.oa, s i fldlid is nee$ary ro ppal t.m io oths, Fom a 

sicral p.6periw, th* poicnri.l h!@ dc 3!frcidfto judry pot .tivc ill@ati@ 

dd €nlbrccmft oi tr.otrnoi borh ph@ologicrl ad b.naviod conbols (St phasd, 

2000). 

Ft{cotio. ofEl.!6e i! inportad be:ue {ery rift *nm Eap$ @N 

srnptons e tucdbaled or 8er wonci behayior olth. parie dd ogniiile fuctiotu 

@

vjtal olc in the sial cgendadon Md r@oNrulion ofa mlion, I i! rh€ na$sl &d 

fundanot l uit ofsicry, .!d drided b ploretion by slale Fmity is borh . 

com'ly ald d assiarid d at t4t . bddg. bereh lh* (euddu! 1995). 

Msinly ihft @ rwo fdily syglm i.. nwle f@ily stslrd ed ,oin fdily 

8ystd, Nucl.d fdily i! &e stull€t 1r!. of faEily orgejatior I is conrpos.

Tmbull, l99l; cil.d fion, Willd & Kat 191). Iltd. is consislcnt evid€nce rhal 

fmjly fu.tion a$a rha fmity srrurN hs r[€ 9@16l in4Dd uFn our @ fd rhc 

Fdily @n6i@ r@lML rh. dN .mtiolat hord! dor !|@beB bav. witb 

€eh other s w.[ s lbe lwel ofiodep@dtre lnot d individual dpqie@ virhin thal 

fmily sysrm. Fejly ad.pbbiury Ef@ to fuily., abitity io chag. in r$!o@ io 

srtMnonal .nd dev.lopnenrot str!6s, A.bplbitity n€lp6 to forg. ns vlys end fofrulatc 

nry 8o.b 4 ctoDc to dy ch.ngo md h.lps $e idily ro .f*tiv.ly dcat witn $!l 

srr6 (A.P Tubul & a,R, Tubult, r 9l; oil.d nom wiltim & Kry I99l). 

lfi Erca ol r.lrly o! S.nnoDlnd. 

Ir a lssc Fniotr of lirer.r@ .!our fanity lrd psFhiaidc j n6s wnid feqld 

on th. hmc .nyirctltMl qd de @odoDd climr. of rh€ Emitx thc fdjly hs bq 

repoicd as adopling ! D.g!ijy. lnnudc iow&d! rte fanity ll@be leh€led e Mblly 

(Boy., BcoEtu, & Malt, 2OO2; SaudeB & Arn€, 2OO2). 

'u 

psdtq siblings ed other 

hoE hold I)@beB tave hen tude r..loosible lo crue tnc inirjal psrlhoric 

Ailorte, 

a wll a su!6cqqr Et.p.! (tu8tu yd, Schultz€, & Dierict, 2()O3; Bdly, Nt CliA 

2004j Esp"u, Oneeo. O.hd d€ Atda & 6d,rLa 2003). 

The olc oI fmity in Scht !,ltrui. is mw welt docMr.d de ro cxpGs.d 

emlDns ed r srcwins body of t!s*h suppori5 ilis notio! (pb@b, Mri, & Sftird, 

2000). IheEpisls $aned showirg con en b fdily,s tutional cliDrte ed ioll@ce of 

none .nhonnal on parenr with scni&pn@i! il 1950s. working widr 06e fdili6, 

|n.y norcd jwbted qd loDnldictiDg ool|lfuicari@ styt6 in fmity seiotu (B.tao4 

,&Lsn, Hrl.r & w..tLad, r98 t ). fte cryl€ l@ rfledv€ of.tinuH 

ll

FLtio.Aip. &d dyliedool f6ily @trpoliti@ .trd c@iddld @t!_bur$y tc&f! 

aor maSc@ .nd nint.||@ of .yliprolE ir th. |facd nDily lFtbq. tt6c 

nniD6 wF! .Lo Frdv.d .. io bc oq imlld or .dAH wilt a.6 othd. 

R.pon dly lh* t nilid hrv. v6y w€l Saoli@l hoE&ri* 

Com.rl! litc mic.rioi

who do nor exprss rhcir egpr .d e ofEsirict d style lhey ed up nd.ing d.e&d. 

thlt patidt m mt h..! or feb di6c'rlr b tufiU, rod i! cpo@ p.liot f*15 sE$scd 

(Hdb... DrddE & Shilh, 198). 

The mst dilrcsing srmplotu r€poncd by lh. rcl.lives e th. nc9ivc 

slnptom, suh 6 decrc$ed level ofoersy, lo$ of Soal di@Ld b€hsvior, lnd gddrd 

u Esromivd6s and ca. giv6 attdbltion of th!!. n 8ltire stdtlod to P.ridCs 

bebrim naws Erhd lhu ilh6 (Huiio4 Dad&, & SnnL 198; HiEi.he & 

Lib.mra 199; Wi!.fu, NEhr€rleia Goldslcnl & Syldd, 198)- Dldc D.8.liv. 

stmpr@. e oft.n b.in8 preiv€d s cn@l4 ths, being @*@ thlt ihce 4c 

ch@ledslic synploru of SchiaphMi.. Onen fdily nmbe6 .tt ibute thi. bch.viot 

with deUb.de .Ifon !o iEilat , eoy, or tur€ upla ott6 f.nily m@b6 (HooLy & 

Cmpben, 2m2). MoBvd, riblings rnd pMb on6 fel embmis.d d@ ro rynpt.6 

!d behovior ofth. ill fmily nenbq ed lvoid inviting oth6 d bringing tia& hone 

(BEdy. Mccaia 2004i EsliM, Ortego, O.hordoAld4 & Gonala 2003i C@bdg, 

!n Badl. (2004) lt'ldr nd!6 dpF$.d th.n somw for b.ins blb.d of 

oBine Scni&ph6ia h thcn ofrsprb& IXc, v@ .ls @rcd.d ed upo.l dour tb€ 

ill Fsrt 

faL !fta th.t d€!rh. Having s .duX ofispring with S.hizghMia b 8le 

lswialed wilh poblehs like lMiLl disond, divote or leadine to d rolDppy ndir.l 

life (cned fron Ar.dy & Mccajn, 20Ot). Noml si.l intdctios rnd k€ping a sial 

netwolk for all fmily ncd!.6 CeB v6y difficult ifa @Eba n{ 4 illns lit 

ScbizophMia. Findinss of fdny $rdi6 frw Mi&L E$l4rn, Anim and Ais 

coDlris e nor n g.tiv. &d faDnid reporcd pditivc feli4! livins with Ptlidl of 

13

&hizopheni.. IEc Eports G v.ry unlilc io 3tudid nu w61dD ouEi6 (S.h*Ir, 

& Cidren, 2002), 

l.&2 Impftl ofM.trt l illtrg| o. Frn 116 

Ar incr*ilg nwbq of ndtdly and chrenically ill p@ple d@end or fmily 

nmbds for crc. ft i! minly the fdly wno p6vi.lc ce for hin or hd (Eagls, C6i& 

R wil$n, R6t ll, Bodc, & BNq 1987; J@d, & Vet r, 1984; Mohid., 193; cir.d 

6on rqw, l9a). -ftc mjor inp&t of @ giving is fdr by ln@ who pdid. ce or 

th€ inncdiaic f.nily bemb6 who ssMc rt. '!+oBibilrty for Ihe patiat (Mrglimo, 

Md$co, & Fiorillo, et il., 2002; Roick & Heida, Tomi, & Ang€Iftya, 2006). U6uUy 

tne mjor burdn of.e€ fslb or tn shouldeB ofltc clc.t fdrle.elalive (Smith A 

Bircnwood 1990; Mohidic, 193; cit d 8on (!w, 1994). In @sl cs it ir $c 

tulhd, pifc d sistd who .ffi d. ol. of .c (Gilhooly 1984; cn.d from Ka|s, 

1994), By asmirg ihe blc oI ! cffi, . hgh p.jc. ha !o bc plid bs.@ being . .F 

my lffet lho qudiry of life phrsical dd lMtal wcll b.ing .tc. Cdine for lll. mnuUy 

ill md dependdl Elolive n6 bm ESroded a r !t6!irl rcl. dd doti@rlly 

didr6sing cxpdichc.. It b @omdy h€ld thar living vio! ! ndtally ill is bu .Mm. 

dd notiondlydblr$ine qpdidce (On4 & $itubury, l%8t Psulshoclq & 

ll hB bc. r@n d hy tE4h6 thlr dbNbcd b.bivid of lLe pdidr qls 

no,. dttr 6 in Gl.tiv6 ed is Miated wilh high psrholoeicsl mftidity in fdily 

nembe6, fter. ir broad asEm€nt uong6t F!.dch$ dEt behavitral cnmgcd e 

mr€ likely to bc r@o.ted s poblm.tio, in p.niculd, orer dMdirs b.lEvior rd 

n€d foroottstsupdvisioni. smphlNical illn*6suhs slrot rrd h..

(Gilh@lx 1984; Krle, 199"{). sirnely R rch on Mtd ilb6 !ho* rb|l 

syhplom seh 6 lerrc$io,! contusion, iEitability, violde sd @idly dbmsilg 

behavior, pe@id idaiion, islatron dd Fithdr.wd caue mE pobl.tu for the 

alrdv6 &d @ v.ry difl.ulr ro liv€ wirb e fmjly mb.B f*l mc dLtr6 od hav. 

mE rcjclrg .6iude 1ow.!6 p.tiat (L€b.l!, M.rdq, L MirE, L.Mitq & roq6o4 

d al,, 1993i Hcilg, & Hamilion, 1966). Due 10 tlEs behavioral poblffi tlF el.tiv6 

.t lim6 wish lbrt lhs padcnt vodd be b.tt. ofd..d tud ene hav. qpqi@.d 3uici.!.. 

Fclins of !nc@ ws ale hid i! 50@ El.rir6 (O3tD@ & Kj.lli4 2002). 

ThN @ IMy kjnds of sdaiG ed pDbld wbioh f.DniB go thsueb wh6 ! 

peen b diignosed $ a plti.nt wilh Schizoplronia, This should be t?i in nind lhdr 

vith chmgine coue of illFs fhily expdi@E dilI@nr tr?n of hsl6 dd bEddt 

Io. danpl., a fmily who co@ 1o bov dour S.ltophqir for thc f6r tift Dy 

fel mE distss€d b@.w lh.t @ slill in d Btolirhilg plE$ md e ilyirg & ab6oft 

the iofomlion provided ihen by mdtal health pofdsiomls (Fldl8rd, 2003). Sinilarly 

McDoM.[ Snor! B€rry sd Drrt (200]) Froncd r!! paridb' ag. .nd fuily 

memb.is aw@s about prtinr's suicir'dny y@ me Mi.rcd witl tdily burdd. 

Failics ono cxpdituc a tnadou mbt of diety ed rrilt wh€n they 

fist com. ro tloN abolt ihe Mrol illnes &d fi.n n* ole a a ce givs (AtkiNon 

& A@ir 1995). Th. fdiliB whoe potiat n hs?ir.lized feeb md dfttres.d 

@dp8Ed L' fdiliG wnd lhc Fti6r 

i5 b.ing tatld at od d@r bst.'Ih. l@d of 

ui.ty i! olso relal€d io th. gcoda oflh€ afioied fmily menbd, Fry invcstieabE 

hrv. Ep.n.d ob the djfi@otial efiects oflhe ex ofrhe relarivc on th. degl* ofbuder 

35

fti i! p.nicukly s for rcw csE8i6 dd fmilid wbo hrv6 iI f$ily @nb* b.ins 

[st d a out p.li61 @!p€&d to t[. Idily rho'r pltidt is h6pibli2cd. 

ad{iMn (1995) *dincd the sEdd dj,Id€ncs in dege of burdd. TlEy 

eFoncd &!1 SchtophFni. ilbsr in a sife had a mrc disnpliv. .ll6t on fdily thd 

drr in . hubatr4 Fw Bntilh 3tudi6 dle h!* plid !@n .il@ti@ 10 tx diem. 

casd., wely &d Mmy (1993) noied thd rh. mdc pad6r .tnjbiicd n@ 

dislubees in Milll rlrtiofthip6 lld pldtrl fmilics, tn6 silu.tion beinS H6ed 

wba $c p.ti@t wa &d|q OrlEla walktq\ &d Kjelin (2005) foutd $al s!oc6 

sho*d mG butt€s e tbcy w@ ne itr@lvcd i! cN givinS $d tlltMt pLr a 

ompdnd lo siblinc! $ey w@ 3el

"clftnic somw" (Olshdsky, 196l ciled for4 Flda8rd,2003), P@plc wjih 

S.btopnMi. behave dilIffitly tDn tn€ wly lh.y usurly d,c, $ &.n i ns is 

nisundGbod by olhm rd thcn f.bily ftmbd3 .l$, aid a . 6ul, lh* Fdol' e 

StigM cm b. d.fb.d a a mt of enbua@! condmtior or di!.ppovd 

*tich G'!ts in D bdividud b.ira disrrdcd or alldon d by olh6. Mdy lnrdi6 h.v. 

rponed $!r tn sdgtutizcd atirud€s ofp.opl. !E *id€ sF€.d lrd .otrtrtrody h.ld 

loward! th. poplc sho e ncntrlly iU (BF., 1999; tom & .I.@Db, 199; Philip!, 

Pae'l Xu & Ydg 2002). The .tis@ Mi.t d wiin all Mral ilbdc is lIong bd 

ga@lly incrc66 4 d irdividult b€tayior difl6 ton Ihrt of th. non 

(Hegbbo$.nr 198; Link, Studing, & Ran|v, 199?t Phsh4 Bohe! & Link, 1998; 

Pon6, I98), Slig@ is El.t d ro l&t of *rDvLda. of lne gddl pulli. abolr lMrd 

illn€$, which is frirlhq lggnv.tcd by itus6 of violot b.havior cxhibited by rh* 

palienh (Andaen, Reist & Hogefty, 1986). A swcy ws conduct d i! Britid ro 8.t 

lhe public opilio! alout rh. Mtd illr*. Th. csFrdab cotm.ly poeivcd papl. 

wirh ncnd illr* a upndictlble lrd das6s (Cn+, c€1d6, Rix, Melrzer, & 

Rovlcndq 2000). Cenainly lhi! .o!s mch p6io, disFess ed sture for de Imili.! 

and ldds to i$l.riotr a hwiliatio!. Mouvd, pdes with ffir.l illns e si.lly 

dclud.d Dd f*. a birsld attiurlc *da go lor dplordoq iBM d r.atnd! Dw 

lo the6e di$riminaling annldc paddt ed fdily dcv.lop hopelesnd whkh tufthd 

low@ thch elfBtem ald th.y b@e 5@idly islat d (Gtne, Wdlsl.!, & Kjcllir! 

2@2). 

31

Fdni6 ona Gtr.ir 6cn rouriB sd d.il, diviria b cN for l!. p6tiqts, 

Bc.e of lhe patidl's violoi ed disr'{'ti!c bch.viou od t€scivcd deSd @ 

fmilid l@ lhqt palrcnt tuy hm bim.lfor !o oihas 3o th.y e or coosidt ligil ed 

fal v.ry cxnaut d (And.E!! Rdiq & Hogrny, | 986) !d hav. v.ry litll. fre dne for 

ln.@lc. TbN rbey b@m islarqi 6$ fridds !d rh. otuity wlicn por. 

pdco!3 .t 6k lor cnrcnic hdlth prebl@ dd physicrl dsline (And.@4 Reis, & 

HoSrny, 1986). oF ofllE mrr dldeing @n!.qudc6 of lvbg wnh a tllalivc wilh a 

p.6iscn1 Mtd ilb* tu rh. dclqlMt to dhl ed lci5@ &tlvili6 (Holzi!8a, 

Xjlie, Lindobeb, Pcr*hcldir, & ADgm.yd, 2001; Saurxt rb & BF., 2002). 

Fuilid who h.vc a n.nbd sufoing frcn SchimphEnh ond incu 3 g@l 

finmial bu.den, Du. ro d.biul.titrg dle.l! of illr6!, palidt leels diftodt 10 contiru. 

his fotm job- r1E pobl@ ir.lag *hd doUa feily tmbd lar6 his job ro 

look affd the patidt a w.ll a bd hor hold dd @fimdabl. D.dioirc dp6s 

(Alkinsn & Acoi+ 195), IrE siiuatior tuine woBcns iflhe pslidt wa h.viry good 

.@ing b.foE ns ed !!ou. is th. cdc giva (A&insr A Acoia, 195). The dtnt 

lo *hich th. fdili6 of pstrhi.tric p6tidts @ ilpovdhn d shodd noI be 

uds.ltibrt€d ?!Ml! gci wdied Egqding rhc c@ and fimd.l pls .bo!t $* 

poti6$ in the lons M whco $ey ger oldq dd noi abl. !o late ca. of th.D. ftoud 

sibling! povid. emtiorl suppon bu dcy siw mniid fmcirl sulFon (Pructm, 

PrFicL, & B@! 1996). Fdili6 imu a oGidcnbl. buda *nile 6ing for ! Mrdly 

ill p.mn; rhe followine sdor pdvid* r b.ief ovdiw of concepi of nnily budo. 

l8

l.&2.1 F.rdly Burd.! 

Fmjly burd.n c& bc ddrcd $ ds p@nc. of pbblo!, diflicullid o. cfr@t5 

which sller thc livcg of pdtchin ic pdridf! c.6 .,9, nmbar of dE how hold, 

Sotu rlthoB h'. @Mr.d on r[. co!6 rhd fdilie ituu in rm of py.hologi.d 

strin md sirl iehrior (Ctg & wiry, 1974; Ho.irg & Hd ion 1966; IoF & 

v.1@, I9Ea).T!.y E8.rd lEh mtioad ftriB .!d @i@o@Dic d,f6cr i6, stlich 

e hdn. by fdili* .s trnily hrtL!, 

lnti.lly Cll'q Dd Y.lw (1955) p.id lnadon to $. dylMic. of oid 

.t{f, of tbc fmili6 ofp.dcd! witb Schibp|rrai. in U,S, An@.(ls Mi[. (1962) 

pomr.d rh. i&! {d l.d Gid !d s.inoEy ( 1963) io loot i!r. dG sid rd 

psrrbolosic.l Fobl@ ofpdians r.Ltiec5 rnd in!.

6!€iallt whd U. lmtlly iI peen liv6 !r hom. At hom, ce givins i. ..sirt d 

win nm@u cri!6 ed frEqEt disruplj@ of fdily life (Solo@ & Dnh., 1995; 

T6slq & Cmrch., 1994). l, particul& for thc fmili.! aisinS childM with hdlal 

illne$; $erc b a contineu snuggle to tuct &c rc.d! oftn wnol.laDily ud !o sEit 

a b.ldce bdwa rh. FtiaE spsi.l nccds dd ne& of tn otnd fmily t:mb.B 

6p@i.lly riblings. Burda on 6oili6 ha b@ divid.d into objetive .Dd tubjc.tiv. 

brd€4 rhir dierion E d$ ba

teles to fie ch.ng.! which nay. omured du. to pftM* oflhe Ftienl 

md lrlc 2 

burdeG Eflecr chugd Dd srrploG in rh. palidt *hi.h bave $uxed diEdy nod 

rhc ilbs. Subj*dv. budd Fllets l[c globd ntilg ofburd@ 

In 1980, Zdit, Rev.r od P€r@n dcfin d burdd 6 felilgs of distfon or 

@ces wii! @p@t 10 lhc p€dologial wcll b.ine, fi@cial siniat,on md @i.l li& 

of tne cd€ giva. Itry linited $en deaDition ofblrdcn b tn€ 3ubj4liv. cotrpondt of 

il. Thon{@D a.d Doll ( 1982) dlsna€d 6e .Ilotirc di-rion of bud.n a d 

.mrioMl st lrd u.d rhc @mer ofbEd@ io cion4a lbe f€li.g ofovdlo.4 

felirys ofb€iry rappcd, esntrMt dd dcluion, Objetivc bnrda w6 d.6rcd a 

disoption of evqy d.y lif., s a E$nt of cding for lhe ill fmily nemb.i, It ha beo 

*!@ted ihat 50 io 80 pd c@t of p6o6 Mth Schi@ptmi! ed Elrt d Fychotic 

di$rdr live wiln or hav€ Egul{ mtrct wid ln. fhjly ce siw (Gibb$[ Hd! 

Pow.U, 1984; L.ntu & Sr.irwh€q 198). Tt* cm giv6 tpon higlt l.vcls of 

bu.dq ossill€d wirh cdins lhe nalllly iU Eladve, The budd r.lrtcd io .@ giving 

includes expendihe for ratMt sup€trisioi of n.nklly iU l)mbd, dcalitrg vitr 

sial sdera alsi.lcd ro @lrl illlB ud daling wilh mtio.al drstE$ c!u.d du. 

!o ilh6 rn .ddiriotr 10 rhe mtio.al 6n of {itrg' th@ is o potariil phtsicd @3r 6 

pbviding cde lo ! chbnicdlly iI family mnbd ir hdd m lbe Ny. This burdd il 

equivolot 10 rhat of thc care eim ofpotiert! with orhd paihologjes like Alzhcjneas 

disee, tHlal re$rdrtioo (Mdy. 190) ed phylicll dieldft for exarnph di$.16 

(Bi€g.L 5,16, & S.nuEl9li Gnh@1y,1984; Pod. & Ca+id.llo, 1996) d.tMti! 

in clddly (Ede, Cni& tuwilsoA lr6bll, B..ni., & B.s4 l98D chsnio 

4l

i'fr@logic.l dsline, iocluding mr. !.vsc .pkod.. of infetiou illn6! ard ov...ll 

p@r ilmue slslm tunctioiing od cdcd .lo (Kioolt & Olsd.1994). 

Biegel ed Milliee (1992) obsry.d thd th€e @ hulliplc sE sss for povidilg 

cee to mddly iU Md lh* @ lwsiv. lor ill fmili6, t w ld.l oftunctionirg of 

fie pa:iol is dsial.d wilh highs ldv.l ofdisrrB! in ce gi!6, hidr deSre. of 

dsbes od burds in rlatives als d.p!n.b on ihc numb{ ofhos thet spdd iogetnq 

&d how cloe lhey d€ to €eh otq (Koukia & Mldiaei, 2005). scha. (190) had 

tfDed $e @rccpt of obj-iivc burdd lrd .xpldDd ir in l.@ of tsl! ihai a ce giva 

or fdily cdi6 o i.c. hehir& suFdhii& @iE lliig ed psyi!& p.rfomjag 

ativiri6 they @ noI lblc !o p.rfom by tha@lG c.& wrt tobbig club erc, rd 

@.s!que.dy fdily '|Mb€c e &t.!1. io Ffom th.iroh p€Mn l nobbi6, wo* 

axt club for thd*1v6. In @.lr.s 3ubj-tivc bud@ is d.mined by hw ! fodily 

ItMbs qpqimc o. Bpold. to pot.dridly diitrsing 9Dc of b.brvid or sinJ ioB 

(S.heoe & CatEn , 1990). Alrhowh objctiK buto my *m of s@t.r 

significee, suljetiv. buihn ,. rl$ inponm! s it i3 rh. $bjetive iftaptg.li@ of 

evqls wbicb En@15 lh. .tfals on .rrc givin& It b inponer to dhin r[e an ibudon 

ad copitr8 styld ofl,!6. cde gjv€6 (R.G,, Mort, L,W Monis! & Brinon, 1988) &d ro 

inv6ti9te both objeliv. rnd subjdriv. burd.n (Choow.rh & SFncd, 1986; Dsnling 

& Boss, 1986; Kaw, 1994), 

The cuent litq.he con iscly d.filcs lubjccliv. bud.n 6 ihe reliou (sulty 

f*lings) to lhe wo! synpion or dvircmcnt of caE giving, while the aotuol oor! 

ud slmplom e. vid.{t s $bjecdv. budd. 

42

h sut!&y, objetiv. buda hr! ba d.6ned in tds ofspeinc efeb in Oc 

€very day livcr of€d€giveB, c g. dimpdon ofdaily rc|'tine. fituoid dimculi.!, rcle 

sdlil ad phlicd nath poblm @lg cffi (Zsiq P@d, & Pdsl! | 980). 

Subjeliv. burdd h6 bq d.li@d in r€m oamrioDal cod ..!. &du.€d @ot., 

dicly, d.pe$ion (lhonrFon & DoI, 19E2) strd p@eived !i6in in rclarives (BFoks! 

& MoKindl, 1983; Btut!, l99l). 

P&nt l bunta b6 bcn fobd ro h. highd omra pdcnu of cbittta *ho c$y 

on or two dialn@is wilh a@mpdyilg pltrho@i.t in4aiftdr (Angol4 M6s, 

Sl,ug.l, Fmcr, & Coslclb, 1998). Abo, Fh|s wno hft Fc diniry nd1't h..tlh 

prblm c p.&eivd mrc burdddrhd o0dpaMts (An8old, d.t,, t98). Seity 

dd d@rion of .hildts's emlion.t pbbl@ i! lls $sided sith slr$s, Bldo of 

cG d.t E.E ldel &F!d. |4on drc rehriE r .ppris.t, how lh"y F@ivc lhe p.riat 

condjrio! hrhfi tn6 tn &tut d.fi.irs ofp.ridr (S.uzfa & Kuip6, 1996), Th. 

ihpdrtive rol. fmily cm plcy in trqlncni dd tuasmt plm in lujec. wirh $. 

tMLl halrh Fofdioo.ls i. dpl.i&d ia b.tow eih srior 

l.&21 F.nily .nd rrc(mnr 

Thc two imporlanl @ial f&io6 tbat irnMce Mr.l h..trh e the tsily i, 

whicl we liv. Dd rhe siat avireMl wc @m m_ Evidde suge.sl lh.r joinr 

rmily si.etu., fmily coh.siven€$ gHler optonuij* fo. !@irl i eg.tioo ed 

ture positive view loward! Mral iln€s suppon the bens out @h. of lhc illMs 

(Bircnw.o4 cehEnc, Me MiLa cop6Ltq Kuchska & cqi$, | 992). ftough 

involvde.t of fmily @nbe6 iD i.tervmrion programe wc cs work for ! bcnd our 

6re d

NoN rhc isuc ofnow b auwiale fmjly's budm 6s@ixt d Mth noL1 ill.6 

.nd now lhe flhjly 6 b. h.lpirl ir iql@liDg IrstuenI pla will b. diea€d. 

R6€rch did.ft. .u896l3 $ar faDny pbyi . pivorrl oL in lishot of ! p{j@r wnn 

S.hiaphrcnia. nc &lsrch ejih fmili8 h.gu in 6ly I960t. Ilinaly thc fofu w6 

on fanilies wnh q shiapnMic Mbo bn .ft.r lbrt n bbadfted lo includc the 

fmiliB ol ih. wholc nns. ofp6'rhiltic disrd.B. 

Anqlpts io ds.sc f.nili6 in ! e€lnot pDgllm &d swpon povidcd by 

pbfdiorL my b. hdpnn ir erd alpeG for w.ll beiry of pstidt ed tn. lmily. 

In seEd snudotu p.timk wi$ Schiz@hMi! r.quft si$d@ ftom rb. fdily. Ono 

they r6is1 ot efuc ro t t tr.otrnal h.lidiog thrr psrrhoric sydploa lh.y de 

expoiocing e Hl .nd EEhat is @i rquiEd, Ir thele circmtdcB fdily @y 

ne.d ,o tlt d e{v. ble ro aer F cli.lric hclp (Lrblq & RNld, 2003). 

SoDe lim6 th. fmily dd o.ly clo* Eladvd e aw ofhj/ hc odd b.bayio. 

dd bizm tholAl3 rh tne pe&n expB!6 but h./she .void! voloreeiinS suh 

info@tion at fim of plychiaric daluotiorL s fsily cd eive &td&t iD&@lion thal 

cu be t td inlo &@ut for Drtirg di.gmsi6 (kbu & Rosla, 2003), 

ft ir inDdtiv. kr elre dn plridl b g.nbg Edhsr Egul&ly bc.e rhe 

pali@b onen dsnrinrc rrebnnr dd Jlop r.tin8 ncdicin€ dd EfiB! ro 80 for folw 

up, oftfl le.dinS io rclaps. (Owd, Cdoll, Fluih, & Cofey. 200 D. Fuily c.n 

acomae lhc pali4t or t*. ftspdihnny !o @ntinle lralnd $d for r.gule fotow 

up io innu@ dlc Eov.ry. Ovq ti@ e@ p.tiot b@tu e smly is.pritaling 

!d rcy lhd n 8.t' difficul fortld ro Ffom tn n iiqle @!da &dvin6 dEy oe 

44

not c@ Ior lhcn pcenal hygj6o, cbtni!8 ad fooq ihe F.d. e rl$ llld c@ of 

by rhc fmily l:mb6 (C@v!A 2000). 

Engrging feili6 in tqtned plo dd prcvidine rh. infomation dd krowledgc 

for hs is h.bful, b€ie lh. fMily !E b6 my dognt 5lr dly sig6 ed 

sFptom of iopcftIlg rl.p*, .sh s rlillurbrc* il b.h.vior end rculirc titc si.l 

ilolatior or ch&8s in sl@p pruem, wo eelier thd lhe paticnt! the@lvcs, In tnis 

wry [€oh6r ny pBor ! finlbbM Et.p6. (P.na w.ldhcrcr, patiil, Mue, & 

rlmily b ilolvcd i! rhc !€arnai rhcy cm pbvjd. rhc fi6r hod k rowledge 

lbou nEdic.tion d which pltior g€rs inpov.

Fn $. fdily p.'rbo .dN{lio4 dill.Mr &finnios of p€trho €duc.tim ed difiddr 

mo

ale contaiB €morionql a.pecE, ro poriar and $en feily mnbc6 !o @pc wirh the 

il|* in . b€ncr ,r@d. 

The conc.pt ofpsylho eduation fid .pp€ared in m.dic.t lirfrftft iD l9i I by 

Joh4 Doile, atd Nbs€quotly BEir $d Tonrlisr wr. . b@t ..pst€!o .dsalionat 

clinic" in l94l.The tm plrrho€duc.rion into irs plw.t fom was coircd by And@n 

in r1980, D ELdoo to Eaonel of Flr.ts wnh S.b@phmia 

Along Niti poviding infornlrion !o prti€nLs od fmily mhbqs ahoul 

sybprotu ed co6e of h* and how ro 'e.g. lbe, he ats iftluded sE6s 

l)rMg.ndt lohDiq6 ir hi5 r6@h. Fjn lylehniqB of behlvior rldlpy ve 

in@rpodtcd to dc.l wilh @tionat {d sin lkills (oil..l to,! WjtiFtia 

p6ycho.d$.tion). In c.'l@ F'&ho .derion ha bd d,*etop.d si@ l98O s d 

ind€p.nddt psrhoth@p.uiic pmgtm &.Bjng o. rhc fidsork of cogitiv€ 

b.b.vior rhd+y .p'pb&h {B&trut, FDboF, rtuq, R.nr@, & W.ta 2006). 

Poper pstlho€ducarional irtdmrions, bs.d on ! psycho c{tagoeicd tn6iy ir 

.u|mt qe ** d.veloFd bt lbc AllrbEgh gDup tsd by Hosarty md And.Roo 

(Fogatry & Art!.Eoa 1986) in thc @nrxt of ftlrner ofs.hjzophMi! !d .dQi.d to 

multi fmjly sltiosg by Mc Felan. dd @U€.8u6 (McFstMe, luk n6, & Du$, 

1995). The pE8t|fu h!v. ber i cgErat wirh u!.1rMtuar pt& for pdidr of 

l.t2 Mo.l.k ol &y.toduc.riotr 

Mdal n!.llh pbfssiosk blve devclopqr . nhbd of fdily Frrho .dution 

pogld! ovd lh. p€.t iw4ty fv. ,!b, F@ sun s Libdm., ard rat@i, 6goiliv.

chaviorcl irt€dorions in thc fmily (Libtu, l98t; Flloon, .1a1., 1985) Letts 

prtrh@ci.l inrctBlios (t fi, d at., 1982) ed cotdsrein! mtnodt 

(Miltowitz, & GoftlsLi'\ 1997) s@ *t-dc pEcdce rh.r @nbh.d .tclMl! of 

Fhily prrno cdetion nodcts nrv. vdioB ddign, for exMplq Dutriple 

hjly (McFdl$c, t 995) sinelc fdily {Cot&cin, ct !t,, 1978; Tdicr, er at,, 1989i 

Hoglrty, .r .1., | 9D or s El.riv6 gFup (tdT, d d., l99O) or mnad sionn ib€ 

pdiod of lEaEnot ilvolv@r of r!. p!tio6, sire, for q@plq cthic b.!..r no@ or 

any ot]tq l@otio. i! lh. .omuity. 

In linglc fmily scftin8 s rhe nme i,pti6, pariqr dd fmjly dohd! or $. 

nh @ giB of orc fdity mr6. gop, bdp6pnocdurion l inaution 

rF.Lgie e. qDlid or l!a1!.lricutd ftDily $d parjdl. Mutli f@ity gDupr s@ 

dd.lop€

.ny ralogoa tcls such s Fy.h6rb:i. or fmity rhpy il$14 psyrho cd@tion 

loday is 4 Bbb&lh t€nrl u!d!r whch sml ditr@( wa,s ofpr.cricing e no61c4 

Th. €voludor of p.ycno .d@don d.pqds hrSdy Won l!. m@jlgs we dftibuL ro Ois 

tm (cned tun wjrjpcdia). 

Frmily p6trho .ducsrjor hs a gnwinS body of 6@ch and 3trong *idc.cc ro 

bG pr&tic.d in clinjcat tuulin . Wo hw. !o @gdzs 6rr !6jr[o cduc.rio! hs beom 

lh. fmily lra!ftot ol choi@ tor scniartMir Bapold di.od6, d.pffio[ did, 

disord4, e1i!g di$rdo!, p€noD,lity ttilordl6 ed othd physjql .tisrders mwadrrs, 

ed 1nal the pstrho €ducad@ for lhe fmily mnbe6 ofpalicnts llffdjry fron 

Schiaphdia t lnongly @nm@dcd (McFslmq Dxon, r!ra!, & Lucklre4 ZoOj), 

li h.d E oncd Educ€d rdee brq idp$ld tuEd@bg of rh. p.ridr md idprwcd 

qulny of lif. of fdity ntubcs (Dix@, Ade, & Luclcr.4 2O0O; ptu & Mug, 

r996). 

r.9.1 Obj*tiv6 of Prycho{duc.riotr 

Tn. mi! obj-liv. oltmty p€Fbo .duclrion is ro pB@r Erlplq u,4rcv! 

sid imriorilg ed qulity of lit of pdiaB Mth Fvft,Fral illlEg, Fuity 

psycno cducalio! pngrm pmvidB lhcm idomtion which h.tp! lhch ro uddhnd d. 

iuness as well io deal with iheir f@ily neDbeas .risordd (Dixo4 McFeloq Lefl, 

lutst d, & Coho, €r at., 2OOD. 

Aelnr go.t of rhir plogm L b prcvid. sqpon to $. f4nitie A! disu!!.d 

@lid fdilio incu ! lrdados @ut of bud.u (Fldotogicst, f@i.l 

tunod ed $cirl) e ce 8ivft for 08. !.tidr on loDg tem bsk. Thoush min 

focB offdily psycho .ducalion is io irprevc rh. p{i.nt ouLome o Mci.ted 8oal js 

49

10 promol€ rhc wcll being oflhe fmily (Di&n, A.bE, & Luckrcd, 2000), 

fte poldrity of cdulion fo. fditiq of lhc tmtrlty iI is due io rhc sbd€ 

t@gn'aon of rh€ f..r by pbf*iomt rbt bsicaly lh. f.hily r.tc |le cpooibitiry 

lo @ for r lMrllly in FtM (Crfuv.4 2000). Thtu is p.njcd.rtt Ee iI @uEi6 

wn@ the dlphair on tn cft of Mrtly iltis m rhc 6tlr|Mity. Majodtof rh* 

palienrs ft lrcared in m outd@. ktring dd th.y e living wiih thcn Imilies (sch@lcr, 

K€ilh, Sevde, Mclh.w6, & B.ll6k 1997), 

S€vdll swcrs i4licare rhrt Ehtives ncd noE infomdon .bour thc di!6d 

&d how !o deal wirh it .fdivety. b ni. c& ofschizophhi!, ri. ir@ia!@ of 

piFho€d&.tior ir de d!. io th. i,nudar t*@h f,dings E8.&ug .ipres.d 

cnFIioa. 8614 Bidey .!d Witrg (19?2) qeutaLd qui. qdy rhlt hiCI dlteed 

.edoEadue,orEtalive'3t&kof *nowl.dg..bodtn iunq_ t!fi .ldVaughn 

( 1985) sug861ed th.t Elaliv€s wjth high .xp@e

srlrrloN. x .lo bclpd lheh b daelop 6piry stilli for I:@Cing ibe toubl.d 

b.havior .aus.d by nmril illn€ss in rbch tdjly l]hba (Mef&lmq Dnoa 

Lul@6, & Luckled, 2003), 

Th€ so.l is ro work logerhq for r@ovdy. Il olm in@rpoEr.s lhcir in

.dEltiood inld@ti6 cd b. nun bd.6ci.l in rhir Ee!d. Rq@h didene is 

suSSdriveofitrludi4tn fMily IE €lo ed@.,riodt i.&Fatioq $ ourilc rsr4lt 

pltu td fuilie ald plrim& with Sc[japlf@ia (p.k h & MaiDdd, 2OO5). In t€w of 

l&t of t!s@b ir rhir @ in t.ljs|,n thir snrd, ha b6 @i.d ort Mlh llc obj€otiv6 

l.l0.l Objellv6olShdy 

FoltoMne w.re rhc min obj@rivcs of th. @.rcn 

L To d.luorc thc ettrclcy ofF'tho .dk.ti@al i wotioDs in f.mili6 of 

&bizoplEdn p6ri6ts in Elltio. ro EtsF€ pBalio, in pali6r{. 

ll. To edu.& fdili6 *,iicb b ns @y h.tp o$d f.&ity tl@b.s ro @p. b.fl.r 

wiln diff@r llpet of th. dis.!., s wcU s to

Thc Fyrho .d@rion gb'9 ir litdy ro rqon L.s burd6 .t po.r bra@do 

Lvcl a oqdld 6 ild rFod.d !l Pt! irr.rv..rion ld.l. 

53

Luhrlc R.iis 

This ch,pi6lrcvid6 srnlhsb of Eievmt lir.6iw Evicw€d or rlipse r.tE 

Glrpe prcv.ntioq psrho dlcdionrt int Ndrios .nd bunten i, fqili* otpstieu|s 

wjlh marrl illnsc in Ad@l ..d wilh shizoplrdi! in slcific. 

One majd inp.rt !r dd w.ll inv6tign d prEdctor ofoutco@ i, t€@ ofp.d@r 

@ovcry i! fd y dvibnlMr tnny qviretll@i &.1 arriiu& of fmily Den!@ 

have b.o fobd hdpftt in €nh&drg a n.nr.lty ill Fe,,r aliliry ro tlmin te of 

psycnouc srrrto@ dd i,l}Dv€ his/ nq wel bei,g (refi a a1., 1990; TMj6 et .1., 

1989i Vaugha & kn 1976). Dificml aryilicd studig hiv€ poudd pidre by 

r.poning Ac !@* of foily i .rdtiou which.im to mod i b.blvior &d olc oI 

c@r or@ldly ill pcM (teII, Kuir.n, Bstovirz, & Stuig@n 1985; Falloa Bold, 

Mc{ill., el at., l98S; Hogany, Ard.@& & Rej$, t 986). Clnc,u t !. f@c€d hw 

on tle nnily, rhe Dain ce giva dd lle 3uppon sr.En for I:@C@nr ot pelidlr 

wilir Schiz.phmh vbjch in .h hivc qult d in Edkils rctap.c md ed,nision d. 

D thes. pali.nts. Thftfoe lhis cb.prd cvi€ws t*en lilao@ on El!ps.! ELp6€ 

pEveD$oo faDily burdcn, psychocd@arjon ed ir elld on synp@n s@1, rdqe 

2,1 Schlrophreni. !trd Ret.p. 

Abo h.tfof llc 6si oet p!ti6t3 with Schi&phnnii d. ritcly to ddclop 

rwDl or peFilt nt r6ychoic alrnpro@ (Robi!$D et al., t 99; petu, Wlt(llldd, 

Pekim, Mu!q, & Lj6cM, 2OO5) md D.ed ! long rm @ e ..alM! R.Lp€ 

4te in Schiapbrqia h .lmirsly hign .rd weeb i'n.diaE aMllotr orhai.t 

54

Jrcren $d Bi&l'w@d 0990 h&e doc@.r.d atrp6€ d.. nom a Fvid of 

vrioB E.eb 3ll|di6 a fonowing d. sonilh RG.@t cFup ( 1938) Eponcd 4?% 

of@dnjsior rar. .l tm ,qs, Th€ Nonh rict pel srudy FlDn d 65% Elape 6r. !r 

t*o y.s (cDB, M&Millo, & Jon4ione, r9E6). A lnldy in Bmirddn r4otud j5./o 

reodni$ion EE .t on€ y@ which ircrc&€d lo 5@/0 .id ihc reoDd ,!u (BiEhvoo4 

Coch6e, M&Millm, Kucha6kr, & k{iss, t992). 

h aothq snldy 23% n.d rclaFcd vilh dc ,rd in lpite of hig! d.

a|Idts d€ry &!pet of rhc p!ti6r'! lif. (Hebr@hl, Ma@, Fl.tird, & S&loriu 

| 92} Mo* nrdi6 hov. fou

ofolN ofschtiphhir 0dT, 198?; cit d tlh Gold.ten! 1987). 

2.2 Prycheduc.rlon .!.1 Morir xh.s 

Accordrg io tEdt I!@h did€rcc th. irt.Sra&d traldcrt of 

ph'lrr@logiol rbdpy ald p6Flt@i.l intcwdti@ i. tn. 6l .II*riv. wy ro 

pddt F .hosis (A!A, 2001) dd ibis @dbiraiio! o rldue ol'' ofFl|Plc, panrp6 

lo ahout 15% to 20Pl. (Mciil, Krlit$tgd, Crt?dorcL, & KrlJ! 2006). 'Ih. liif!.elly 

@t€d ed@tivffir of Fy.to cdwti@l irtcrv@ti@ for familid ofp.ti@ls with 

Schieph@i. t .ti.uldy i! el.li@ to rbF. prcvalioo, B 8rn tim i.v6liea&d in 

*ly l970s rld lE dirc. be! coD6med by tuy r6@tr6 h ditraai cdt!6 ud 

coulri6 U'eughout $c world, 

Thft is *ong dida€ to s4'lon tbat El4!c t t dd66 in p.tid|! yil! 

&nLop[Mb wha fmily magemt ir u!.d in cmbidtid vitb n.@lqtic 

dcdic.tior (Iuia, tiw$A & B.mwclolgh, l99l i Laia Tdi6, & Dr.tc, 200')- 

Ba$d or Es@h widocc feily p6)rho .ducition and sqport int rdi'ons e 

ontidaed very inpoftet in tdrmt of S.hizoph@ia (l.hm & S&inwrchc5t 198; 

Diro$ A.!aDs, & L@rd.4 2000). 

h ln. l4l lso d.c.d6 t!@ t d b€n ffi!*lblc rdv@6 in th. p6Fhologi.d 

ir..bnent ofschi@pbieni. (B.ll&k & Mues, l99l; P@ & Mwer, | 996) ..d 6 a 

F ult v&iou f.mily intcrydlion pmgt@ acrc d.v.lop.d liLe fmily th@py in ! 

3ilelc e[ins (Frl6!, .t d.. 1985; Tei6, B.l!!rcloueh' et .1., 1989; tiog.lry, 

Kohblith, GlEMd4 Di.barry, & C@lcy, 1997) ir ! buli fobny s.ning (McFdee, 

L!t@, Dshy, ei al,, 1995). 

Al pGeDt lhso .xisk . cosidaabL body of .L|. non a mdriMc ofsludies lbrt 

57

@dm thc .ftarivas of dill@t @dels of fe y Estndt for rh. rdetio ol 

enotional expr€$ion, .le.Eaing relapse El* aod ioproving .liDicol pngress, wbich, 

nlo@vd, d! rsilled with th. r.dEtion of fmilyburd.r (Diron & kbM4 195) 

wilh psy.ho cduaiio! preglm fo. cladG (Lr$, Bqtowila Shlvit Sten o, Gls, 

& vauCle, 1990; Goldst ir, l95i Walz, L4ht, B6uril, Ki$line, & tueel, 2004) 

sial rElk mirinS lib€d at inprcving b.hvioEl aileI5, s"rptoN ed shl 

fr!*tiodrg (AbmowiE & Co@x1989; Baror & SchFedd, 1990) coliDS skilb for 

Fducin8 thc psy.hologjcrl inp&t of de illn4 dd @ntrolling thc positve synptom of 

ps}chsi$ dcluions (BEloulia, tlgdoa SlN, Clolh@i, M.&s, & Heis, 2007) Dd 

hallucimtions (Mdwell, Fdhdl, & Mott€4 200?) Mth inregrlcd tqdne (Fd!dcz, 

Giraldez, Siu, Cr&i4 Sech6, ct .1,, 1999). Mosr of rhee inier@lio$ e slbslrled 

undd ore c.t.8ory ofpsl'lho .dMtior o. @ntrin al l€ls od @trrpd€ni ofpsFho 

A lo8. body of eviddc. 6ur,pon lhc Bc of fmily psycho cdultion 6 ! "b€st 

p@tie" fq y.og adufts wilh Schizopbrdi. ed tn.n {Dniq. B€.8 ofrnis !t!n& 

evidfl€e res@heE ar thc univ6iry of M4yl&d (L€hru & st inwo.n4, 1998) $ 

pon of$. Schizopbrmia P.ricn$ OuhotuB R6c&h T@ (PORT) idndfcd f&nily 

psttho educdion a @idae b8.d l@li€ Dn rhould b. otr rd ro .[ fanili6- Thi! 

lnd olner Es@h l€otr nav. shom redwed ni6 of rlaFe dld lower l''Ies of 

nospitdtition @4 patiot! &d fdiu6 irvolv.d in th* po8rm. Othq ourcoms 

i@luded incEld Er6 otprtida3 Fnicip.tior in vdadoul rhlljlit tio FDg'ffi 

ed eoployment; d@ed cost ofcee !d irproved wellb.ing of lmily nnb.G. 

Studi6 hrv. el@led fdily p6'rbo .d(atio! for Scnircphreni! or 

58

*niallctiv. disrdd orly- Howevd, l!. 6113 of @d!| mnol|d sidni $pp.lr 

drc ba.6ls of both siryle ed duiipL fmily ialddtios for olla FFhjlEic 

dierd.6 includine bipold dierdq ( ClrLin, Cdpaler, Hdl, Wilns. & Cliclq | 998; 

Milko*liz, Goldltci4 1997t Molte 193) Eqjor d.p$sion (En uels & E'mlkdp, 

1996; t ff, V6di & Powi4 2O0O) ob6iv. @Equlsiv. di$rd6 (Noppdr 1999' 

@di. I'€ffi ( G,61, HciDn&, St dmr Daviq & (lh,4 2000) ed tordalhc 

FeMlity dieid6, Gotrzd@ !d @||.eu6 h!. qt rdd lnii l*ei ro &.1 wil 

d. .{ond.ry cfIFG ofchrenic DhFicd ilL6. 

Prycho cducaiion gmuF for fmjlie who hvc a elrtive wiih w€rc h.ntll 

iUne$ rportcd . veiety ofsi8liffsnt g.iB for thc p.ti@t i@ludine le nt ofElaps 

(Tuid, B@elou8t, V.ueb!, adtu!. & Por.dd'! 1989) r.ded F)rbndc 

s'rbplo8 ..d inpov.d wi.l tuEtioiog. R6.@b d Fy.ho edurion b,' rls 

dou:Mt d 8dtu 

for feny Mi.rr incltding ilpNld eial ed fdilyldjurMrs 

ard elief ftoh fmily burdd, Mclel&c ed Collqgu6 &ooMtrat€d rh. .osi- 

.fativen$ of th! nuliifmily psFho educationsl gFup!. Tne S.hihphrcni! p.ridlt 

oulco@r F!*h t@ @nclud€d lbal .ll fmilid wlo hav. . palidt wirh 

Scnizpnmn lhodd bc otr6.d a F'l[o .drc.lioi.t ilt.Mrid (Dnoo & rrhMa 

1995). 

Ihe PORT sildy (trhM, & sldweh6, t 998) fou rhlrody3t%ofpaii@rs 

Fponed dut ih.ir fmilier @eiv.d ilfomrion .bour iheir illn*, One ustul rrat.Sy to 

expad th6o Pbgtu 

imlud.s inleeldng fdily pstiho eduatior i o colmuity 

Rcl@n did.c h6 s4?oned llr rhc p.ri@t. whoe fuily [!d @ir!d 

59

psrno€dudion showcd twl@dly niSha tldwlioN in r.laFe r.re 4 @np&d io 

pariars who l4ivld Futirc tah6q $. difr.mc dg.d non 20 ro 50 pd.dr o€ 

lwo yas (Pem, & Mw, 1996; Dloa & Lrlwrr! 195; tatru l99l ). for pFlnns of 

noE thm $e mon$ duntion, rhe EductioDr in @l.p$ 616 vs very pembing h 

addition, rhe wcu b€ingof fdilynob* inpov.d, pdie s'p.rlicipdiion in 

v@anon l Fhabilitado! ieeasd .nd d. cocti ofc@ d*rersed (Tdi6. l9l). 

orhd h6r pr&tic. st rdlrds litc toirl Comi$ior on Ac.Edi&tion ofHall 

C.rc O4diz lid 6coDg. fmny €duado. Ir a

$anddds domendins fmily inrdalid, I6s thM I0% of fadli6 of ouipatienr, 

with S.hiaph@i. @eive tltse wi.6 (t hm & Stcnwrcn6, 1998). h ! sN.y 

Kul8n w.lz, Babal, .nd Ki$ling (2006) inwnig.t d th. p€Mtag€ ofp.li..l! .nd 

th.n Ehrivs pdnicipatc ir F lho .dqtion p@gm. A@ding io |}€n tudjl83 m 

!v.dg. 2l % of lhc D€lidts dd 2% 0f lh. rchtiv6 toot pln in FF[o .dEdi@ in th. 

)a& 2003, Sinjlely in mollr ce b16 Fviry by rrupnils Piuin& K[!psy, .nd 

Dalbn (2005) E oned lhlt in o.ly 5% of s. tilas ed 7b,,6 of cd6 '6les lbw w$ m 

didoc. of fmily intfldtioN, Tho usc of fmily psfhoeducltion in nurin clinicd 

practioe is almjnsly linid (Dnor, M.fdldc, L!n.t Lwk1e4 & Cohd, 2001). 

Frmily psfhoed@ation na a ltge @eh €vidcrcc ir it f.vou .nd dp€nr in rhe 

t.ldhav.rdchdorumi@uopiriorrhrrrh.*i d@do6shouldbedint gnl 

plrr of Eqln{t iD p6ycbirric disrdn. Thc diffdr sndr6 bave dillffir liG ro gd 

.lld ol pry.no.ducriol h lbe wtion Sivm b.low lhw rnldi6 @ dsih.d shich 

rihd lo pBdt lh. Elap6. i! S.hi&phdi. ttftugh fMily psrho edurioD,l 

2,2.1 Plych@duodon.nd R.lrp$ Pnvenllon 

Hogany, Andr&A Retq Kmbliib C@wl4 ,.v., and Madou ( 1986) 

cei.d our . study !o exeirc de €fetivdd of F rho .dwarion ro F€eI 

FhF..l03 p.tidts .lrrying rhc diagrui. ofs.hizphEnia md *hizo!ffetis disonld 

uodina to Iw[ diag4ti. cnrdi! od who wR livins ir high EE low no4 

w.E Eruird for th. siudy. Tb* pnidl! wcF mdonJy eigned to fou rqhal 

nsdllnics, !!4 itulude tmily i ewdtion dd m.diodio'l. thc otha soup n.d locid 

ltill5 hining md neiic.lioo, thid srup re.ivad rho conbination oftnqe two dd 

6t

foutn emnp *s only on ne{ticalion. It ws ! two }sr 

62 

follow-up st|ldy, The tlapse ate 

al one )q fouow-up wcrc lEl0 for psyclo .dlcadonal fmily Ma€doi grcup, 20pl. 

for sociol rrinins ercup md @/0 for th. conbined group, where ar ihc @rtDk lhat $@ 

only on m€dicltion had 4l% Flap6. El.. Thd. w* d dbsdc€ of ehpse i. hoe hold 

$a1 chaeed io low EE ed it wa @nclud.d thll the conbinatior halmt is s@essnn 

to $sLir Emi$ion; now.vd ln. lonSd follow.up dclaF thc ElapF ml. the io F!v@i 

In a @Iabooriv€ snldy by Nationd l$titurc ofM.nr.l H.altt, oa tEatldl 

stztegiB in &biaphMi& S.nolo, Kcith, Se6q M!th4s, od Bcll&t (1994 

6tpr.d d. n dication !t!t gi€ {$.nd,rd doe, ed'tugct d" &s ir intcn tim 

vitt tw i),p6 of f@ily intdvmrim (Altucd ud Supronivc) .Iloleh ril feilie 

w@ cigb.d . fnily clinicis for crisis mDAoal th.y .ls ltrad.d mdlny 

swpon CD'4 mtit€t, Tbc ArPlicd erditioD irclu

L c p!d6a wilh &hiaplaai., bipola p.tia& e .le .! ridr for ElrF. G@ 

8!rdn8 [h. phatuolo|N| !!|!Mr MiltowiE, G6ry.r P&h[ds SirFM!, .!d 

Srdd.d(2003)otrdlctld|.ulylod.tcDin thdifnDilyinrdErioBe@6bin d 

wil pb.trm.loSiol [ati.ol.de€ Fri6t! lDod.tlbility.trd F!v6t to chp4 

Ih. {trD|. fd rhit iudy @i.r.d of E2 .dni&d p.riot .ul t9 s@ Oc o{r !.ria|! 

rlfarld by phFiciu. Pdi6r. *to n|cr rh. DSM-IU R di.8lGlic 6irqi. q@ 

trdolEly.lldtcd io two !6ld.nt iror4d, ftirty @ p.tiat r@ in nhily feu!.d 

lsrnor aol9 &d 70 p.ridc ilro qi.ir lradFrsqp. Prlio&ofboosolp. 

v@ 8cting pll'r|@loSicd tanhr s *ll. Fdily F6u.d ltdpy(FrD iMltrd 

.ll ndhbL fdily trHnbq!, .d sioi! ws! coidlcrd in Oc prtds'hoE Prtrho 

.dutioDl 6i@ i! lddiri@ ro irfdEdd $ool illnai, F.vid.d 

ah|e|Mt lr.i!i!g od Fobld .olvilg stilt E i!in8. 

63 

rhc co|t@dqri6 

TrE6i.i.!|u8cDo P'.gd4thqqistDovid.d2.@houbodb.*d 

.dEdi@ BiM for tt. fid lwo !M$r lha rlc rtrpidr ofi.r.d inl.Eti@ 

*neG !..d.d drias lh. 9 mdh. Fio

Schizophmi. r study wa an

goupr w@ divided inio ero!p6, 6ve fdili4 tudc a goup. Th.y @iv.d id@ti@ 

lhout iln6 i! addnior to .sdliv. nririlg and pDbld slvirg stils in 2-5 houx, 15 

w6uy siG. Pha n (bdivid!.1 l!l*6ti@) i! thi! pbe indivi(M si@ eirh 

eh fdily ws mdd.4 6Dily cl)|elitrg .!d b.h.vio..l @!tr&t' w@ qtlicd 

Ph.e III followjp, n wc cdi.d out by lll.s of t lcphon cdk an6 dery l5 days 

fmili6 rcponed ihe srale of lle p.ti.ni Ana follo* up tha. ws no @rtact witn th4 

fdili.c lor 0 p6iod of ! trd. 

Pnae iv, two ycs @ot!.t w rud€ by phom or mil ir 

aU c*B md iilomlior w$ galhercd abod Flape or s rdhisior in ho6!id. R6ult 

indjcded dal In@ wei€ no &lapes or Rdmisbn in 15 dpdiIMtal grcups' fmili€s 

b |n@ wqe fou @dmisids ir th. @rol goup fmili6, This sbqs lle sLir.d 

cfadva* of fmny rEho.dwrtiotril ilr.rvdrioD ovcrtie 

xiong Pn ipi H\ Wds, D!j, KldnmA lrd KldM (1991) Fna'ctcd a 

.tu

gFr+ r@.ivcd nidiM ddrg. of m.dici.c ard faily thdPy @ttP&d Pith orly 

mdiM dq. n dici@ @ fmily th.6py, Six *€tly fmily m*tirg, w.rc 5rr!g.d .t 

lhc clilic fq fuily i .rv@lio! gDrp. At th. 3ix nMth! follN W th. low doc Do 

dEEpy gFUp hid 48 % El.p6., shil. lhc lo{ dsc / fmily thcnpy gDlp hd 22% 

Glaps, Ih. nFddle do& / m d€r.py gDup hlrl 14% EI.IB. cofiFr.d io nEd...t 

dos plu fmily $arpy grcW whjch hrd 0 D.ecnt FbF.. Thi. scdd t!. lisific.ar 

cFet of @mbi!.d r.qtn@r. 

It bq rho ba &cllMtld Ihd flnily iicl€tioM itr Schizopbdi! @ 

cfativ. i! &byilg D6Jrtotic El.p6. os p

T@tftnt sbrp @ived f&trily intcdoljo! sd nFdiqtion- Ssold srel4 M ody or 

n dicaijo &d did w6 a @ntd ero|+. Prtiac w@ follow€d ur fd dnc lMths. 

ARa 9 mrths lle Elars Ete iD fuily irr.dqt6 gFrp ws | 6% $ @q8.d to 

n dic.ti@ gol4 37% od @lrrel CroW h.d 6l% cbp$ Blc Rgulrs ds Eporr.d o 

in'pbv€h€nt in bowledse .!oul ih.ssr .dhffie io dqondr ill.@ed in latiall- 

Thec ws rl$ ! signfimt lositiv. chae. in Fladv6' .nide roedds patioa.'IrE 

study pFv.d the .ffic&y offmily Fycho .ducrtioral intdvdnliom em with tml 

Hogtnly, Konblitll C@nw!l4 Dib.ny, Cooley, ed coll€ass (19?) 

condrcle

Ela!$ lad b@ d*lop.d by diltqdr !!s@h6 and to s its .tretivod . sfidy 

ws @Idmt d by M.ij.l, (nit*ag.a G{& Kl4 .nd C4GdoFk (2006), Tonl 95 

patidrs wd€ irclud.d ed rudorly sigD.d to ap€rotsl goup ed contiol gdup 

widr one y@r iollow up. ?atimts w@ a!c$.! oD PANSS scale alonS wilh snc othq 

i6fim@15, Rcl.pF ditcrion m e irc@. in pstrholic strpk'm md in rddition 

cliricd judSDdt ws se{L Ih€ ir4oflet falw of this sludyru thst rllB w@ 

Fained b e thc intdvdlid. th. nls of rh. qpai|mt srclp ** E ind for 

aFlistio. oft. int*ention. Th€y w€G qpl.incd rhe uldslying objetiv. ofrhe 

tnmpy, rolc playinS .x@i@ w6 ued b p!&ticc the jnlefl@rion, Expcrimdt l gro'4 

n6.s aho involv.d tnc paiioi s Elativ6. Th. @n[ol eoup Eciv.d ce s sual. 

Nlls qft rh. @in @ Civ6 in tlt sfudy, 26 of Oe iu@ wq. in dFilMl!] 

gDup ed 22 ir th. @ftd sDD, who p.@&.d .u thc prcsls E ort of rb. p.ti6ts. 

An6 on td follow.rp the rbFe a& in cxpdirEnrd gn'p m 12.5% s conp&ed 

to @ntol goup which ws 26_2%. -nDugb this w6 not stalilticalty 3ignificer, bur rhi3 

showedlhatilrc@*s!dalin€inFlaps.et .ftqrheaplic.lionoI.pstlhosocisl 

To !5s tlE inllume oI a shon lgn clinicdly bs€d ps)&to .duclrior FDgm 

by pref*iomls a ltu

chorpir.lizlti@ sray. Thc pmb.bility wa hidd ir 1[. gDup who did m1@iv. 

pty.ho cduc.tior So ! loriliv. r6!D@ ofp6jcho cd@ti@ D€nicip&t! sugg6ls lht 

pst€bo €ducation snouu bc slppletrmt€d ir tr..l!Ml pl& lo ehicv. fawFble 

temc out @m ed 10 mjnimie &lveE hallh ed r@i!l a.!.qsoc6 of 

Anolhd sfudy by Wda Bluid, B@d.r, Ens.l, WegB, od Ki$ling (1995) 

.xmine4 Nhelhs psycbo .du.ation wih paliois $d fdili.s cd rcdrce 

rcnolpibliation i!r6 ed inpev€ @Dplie. o. nor This study ws condet d tod 

1990 io | 94; 236 h..pirli2!d paridis wil! Schizopbmi! wno hld egule Mtrcr wirh 

al lc.!t ooe Elalive w@ r.odon y Gsien€d ro two gouF. h ti. inr.fldlioa condilion, 

pal'cnl 4d fien rebdv.5 wce encoMg.d to ariend Fyrho .dslrion gFUp6 ovo a 

Fiod of 4 to 5 mth!. Th.y n d s.pdr. cdearidd sDl46 ed @b hd 8 si6 

th. o$q greup€ @.ivcd only ourine Estrcnl, Ol' m wq. @npe€d ovd 12 

ho n3 and 24 mntbr folloe up pqio

condul€d a study wilh tudoDizd trial of inr.gFr.d t4rrMt vdu Eulirc tsqfn.rr 

i! frsl cpi$d. Dsy.hdi!. lte intcgEtcd donndt irclud.d o.di@!io!, @i.l *i[3 

traini4 lrd fmily F lho.de.rioial ti.!tMt, nc int snt d ra[Mr dctunsFlr.d 

sv.ral positiv. .lf€iq it edwed Nmbd ofpoliliv. and ncSelive sFptoG (d ir d$ 

Fduced burd6 in El.tivs. Tte rclalivB who wde in i egated lrddtunt SDup wer€ 

mE slildcd wnn th. f@ond 6 @mpdld wilh dE relativs in ouiiE !!rrMt. 

DtrL, Sho4 Hddrtx Nor.I, My.B, Pr|l@n md @[agc (2000) cdicd out 

a stldy lo c@jn tlrc out @e ofrc8.tivc aynprom of Schizphmir.RoFcivjns 

psrrho edeadon multiple fmjly goup t&.tnor. 63 paiiot wirh disgnosis of 

&hizophrdia e@rdin8 lo DSM ry cnhir w@ r@ruited for rtudy &on o out prtienr 

nent l hallh carr. in SpokjnE Wa$i!gron.Th6. Fn6ts w@ livirg wilh rhc fmily 

or bad rhc rcguld @itrct vitn lle fdity. Pllia|l v@ Bs.d 6irg lh. Bri.f 

Psrb.tric Rlling Srrlc (BPRS) ed @ Modilicd Scatc for Negariv. Sttrpiotu 

0/9ANS). T1'c p.Iidlc w@ tudod y 4ig1.d to lwo tr€.t@i gDup on gDup 

getting the o in phmologicrl treidncnt ud Dhrbjliarjy€ seric.!, th. ldond 

ercup @rpn5.d ofmultiplc fodny erelr rsl,Bt i, ad,Cilion ro ncdiqtion. Thi6 

lratnor lncdarion in@lvld r[e t y fhily n@b6 and i4!rt d fic infoturi@ 

rbo tne S.hi&phmi., DnrE ofillr6, Es|mal d., p@vided on spina ,urport for 

about rwo r€es. Prcblm elvilg *illi w@ al6o included in lnjs prckg. ofr!.tman. 

Corpeison olprc ed post sesmal eoB of BPRS md MSANA indicaied 

signinmt cducnoD in n.g*ive slnpioc on both osod $al6 in mdtifdily 

prrrho €duc.rioDil gbup I|* sllrdy r!.dDErlrcd rhc €frelivos of!6Fho 

cdutiobil nuldpl. fmjly goup inravdrion d @npeld ro reurin€ jnp,ovclMl of 

10

neg.tile synplom mdrondy prdtuted rcl.p€ in lbis goup dd inpsved q!,liry of 

Shin ald lutdr (2002) cond@ted ! sllldy !o dmir. th. etf6r. ofF do 

€duoalion on rorcs Amsicms, $ Kotu d?EMr orc of ihc aowing cihnic goup itr 

rhc U.S.A Parriciprts for rhis rrdy qm l!@i&d non o olr polidt D6r.t halrh 

cli.ic in Nw Yoik Ciry. The pdiontl diagnoscd wilh SchiaphFnia, ehibdfeliv! d 

s.hibpnmifo@ Flrbosis w@ ircluded h lh! 3fudy. Thc DSM rV cdtqion m uld 

to dia8nos tn6. c&s. 48 p.tidr! Be Eldoott ss8ned lo r"o ercuF, .rFindlsl 

gDup, who @eiv.d psycho e.ludtion in ldtldon 10 suppo,riv€ tt@py ed rhc @rtrot 

8reup vho rs acttng oDly supFnire lh...py, IGe rft tsGsed o! PI. Dd posl 

tqtneor lime on brjef p6ydnadc Etbg eale (BPRS) lh. stigna devatuiion sc.L ed 

th. fmny crtui! o!i6r.d FMd d.lu.rior srl6. Tb* $d6 ll@U,.d ,)arprom 

sev.nty, .nnu&s abou orl u.lo|lnding of tMrlt illn.$ ed 6pine skilk. Jhe 

exFrinefld tlslrlnr @Bisild on weuy psrlho4d@riond 66sioN fd d @t 

plq . $oE of sul9oniy€ ih@p} E&h *ioD ws 90 hirutB t@& pariob of @ntrDl 

srcup eceived i.dividu.l supponjv€ !6iol, rbout 45 ninut ! lone, posl rrearmal 

alsMi E tuiod out rlE wa* lndrc pMicipets @nptd.d rbc to we€t5 

pognn, Whq lhc bo$ gbups wd. @nparcd .l ,osr ss*srud time, lh. psrlno 

eleatio@l gbup ihowed siii.tudy Edu.cd .,,I}lom everiry, red!.cd pd..ptid 

ofstiA@ .d inPovcd copinS rtilh. Tn6e findings ,uge6r thrr p6rlho .dFlrid 

i,l.ddtior is qctul snod tem u*l'Mt @ddiry, 

Augli., Flbrici, Bdtossi, Dd Bsi (2OO?) @!d&rcd a lrudy ro dlnim thc 

crelivons of p6ycho educatio. in reducine &tlpse in pstidts witn Schi&phmi!, 

7l

This nudy qa Mied our in lin.a olr]l@ily Mial halth chr6 in lt'ly for ih. 

dmtion of onc )sr, 150 patieDb of Scni&pnenn 6I6IiIg th. di.8no$ic cn&.iB of 

DSM W wd Erdodly allqt d to i*! gbup6, Thc €4dindlll gFup irlud.d 69 

pdiidts dd th.ir flmily m@b6 arxl lbe conEol goup conprir.d of 66 p!tidt5, 

Conlll gDup @iv€d eniv. @muny rd!ftnl in drlCirion lo oliplrlhoric 

drugs. T[. .xFiM&l gD|4 twiv€d eri pcrnodc drgs rrd . Fy.ho edutiotr 

pbglm. Pation dd thcir fmily lj@b6 panicipal.n s.ptr cly ro eiebt difi@ir 

psrho eduoarional s!io6 of 60 io 90 ninurs. Thc pstrho.ducalioml p!cko8. 

pDvided infomrion atour disttq ic ca|E .boul nlsgddr pts!, Et.F. 

psstion .d bl. of fmily io natuor pld, Th. N6mot w ceied out .l 

bEelirc aft.r 6 mo hs dd .t 12 honlbq uing Briefpstrbi.r.ic R ting Scale for 

.s!6sl@t oltcitv€ dd rcg.live slnFoB, q!.lity of [Ic s.t. .id ! rlting for 

m.dical iltlucGs. The 6ulr5 rcvsled ! d4ss in srnploh gn ity ofbolh rhc 

gbups bur rhed w4 . lratislicslly derficdi inpbvddt in ih. expdin@irt gel4 

@ Bn€f P3Fhilrric R rilg Sot. ed S.dc fd r5.6sMr of pqitir SyDer.c, O! 

Scale fd N.8arirc Synplotu th.e B !o sieniiicdt ditf@ b.rwm rwo gbups, 

Qulity ol lif. s4 inpreved in rbe qpqimolll !bup. Tnft vs I o@c u 

nerbd ofhcpillltatio! .r!d $bda,rialy . .bc@$ in rcbF. mq Itre snrdy lDup 

had shoM ihp@vmd clinicalty ed i! qulity ot life s w€ll. 

Ii ordd !o qmine lhc .IId of &nilial lolding o! .oB. of S.hiephEDia tud 

lhc blc oapsrho .deation !o modiry d€ @w, . sludy ws Mi.d o,r by Fetdrur, 

llommg, BEitEnd &d AFlt (2@l) lB2 

'|ri.nrs 

witn S.hiz@hMia rft E don y 

all@ared to lou h@tuenr 8rcups &d o.e @nEol group. 20yo oflhcir Etaliv.! hld 

12

history of$m fom of Fych6is, Patiall w.r. essed b.foE ed atq ilt@otion al 

follow up. Tne 6'nr3 indiGld d inprovffir in @n!c of 3y@roh 'uif.ddio, jr 

ennc.d lignjficdily. ID ontol goup srnpto@ w@ irc@le

cmbined patidt and fdny sE, 

Sludi6 lhoul p6ycho€du.tior md Eporu on oulriplc fdily g0146 bvc 6lbm 

GlElions in relapse erc in p*ieDts wilh S.hibphMio. McFslee, Linl. Dusluy, 

M&hnl, ltd GiXy (I95) @rp&rd pstrho.d@rioMl nulrifmily grclF wirhour 

psFhoeducador Relap6e w6 lhe oul cone iitdi!. Al fou ,rs! lhe Flapse El!! weF 

5eA,78.Aqd5l r.apenady. The Bujr3 d.trDDsfal. $al bultipt. frbny 

psrhoeducation sFup6 in mbinerion Mlh ndic.tion d. elfioacious. 

Edu.ri@ of palidr ed lh. fDjly ffibd iopo6 then bowt.{tgc alour lte 

iune$ &d hs a b.n.ticial sftet on @rpliucc Mlh nedjc.rion, Thi! *s nr1her 

coofncd i. ! rtudy by Snnn (19?), TwEry r|!c bosribliz.d padd|l rnd ren our 

paliols rnd tn n Imily nffilb6 w.re pmvid.d cdu@tion ,€e..ding rh.n nbe$ ed 

ll@geMt. Ir @nfinrEd th€ firdiDg ilal .ducalion irymrcd rhc @trptiDe hchrior 

ss well a impbved 0r. n@gd.nt stdlls of th. fmjly ncmbe6. 

Cognnive behlvid iehniqu6 e lhc irQortoat cosrpotrdr ofplrlto.dqrioDi 

mle(dlionn while fnily i ddti6 bav€ por€d both ik cild.y 4d efretivlo* 

in rcdwrion of El.pe (Tmie, Bllwctou8h, pordd!, & fi@afic, 1994j WlE 

Ldcht, B.uorl, Ki$lia8, & Ane.l 2OO4). Res@n hs suggdred rhat psy.n@ial 

n:m8.Iml of S.hi2.phmia 6 ! cohbiDtio! of CBT Dd fmily bt rycntionhs 

prcved b€..licial lo '!du.c Elaplc dd F rholic synplotr (B@wclo!gn, qaddo.t, 

Tuid, 200l ). lhil pan conlaitu lh. Frlhocdlcatjdd inrddriotu EiDg CBT 10 

pqdt r€rapsc ard Edue sp!1om *aily, cBl hs pDvcd ! Mc6stul Eern ttr 

3trnrbG ofctFnic Scht pnr@iq rtis hs bs poved by Mera ardFi, ofdif.ror 

rids ofcogDiri"€ beh.viod tn.Epy (Cort4 MBa, Bollo4 M.r€, & Coq 2OOl; 

74

Pillirg Bebbingoa & Klips, 2002) Epon.d lh.r fmily inrdmrio$ rdw€d Elops 

dd rs{,Disior nte md nnFov.d adn @. to madicin . DNty, Bircnwoo4 Cah@ 

.nd Macmillm (19 ) repon d $ar @ov!ry tift w!! sigifi.stly de.@ed by 25 lo 

tipl" when CBT w6 conbin€d with ouli!. ir..lmcnt, Similaly theF ws a 5% 

r€duction ir proportion of paliol3 wi$ r€sid6ot synptoG 6 conpd€d to 56% in the 

A st!(ly ofbehayiodl fanily mr&gcmcni by Faloon od Peilcnon {1985) m 

condered. 36 patiots w€e re.lotr y $sip.d ro individul patidt $mpy erow or 

fmily thdpy gDr.p. 11 f@us.d on t rcnine fmilis cfbnvc poblen elviry ed 

ffihiorio! stills, Edetion pDgM de irclud.d infmrion ahorn S.nizopbMia. 

Edustior ws previd.d io fdily including p.d.nl on individudi.ld b6is. tre sios 

w€c '@ged ar paiql5 hoR for drc mndB, Muhf.mily snup sios s@ 

@dured at hoait l, for h.hvior feily tM.gmml rd w@ follovld l4 fd two 

)sB. 

They rcFdd rdetion ofELF. 016 i! S.hiaphMid nln 44% ro 6F,4 in nine 

nMth dd 83% to 17./o in two y.iB. 

Sinndy, a t*@h lem (Rddol.ph, !dr, clttu. P&, Leons, Sh!M, 

Sttuhfl, Escobu, & Libm, 1994) conduol.d b.havionl amily @agmenr al 

psychialric division ofw.!! Lls Angls, usin8 prclocol dcvcloped by Fal@n (1985). 

This study ain d lo ffld the emcacy ofbchavior fmily thdapy ro educe Aisds of 

S.hizopbrmia. They !l$ ted€d th. .ffrcey ofinGivention with Elaliv.s. radai! dd 

fieir fmili6 we tudon y aiglld !o @.iv. .ithd b.h.vio. fmily IiMsened ir 

@mbimlion Mlh cBlonery crc (D = 2l ) or csioowy cde alonc (F20) tn@ w@ no 

sisnincMt difer@6 in adily ty!. !.d g.!9 'i@g.tMi Ana 6c ts of 

75

ir.a&nal, only 3 (14%) patiais nm tbe 8to!p offMily Mn:sddr sLowd ietls 

in s)mploN s @npeed 10 I I (557, in culomlry ce oloDe 8roup. So rh. 6ult of 

drtu sludy suFPon ibporloce oI ircludiDg fuily nenbers in tl€ltnEnl pbgffir for 

b€ller out cone in lhe long M. 

In rhc rinilair contqt eo&d nldy w$ condrct d hy Honu& F.ldnr4 

Kinghery, Buhlctrr ad Rcka (1999). T 

n.y cx@i$d the iqa.t of lorglqn 

psycho siution on rc hodllizition nt . l9l pdiarc with S.hizophMi. w@ 

r@ited fDn ffi ou. prli@i depdmEnB of !6t!hi{oc 

nospir& in Mudlt r/ 

Gem&y, lsliq$ weE Bndon y all@ltcd io orc @nbol e@p md fou heatrnni 

conditioft. 32 p.ticnt werc asigndd ro prrho.deation ereup llorc; 34 to Frr(ho 

educalion md CBT grclp, 385 to p€trno .dwltioo ed Ehtiv6 @u@ling grelp; 33 to 

psrtho cduc.lio! plu CBT in @rbiEdon wilh r.l!1ive ou&lilg. 5? palialr i. 

doDl eDup F.ivd $i!.tu€d but mn qeific lcis@ tim emup- htrho .dstion 

gDup w.r. ol$ ofdrd ! l€isu tin. grolp rr old oflhc irairilg. The natMt 

comenccd Nit! psyoho €ducitioral $6jons. Teo &siohs w@ conducted with 

dife@nt inlryal!, wbich wq€ follosed up by l5 cognitive p6'€holhmpy esion!, Th. 

edlqtion w$ pFvid.d aboul iIns, it! tetmat lind lo pbnoting @aDlimc .nd 

disk tmrg.lMl'rill3. Coglitiw Fydotndpy f@!.d otr pFblm elvirg ed 

@pins skills, Couaelirg ofr.hrivd .jrEd .t inpDvilg in howledgc rbod 

Schi&phmir ed copirg sldlls of lha ehtiv6. lati@ts selsiMi w6 don !i be 

lire, soon afid @npledo. of lralDffit ph6e, sd .no two ald five t€G. Patienb qd 

Nessed for F hospitluatioa srrpron sevdity md for ovd aI irctionina .t fiv. )@ 

follow !p. ftcd w€e m sigaifmt difi€r.lM bcrwa tlc @nrol dd fou rqr|@r 

16

gNuF in c h6pitaliatio! 6le- Tte gFup who @iv.d psrho edu.tion ir 

@Dbifrtion rith CBT ed Glrtiv6 oueliag h!d42% @t6pn &tli@ r cd'!!td 

!o @!fol soup 69,6. Ovq .i nmfoling of@mbincd [qtnat grol9 w$ bc(!r lbd 

A nulrif&cEd inlwehtior ws Epon.d by Dtuy, Birchwood ed Cocltre. 

(2000). Thjs intefldlio! idolvel both individql ed gFltp @8!itive $dapy, h wbich 

pltiars lam.d ro cop€ wirh delBion od bnll@idrioc. In .ddili@ d.y t@t pln i! . 6 

m I long fdily pdtlho+deation prosd &d slivity Foglu ircludjrg lif. llills 

grclp. Th€ efI@G oflhr! irt fl€ntion we. conp.rd lo thoF oI o &tivity p'ogm 

involving prnicipmr! in sporE, I.ism dd shl 8reup6. the shon dd njd tm inpet 

of $e inLrmtion w.F itrrplsiv€. Iho* in th. sriv. rh@pdtic pogm @ovad 

mE quictly following rhc Elar6e thrr boughr rho inlo dF rbdlt By 9 !n|!5 

folow-!I', 56% of tle @nrol sF p si l nrd hoddre or s.\@pDblm ir @rpuien 

io 5% of$e in!.B.btion gbup. By dve yee follow-up howevo, tn* wa no .vid.m. 

of my lonS lem diildeoce b€twM liE two gtuups of ft6ws ol elapse rt6 o. l.vel 

ofposiriye synptoB to achi€vd loryB-t rm b.ncfit , n @y be n€ssy lo int odw a 

.@n4 b@3rq i.clvdtror to minrain |bc long r@ cf..ts. 

Liilm $d Dingm ( 1996) tslxlon y eign d ?6 ouFaliats with 

Schiz@hMia to two gDrp6, behavid fmily rhs.py alorgrriih individul odcnt.d 

h.arndt dd irdividul o.i41ed t atMl alotu, Th. beh.vior fdily th@py lroup 

focued on @mwic.tio! ed Foblm $lving rtillr tnining plu .iuqtion io pdal 

Elope. Eotn sbupt w@ @iviDs DdMlogic.l tletr@r @ olt d.o b8i3. Ai6 

6re r€r rhee e@ no df.l!rc .el!p6. 61c in bolh gFUpE but ovd lll chp6. Elc 

'n 

11

ws low. Fivc trd 

follow up al$ indicd.d @ rdd.d b€Defit of ldily lhdapy lor 

rlapse et or sial fiuctioring ed qp@.d .mtioN. 

ln oda lo invBligr. thc ldrdi.sc of .rldios Flrlo$i.l EatMt to 6udrc 

cde wi$ patidl! of S.hiz@hEda &d sub6le. rbu. a study wr! cei.d ou1 by 

Bmwcloush, Hadd@k, Tnid, rrwis, Bno, S.hofeld od Mccov@ (2001). 36 

poriars wilh Schiaph@i. .nd th€n ce giE w@ Eldodly ud blindly aigncd ro 

two goup' Expdiffid gbup @iv.d idc'Mti@ pog@ in ldditio! io mulinc 

t@tnenti ed control Sbup ws or rcutir. r!.rtlMl ooly. Ilc inicgFled tssrnai 

poem @nbir.d lhE rqnMt .rprc&h6, mtivadonal inrdvi*i.g ro il!B. 

p.tidls mtivnion for cb4gc, $ lhe patiat &cept ile Esposibility for prcUm &d 

lhen effon for cneee |o aftin thd4oric cool. Coitivc b.bavioi lndlpy rr8cr.d 0r. 

deluiou sd hrlluiutioE .!xl fdily inrdvdtion wil e dphsis oa promring 

fmily cEDn$ d.sigr.d s mriErion.l int *i*ing sryL. plM€d jntermtion pdiod 

w6 9 noDrhr dd sesion loot phce in paiiqb home_ pari€hk w.F ssscd on global 

lsssbol of fi@tioB &d on PANNS ert. for rcerrivc .!d posiriE slDlrom lDd 

dog aftitud. inqrory 10 m6.@ coDplid@. olr core swmnts w@ ldDilisrdld 

al b& line, 9 mnthi dd al on. yed i.e. thc monoB aftq rhc c4rMt oI rho|py. 

R.la!6e wa ddmin€d by nmb6 of admisio! in hogir.t duil8 rhlr Fiod or if 

diLtion ofcxeabariotr of !!nr't m ws longd tns 2 wek, Th. Gdls i&ticdLd . 

siific&t gr6re impov@cnr in p.tienr! Slobal nfftioniig in iDEgrated h€irncnr 

srcw. ThcG wa . sisdlic$ &dmrion in FDsitiv. stbpto@ .t 12 Mrb! i! 

erFrilmr 8D|9 a conpaEd ro co ml erclp, TnF ss d@tu. in Etap!. nr. 27% 

h the iltcgBid sreup os conpded io 55% in Eudne c& g6up or 9 nonrh., Ar 12 

78

nMdq th. i €rncd golp t .l 33% r.l.De d. a onp.ttd to 66% i! toili@ w 

tqtDdl. Ce giv6 nE.s &d @lts w@ Dol E oi.d in thi! rntdy. Th. b@cfit of 

inr.gnt.d trq[Mt k qid.dt i! rcm ofrldetid in.ymptod lnd EL9& a 

lr sodd nudy by Tdia, l4ir H.ddo..lq B@r.ll, D.& Kindada 

Kinc&., Siddlc, !d @Uag|l6 (2004) @snilivc bd.vior l[6.Py w pdidd ,o 

hoaii.liz.d Fli6t' Fn.n dnirior CATw givd i!..!ditio! io taMl e 

urd, .!d a 6np&.d *ith lupponiE @u@li!8 pla tatMt s u!!.1, .!d 

estMr a Nld .l@, Thc rntdy ws dltz.d i! tm ph!G., ri8nj6c.at d..e..d it 

synplonB w@ rltoicd for CBT gow ova . Fiod 

of ? welo u @q|l!d io ollq 

rwo Iro|4i h r!. !@nd ph.!., . oulri cadlt turldiz.il @toll.d ti.l wa followld 

up fd | 8 nsth!, Tbir rid rLo conpd!.d od t[@ gqp. B d6.nb.d t fc Ttc 

6ult3 ildiqtd lb.t CBT ud lwF.riv. c.|@lhg both g@ a4qid 1o tahBt a 

uurt dd rhoq.d .iglifiNdy inFov.d out 6@ in c@ of bara srbproBic 

Fov..y bul N rignilidl tldu.lior i! El.p.. nt w EpotLd a @r4@d io 

Oles! Wd., Coftoo, Alvaz, Sphilior-opodoa .nd @llag5 (2007) 

on&&l!d ! lndy !o d.ludc lhc Flc ofco8lilirc B.t vidIls|9y i! FdFti@ of 

synprdn ssily of 6Di .pi!o& F.trh6i!, 8l p.ri@G wc ndbmly .tldr.d ro cBT 

emp dd 1() Fridrr to goup who @it!d fstEr a uud, PrdaB 94 .sa!.d .t 

belis dd .r follo* W .n6 .ir midd, for Fy.h@i.l nu.d@i!g Ed r |u!w 

fd omrbid .y!plo!E. Colp.ria of bol! gF rp! d pod .rldMr dm @al.d 

t!.t thcc s6 li8nifddy low !.dB d d?|6io. .!d ..8.tiE .trptoB h Cm 

grup q @rydd 10 rqrMr a uurl. Thir iniold rh. pditirc dlcrof 

79

psrhosocial (cBT) i ervarior ova ro blrtncnr 6 surl. 

Cognitive Bebavior Tnsapy hs pbvd it! cfficrcy ir EdtumI ofEsislot 

d.lciotu. Thji va €xdjle

con6 tu all 6pel' in th. psldoeducalion Sroup $ corpm lo tuulinc t .tndt, This 

n[ths suegd a ltql,naI pl& to 8.t nvoBbh ouloffi ard ro d..@ O. rdvq$ 

efiel ofillnd on ldiors. 

h a randodiad tiol ofcBr by Tolin$on, Kingdon ed Tuq (2003) 422 

p.tients dnd Ureir cders w.E conpeed on CaT ed ftatrMr .s sual ,R.!ulrs qe.l.d 

thal patiqls *ho E.ivld CBT dlowed siSniliqt Educlior h symplotr ard d 

itrrpFv@ml in iroidt & @trpNd to lhos who @ived hr@@t s uu.l. b mtbd 

studt To@, Btich*sd, Mad.a Bt!r., N.lon, lrd RN (2004) qdilcd rL. 

elFc&y of @gniliv. bchavior lbdapy virh pardi3 of Schizophmi! bavinS coli)fud 

hlllucimtion, ComDd hrll@inatior is a synpiom which b vay dilrclsing for th. 

palist ed ! bigh .bk stDplm $ w€ll. Tbny .i8hr p'tiar w@ fudon y signed ro 

No gorps. Oft 8reup @ivcd @iriv. b.lsviord@py for @n !!d hdlFiDtios 

,nd the othd goup @circd ratuenr 6 uud. 

The6. patidls *@ aesed or . nunbd of*.I.s for wice ss,ndt dd to 

m4!ue pslthoprtholo4/, Follow up s6 for six .rd twelve mdhs. At twllvc nonih! 

fonow up lb@ wa ! signifitur adud@ in @npliee bebavior .!d dcge of 

contctjor lbout lh@ voie ilBpoe b rhe hr *jurioE in @iriv. t tlvio. 

tt€Epy eoup, No chage @cEred i! codtol gbup. Th@ ws also a Edrction in slb6 

on PANSS sd wbich wrs e indicanor ofd@rcsed sytrpton swsity in CBT gow. 

The Fs|dts slppon ihe eff*tiv@$ of CBT in rcducing srqio@ ed @nv.rlety ro 

To inv6tisd. de crcE of@gniriv. b.h.vior rtre+t for Efrrctory'ynprom 

of SchiaphMi. paricnls ! sllrdy w$ condkr.d by S6sky, TubSron, Kingdoa Scotl 

3l

Sid,lle, Cmll, ed Em6 (2000). Nih.ly ptli.nts wcrc rruitcd Aom fivc cdtcts in 

Wd Llndon .nd Nord ofErClDd. The w@ t rd.mlv si8r'.d ro tFo gDupl or. 

gorp s€iv€d @gilive behavior thsapy iote(cDlio! and thc conirol Sroup wa 6 

Betidding i$@olion, Both intcd@tios w.c d.livercd bv two qFnac.d ns6 

udq a ESrid suPcflisiol nE tuin '!$sslml l:EG {@ Clhical Ps*hi.rric 

Rlting Scale, Scbimphtoi. Che8. ScoE, tll. Montgpnay D@r$ion RdinS S..le 

dd thc Scate for A3BnHr ofN.Stliv. s)dPtoG. ?aliats FG .$6s€d !t be lin 

{d on t mi.,rioD of th@py at liDc of ffnrl @cs@t th. CBT ilteryaljor feus.d 

on ro wddlondilg of tlc d4elopn.nt of synPt\ta ed worl to !.

conqrEd Mth .upportiv€ @UEling plu murinc ce ed Duatu ce doE.70 P8ri.nis 

out of ?2 wd€ lv.ilable for 6nal ss.s@nt .lid 12 mnds followrp. Of rbe 23 

potierrs had rcciv.d CBT, 2l had Eociv.d suFPoniv. @uMling and 26 had buiine 

crc. BctwmD Sroups compeis idic.Ld siglifi.&t dilfaem6 betwen cogDilivc 

beharidal thcsPy .nd outitr c@ or folow,uD fo. F6iliv. stdptom, 4 th@ w$ a 

tMt€d 'ldElion in rh* syqkrN, Both 6itiw b.hlvioEl iheipy dd $pportivc 

cowlinS wd n4qior in €m.&y a conpr,ld to 6utir. ce. 

Ir . slldt B@h

Fl.ps Fevqliol A 24 mnth! folow W, lhd 9@ m siifcdt Itoup ditraffi 

Fg{ding rclaDs€! synDtm w.rity, !d compliNcc ro dret Hdcva, on d€s.npdv. 

ldel lhd. wa! lss re- hospildliati@ ed inFoved cotplidce !o medhation i, CBT 

gFup .t follow tp, CBT had $!bin d .f*1. 

vrl@eea Ges, Teid, Pjjndb, dd Sl@t(2005) @ied d r .ndv io 

exmiD. lhe el$.ey of cogitive lherary on sttnplon weity of p!ti..6 with 

S.hiaphmid. Sddty lwo inprtienlr w@ Endo@ly asig@d lo two grcup6, one 

golp E.ircd CBT ud B @trplr.d vilh lh. othd gow who wa Povided 

supponiv. olNlilg. Pttitc v@ 6s€d d be li& and ar tix mnlhs follow W m 

PANSS rnd Scale for PsrhiaLic SrBptoru. CBT ws u$d to cntlbtgc the beliefs 4d 

lor thouSht Gruturing, In lupponive cou.ling th. bdic mles oaco$.ling vft 

aollowcd such s eeplftq w'mth md gdtins .!d dpathy b lbr@ l[. pariars al 

posl ellJMr lhe 8ro!p who eeived CBr lhow.d stpifiomt d@Ita i! 

hdlucindion dd deluion! as @mp@d lo thc supponive comelling 8rcuP. 

L a lobSt m study, Tdia, Ha

'qtrction in pslrhoric lFpllm only l5% of th. .upponivc @wling gtoup ehined 

lhis ldcl of bdefit, 15% oI the shes @gen nt gow md 7% of th€ 6uppotnve 

@@lirg @Idiion w@ te of .ll .FpioB. N@. of lh* i! lh. drug thmpv gorp 

..hi€ved rhis dnerion.Onc y.& l.Li, there m.ined signiidt difreMces bctw.@ tno 

thre sbups, favorinS dDe itr lbc ttB n@8ffit @ndit@. Bv ttu td follow |9, 

howevd p@pb vno only B€ivcd dog ihd.py hld sigificDlly tlrN pobl6 tbA 

lhoF in the &!ve lrst nml gDup, 'nr@ vde m tiSnjfcdt difieucd b.twcd $€ 

srs nDagmd and supporlv. @!eri,8 9614!. In orda lo s.t slerincd .trete 

lh* inl.ryqtions should b€ on conlirul bait 

P3tlbo cd@lio.d md b.bvion! fdily intflatid3 lor Schizo?hdit hee 

b@n proved suocdsfll in EdEing r.t€s ofnond cpisde (Goldsl€i4 Rondict & EvMs, 

l9?8; Fd@tr & Bold, 1985; lcfr & BdLosilz, 1990; Hostrry & Atdm4 1986; 

Teri€a B@wclough & Vaugh, | 989).Th€se Fycho edwttion l 3nrdlc! f@sed or 

olming th€ @pine skiUs oflL fdili* ofpsfhi.lric paliols. 

2.1.2 trycho.duedo! . Truttutrt adh.dne 

N.ilfsdudieradd&sstn.spelrclaLdto@mplisc.of trEdicin b€.@ 

adh@nc. 10 medicitc sB drc g6d ou @ft. Irrft is a dirc m€d for P!)aho- 

educrtion bodr for paridt dd fdily io s6sme rcslomibility for lrslnml .theMc6 

'I!ft i! a wide +rc!d intclt l in Alttho .dw.tion ptogllm6 for EktivB of p*ie.t 

with Sctircpltrdia bui th@ ns bd r very litlc inv.sligalim ofthe ef*b or 

previding edEalion lo patienls lboul tiien iIB. P6endy 3 nmbr of otn r 

€sdh.E haw qarrn d $..ffeloa edultion on 64liD@ EoClt & Aubry 2006; 

Kilnilz, 2006) .ll indi..t d iqrov.d ooDplioce, wna .ducdion.l ldluiqB ud s.lf 

85

M!8mdr skilk hrE bd imrPonr.d of vhich @!p[@ w4 . per (1vd2 & 

P.l*.lr ed Mdinds (2005) did I diN of rtudi6 oo p6rho edEalio for 

Sohibplr€oi!, Ta lhldis wft ituluddd in tttis rdis. T!.y..pon d th|t @!Dlis. 

wirh ncdk.tion s 5ielincdly irDov.d, 6ing b.icf i!tcl@!@. Any ki.d of p6y.to 

ed@don iltdv@tion sienin@dy

8roQ. ExpdiMal Iroup @iv€d F do.du.totr in additid !o nr.dicdid ll|e 

c@nol gFUp a oDly on n diqtio P.lia$ w@ Esss.d o! B.icfP.)rhj.tic Rding 

S..1. &d Cni@e V6ioo ofclob.l Assmcnt Sc.le. ?.ti@15 wcr. followed W ai 9 

ud 12moDth!.At!i!cmntbsrclap€€Btci!duatjonerelpw 16%vhil€i!co .ol 

goup ir ws 179/0 bur nor sl.rildcally signfiMl Howa th.E w . riific.m 

&dwtion in syaton wcdty in @€ril@t l gFW, Paridts s@id nDcdoing .!d 

fmily ftnbs tnowledgc $out iln6s ws also inplove

to irpovc @npliecc sd .cds. cl4s. 

K.dlP. KiDv, Evdi6, Harywsd, &d D.vid ( 198) ucd . lh.6Py ddivd tom 

@tivdiotul intdviqilg i! o.da !o .!he. dh.|frc io m.diqtr4 rd ! clidcd ri.l 

paticnt with euL Eli!* wd nrdonly ai8!.d to two 8t up6, dc Srorp @ivilg 

ourilc @ plu ! bri.f p&t 8. of mlirtioid intdi4 !drPi!.d for thoF wilh 

s

&hiaphmi. .Dd hsllh .dutid wu Sivo 

Tltc f!di!8. tug86t th.1 durti@ 

inpovcd @t!pli&. .!d ..du.cd ..rdiv. iynProre T!.a. sioa d.o l.d to 

lignitcur chug. itr isiShl, 6c 'Mlh pod i .rvotioa i! .d!crti@ StoP Sullslil 

ud u.r ich (1992) irpoftd lhrl .nd .dqlio ptogr|ffi 86% 0f6.n -biapbMic 

p€ri@r5 @pLl.ly undariood ih.ir b*, ft.y .ug86td ih|r ag.ginS ptial! 8d 

f.Djli.! i! cd!.!!od Fo€r.|'@ h.|p. in d.vclopirg utrd.(lllndi!8 tad Dmd trEt Il 

dlo hclF !o tq@w r.+?!d ."d FoFtc rppofirc w of drug ttd.p, ! wll ! 

Up ddl tw r sDwi!8 tody or!!.sh hI rlpo[ld.lbfi idrldani@ i! 

r.bp4 *,16 !.Jeho cdroti@.| irtdi@rioc! q@ .d.lcd ao drug tatml, bd il 

ltfuiicd u.ld *tcrla t.m.h&8c oeB! in ta p!d.n ! i 6rt iold dit..na 

ptdiciDdio. i! Frhodudold tsriEt .!d h.lp. ro P'*rr rd+... 

CtEs!. i! Fd@r.' c!pi!8.ry'd.na 8!tri!8lDdivftb.l.rd frDily nbar 

aor ScbizolhEi. 9@ .ntdid by R.r SE*b.4 CoHr.in, F.[o4 .!d Hrwog 

(l9l), Ibi. study q6in d l[c ct'-96 in i q*tio.l ny'. of33 p.tiaLrirh 

Schiaphmir i! citba iidividd o! fDily !qtE.d. Th. inlividud lqtudt 

c@btd ofnDponirc p6Fh.dtarp, wtict ilvolv.d trtdul!|E oft!.didtioA oi.i. 

ilr.ryotioo, .!d iDtomtid .boul S.hieDbmn. Thc fiDily Eusomt i@luLd 

Foblo elvi!8..d cot|)lMidtion .Lill* .dqrior rtour S.lizt pfilEir Th. si@ 

lft r.td e!.tly f@ thE nuth! dd bisEuy fq s Dnlh! r8l fold.d lD fc t*! 

rrs. Thcy E?oncd siifcor ch&g€ i! lh. id.rr.riodrl .rylc ofltc p.li6l6 i! t[. 

i nvidralEgEE! . SiDilacb.trge@uEdinlb.f6ilyra[Mtgtu|,pburh* 

w@ @l dift&t Tlc qu.lity of p.rid! iot.d.lid.t !tyl. t foE.D.l |iadid !d 

89

Fedict EllPse in eithd ereup. Uow.v.r chsg6 in r.l.tiv6' int@ioml !tyl6 w* 

Eported n@6sary lo ail41 lhe shon @um of schi&pb.nh, 

kxhoeduadon6l inteflcntionr de cfli@ciou in othd patholo8d olso; lhe 

srdies in tlis stion d€ .oncemed io oth.i psFhological dd Phy6ictl illn ses 

Psyrho.ln€tior is rct only helptul in ndtdl illD6! bul ii hd Prcq 

90 

10 bc .lEceious in 

oiler patnobgies 6lso, ktlhocduc.tion l inidotion *6 aPplicd oa pltimls with 

alcoholic livd dise and abltin@cc pbblm who wd waiting ld liva ttusPleLtioD. 

The study ws cdi.d oul by E ir4 Belom, Tdgty, B*k.b.uri\ Grt 4 BFel*h dd 

SdJ (2006). Toirl 48 prtiqls plniciprt d iD goup tblFpy. Tt.y w@ Mrur.d or 

h€illh elated quality of lifc sl6, Uolpi&l Alrily md D.pl*iotr S.!lc (HADS) ad 

for al@hol absi@@, .t inc bcgiuilg $d dd of lh@!y. DEing th. @uR ofIhaaly, 

fou p.rienc lDd rclat6€4 bur th. |tmining Pltidt rblrd .bstind! Thcir phr.ical 

qulity of lif. irprv.d. The culis 3ho*rd l prycho.dM3tion f&ilihr.d r 

shbiliaton of @rrl w€ll b.ing in P8tidb 

MurEd by .tonol colcdtalion in bsth t!ruin d sle low. 

wirh .l6lblic livd djs.e. Th. El.p6€ are 

Pslrho.duc.tion ha preved vay hclptu .t F@pdtiv. 3tjre. of3Bg6y for t 

svftly dDmtiz.d child, Kolz, Fucb!, Crill, GEh.l. dd R.d.l (2006) EporLd a ca. 

ofd 8 ,ld old gj.l with a lorg lem hillory ofs.vd. !.xul rbae ed D.llramfll 

wilh seyft mtioDd pobl@ wa eh.dlled lor su|8cry ofchb&ci The Frholosisl 

buill 6ppon ed confidence, Ths child sd family wd€ pbvid.d psrno.dualioA 

aimirS ro deffne caue md 8o.l of lur8.ry shc wa! !l$ educated dd @de fmilidired 

with 6urgicd peedu.r, Iinally she wa5 prcp&d for sug.ry wilh h.lp ofpsrtho 

edncatior I cd b. @@lud.d lhlt p8rho.duc.ion is vdy hclptul dd €ffic&iou in pI€

In$tui! is Bsiaied wiih a pstrhialric palhology in .bou 4@/a5@/o of cer. I 

is d$ a &!q@l srDplom in Schizophnnis tnd mst comtr fal6 of the Mia, 

Pri@o ed C.sali (2006) ddutcd l[. our @rc of . shon lqn Fy.to.dsrion i 

&rivity on 4 ofdc l4 pc)rtidic in !.liat diagns.d *ilh S.tiephoi. .nd Bipolt 

disrd.r. Thcy *@ a5sed by mec of d mluctud intcoiew, nGing ob&d.tid 

.rd @rDiling . sl.+ diary for two welc. ThF qakly gb!! sesios, @h lbour l- 

hofi long wls held in @mordece wit] a p6].ho cduetional appmmh in orddr lo tcach 

md disus the pnncipal rle@ hygide tuls. At thc .nd ol rclivity the .rdimtion of 

slc.p diri6 compiled for ! nw 2- w€ek paiod showcd c rlcMd of sl€ep efici.ncy in 

all 4 p.d6rs virh tleep de.&r. Pstrho .d@lioml .ppMh t hebtu in tdeing 

Fmily p6y.ho educadd had pova cllctiv. i! $e lanD€nt of 'Jffiir 

.wosr and bulinia ndoe i, adol@ocq A prtrho.d@tion6l n€.mdt pbenm s 

.vdu.r.d by salbell Bohn€kmp, L,hiltulrl. Pfcifid, od Kon (2006). 32 fml. 

pslials, 29 with dorxia nflos md 3 wnh bulinia ndos, ud lhen peak took pln 

in lb. r@heol pogm This w6 . nahlalbtic airgl. 8roup study desi9, p{€ dd pon 

chdg6 w@ ascd PGposr &rlylt Bol.d . d*r€& in 1he degF of synptom 

ofodng di$d.r aftd p6]cho .dwiion. 

Ldgo, CluD, ard YogE (1988) .v.lut d t pycho sial talMt EgiM fd 

I vinl b$d disd€r rllMr s@it l [dpc, R.D.rr.d @isd€s 

of tbG dis€e d 

r5silcd wilh st6s, i €lp€Mnal tqEid !d cmotiob.l distEs. It w br?otn6izd 

thal individuk r*iving F lhosial inteNqtio. would tton r.dued H€Aer 

9l

Simplex viEl {HSV) lctiyity ! mr impbvemdt on pstrhosocid Lcto6 a 

conpeed lo patients on plecho cootrol oi no ireatnol condidon, Initia]ly fony ciel 

subjels wqe uruited fon two centes thou!! n43p.per, ldvenisdeni ed healll 

cde Ef.mls. Ihifty o.e s!bj@1s who h.d fou or m& .!k d6 pq )@ weE n.aly 

sl{l€d Strddncdid w.! u.d io o6w irf4tion svority dmng tr€anndt colditio6 

andlobaldc.lheefdrsof c?isodcfr.qu.ncy,Diff@nts.l6lit Ze8Dlprsior 

S.ale, tlrlin*s &ale, Mullidindion.l Hslth tds Co .ol Scal. a H6L Scd. 

w@ admirist red io m*u. pE 8nd pod irrd.ntior vridio6, EDtiond dilf4. 

coEnitions, si.l 3lppon rnd str6r wc M3.d by tn lFfiI. 

of dEod di$rdd. 

subjcrs w€E tudotr y sigled io on. ol tn. tlle @ndidoa; p6Fho *i.l 

irt dotioa sid swpor! or sitinS li$ @nEol, Eeh tra!@t colditior @!t ir.d 

two, ive mer$d aop,.d 

wrilinS lisl @nttol@ndrtror @nldrcd ll meoDd Botb 

intervmtiotr sFrp3 dciwd sn cote irc v!.&ly, dndy hinutd sioE, 

In pstrho si.l intcrdtion gow, subjel. w@ povid.d i.fo@ti@ .boul lhc 

nhss! Elaxrdon wB buSnq rr6i Nlgddt renniqE sd imgdy tehdqc 

w* ued- UD@lycd issu6 w@ disulcd md odlPUdce wa ctuolraepd. IXe wial 

suppon sFup shllEd feling' &d *pdiac6 .bod thc d,$e .nd @.d $ pLebo 

conhol s!bjoi.. Msucs wcr. sed at prc po3t ft.tnol ald |t lhE md sn @.thr 

follow !p tire. lnd,viduls @eivine p8rho$cill int lvorjo4 Gport d liertrficel 

Eduotion in hqpes 6€qenoy, cpisod6 dualion ed svciity w$ allo l6s. It rcduced 

dotiooal diltie$ dd loneline$, ed s indee iD lcv.l of imd conlnl, a @npded 

to oder groups. I r1!o ficilitaled tnch .djulnncDt !o lh. drs6e. I wB conoluded thal 

psldosocial i eNdtios ft efiectivo in r.dMinS chrcnicity ofhclpd dilce, 

92

It cs bc .orclldcd thd el.plc pr.vdnon ir o!. of$. trlolt itp.net go.k of 

lons icn llMgdd ple of Schathrai!, Frmily F rhocdsadon if @hbir.d wil[ 

reulift ph@logical tr,lMr 'a{uc6 th. ElaF. dr., 

Itb pm F.qts sl)lr)fuy of eo@ Md! e.ly!6 od .t6 tht did 

'Dr@ i! @nrindt ffih didcm. $pponilg rhd fruly F)cho.dqrior 

rcd'@ Fbr.. dc i! paridt! wi0! S.hiephMi. (D&n, Ade, & Lukr|d 2000; 

l,htM, & Sr.in*abe, l98i MiLowitz & Coldlr.it 1997), SiniLdy . Ma. edFi. 

ofF lho .dqlioDl 5\di6 by Walz, Llceht, BNtDl, Kislbs ud Er8.l (200!) 

!trongly tgn@d.d $!l if fojly nE $

dlorial pan ofllqtnal of SchizophHi. for r b.ttd long tdn proemi' 

P5tr[mial irtervalios ofqd lo fmjliA of patidls wilh Schizopbmia hrv. 

b6 studi.d by difremr l€sdh6 ovd |h. po.r 30 tts, te (1991) nd Fid.d 

dd Mlyzcd rb. .nprncd culi6 o! p6}!hosi.l fmily irlavarim vnb 

s.hiaphMia, He iftludcd six &6ily cdBatior shdi6 of rnorr.r duoriotr &d 6E 

intensive fmily work studje with two trd follow !p, H. fsu$d oa lhe e6qcy ed 

mmhanism of t.ohral irt flentior &d oo rhc cfccr of dilf6d1 corryorots in ! 

varioty of treatuql p&kag6. All lhe rcviw.d studies Eport d . sigDfi@t ldvetagc 

for fimily i e|@tion 6 @npaEd lo contol, with lxce/ion of snrdy by Coeliro, 

whi.h wa a one ssion sllldy. All thc othd lrudi6 rcponed ! gain in klowledge ahout 

Schi2lpbEni! lDd ils ryqro4 i! tbc cxFi'Mtd 8Dl9. Anotld 3igni6elr tilding of 

rh* rtudi6 w6 tbat el.dE oImE Ean o8lr pdidrs slwd s grelq ctdS. i! 

e6 ofE,E nE8rer cbtugirS tlEi. lnit'd€ od ndkira rh. dtuns dd budd in 

fmily' sugg6tjng 1ha1 $* Ehtiv6 wad tud etubt. lo gd .nuetid. 

Tne s€ord sel ofsnrdies i&lutld ir tni! r.vid desl wilh lolgs dursrion 

sludis. The i.|'Bive fmily inlenehrion studics u.d o redoDizd .onlrot dpeinotll 

design. The sperimor.l goup edved lomc fom ofp6ychos@iEl famity int@cntion 

Md rh€ conrol grcup wa ordy on mediqrio!. 1t4 stldi6 w@ @dicl€d by diff@r 

lelm in difffir g@gnrhicd l@atio4, bur rh* hlvc dcmsert.d t[. 66is!an 

findinSr .ega.ding Oe elfetivffi of fmily i .@rior .r 9 null ro @ t@ foUow 

!p. Th. GL0* or. of fuily llohar g6up tug.d 6om 6 lo 23% oqatld vilh 40 10 

53% in contl.I g&|9. By 24 mnthl . f.irly high potonior ofp.rials bd r.t4!e

83% h cotrpdi& sDup. Fall@nt snrdy (l982, 1985) snow.d r flwble ouioom. of 

1t96 Ehp& ot lle two d follow l9. I! .dditio. !o FIS. EG, Frlloon ed @[agc 

Eport d a signifiMt nn!@v.!Mr in otldour.o@ I|)erc,lilc de@e in lynplom 

svoily, rcd@ed nubo of tdrni$io$ in nspirrl!, ed imr€@ ir runba ofdatr 

sF ir@Mity. t f0990).lelt?on d 6 irFovffir in n g iEsyDprmt in 

p.tidr! E!.r.d by fMily th..py o. in a Ebtiv* SDup_ Fall@r rd 6[6gc (t985, 

198?) r.porled tnat bo0! f.nily !d individual fmily inldcntion showed siific&l 

chagc in ss b si.l fqctiding clbiql Dd fdily hurdd Is6, In m6t 

p6)choadrc.lid poglm $. Findy god *a l[. diDl ofFhp6c, nndidgs ioD 

som othq 3tldis iftluded in rhi! r@iw d. Sivd h€low. 

Phtt (1980) fou

.ducarion h.lF 10 r.duce tle suil wnicn t @n]lM i! thclc fmili6, Tal€n iogeiha 

rh* Evi* previd. . @qEn@iv. did.ne fd 6mily i.GIaarioN ro be d irLSnl 

pan offtfind in Schi@phiaia (Circd frodl htr l99l), 

Dixd md L.hru (195) hld Hiocd fdilyps)rlo.dwrion l rndi6. rn rhit 

rcview lhey hsd inolud.d ihe pFviou r6eeh lnjcles dd meia salylh by Mej $d 

S@iffi ( 1994) H@ onlt lh@ shrdi6 e r@n.d f,tich hlv€ ftr tm dsib.d jn rn 

revis rcpon Mtioned rbove, 

A 'mba of nutlid hav. lxeiE rlE cfets of fimity idndrion o! Gt.p{. 

nt€ (Kon8en, Somicheo Mollol.u&r, & Junh 1984; L€fi, Kuip.q Aakowiiz, 

Snrr@4 1982; Vdugho, Doylc MccorSny, Blts&ldki, fox, & Tdj6, I92j 

Mir$ad, & coll*gu.! 1993; Zh.ne & Wd& 1994; McFddq Lukq!, Link 

Dlshax Delins, Nwrts D@., HoE4 & ToE!. 1995) ondul.d 3t!di6 o! p6Fno 

eduoatior of fmiliq. Mct studid showed rhat f@ity iorcNalioru pbd@e lowd rares 

orFlapse ovq |,2 jas 6 @Dp&d ro $.r.t nt Eaile! d€F 0!c aMyby Korleo. 

No dif@rc* w@ foDd io el.Fc 61e &os co.dirion! in his study. 

Simihn, i ha b€n r@otud rhlt f.nili6 wlo Etuc b p.rricip*. or dtop our 

aftq r snoft Fiod ofrim geni.g mjni&l int rye,rioro (Snirh & Birchwood, l99O), 

ft* Lnili6 r.porbdly hr

th.n fie Elapse r.!c incEs€d to, 6tol eoup (49elo), fmily hn.8mnl sbup (23./o), 

sid 3kill t'.ini!g (30Eo) .rd th. coobi.ed goq' (96). 

Ir rbe s!ru mmq, Tei(, Bamw.loud, .d vlush (1989) rcpoicd a rehpe 

raL of l2% ovd nine tun$s fd ! b.nrvionl irrddtid wiih feilis bul il tne p.nial 

r?d.6w€ elinin €d de clale Ere i4@v6 ro 5%. a folloe lp of EsEml Enu6 

dd drcp outs ov.r . pe.iod of9 monlh. indicarcd dFl I2 oul of 18 (670l,6) of ih6s 

plli.nc Eb@e.d (T&iq, e! !1., 1989)_ 

Th6 th@ is .rFL cvidmc auegarilg rhd tong t.m fdily inGdcntior 

ori.ntcd loward .duclting fmily rEt6 rcdu@s pdiar, rtlcnbitity to FtapF ovd 

I -2 ysB. rn @c snd, . ni& mnd inr€ladjotr wc wa .ssial.d wilh . lowa 

rlapse 6re for ar long a 8 yeds. F4er s1udi6 had exdincd th. irp,cr of fdity 

ocrydlios o. orhcr dimioG of paliqc, *i.t iucliodns bur s.El Fpons 

indicat.d pGinvc .fisls in egsd lo r€dm.d Elapse 6te Git d ftom Dxon, & Lebm, 

l9t. 

rI a @fl tui.-anrttris of 2l @!on.d nudi6 Falldn .d @ns8c (2002) 

Mmined ihe elteok or P!'rhocducarion in addition b $ondaid phMthcnpy ir 

pdial5 vilh Schiaphmi! IE G?onedbdcfils ofpsrho.duqtim i@hrt rdE€

thtion !o Ehpsc. A5 high qpr6cd .mtioB in fmilics of paliolc wilh Scni4phMia 

n r?on dly o bbusr ph.mr of Flaps6. 

2.3 Etpn$ed EnorloN .nd Core or Dhar 

Sdaal smdi6 hlve mred $r rte high ldel of qplK.d @(ios in a thily n 

d strong pG

€laliv.. of a 6chi@pt!.nic pltimr e Adictive of @ilMce of lhe di$rda (Vrugha 

& Lelt, 1976; Vdghn, .r .1., | 984i Klm ,.rliE, SilE, Ssrrn , & Tctlc* d it., 1987)_ 

These irdings d€ fulho cor{imlcd by Nngla, Dinge@s, Lil]!a, Do*, ond c6on 

( 1997) who Epdlcd high coftlnion hctren E.E, .f,.criE .niturt6 dd @icador 

devidcq in fMily nembe6. h dolhd study fiere w6 . significmtly higle nlo of 

Elars in p.iar wi.h hish E.E glup 6 @q.!!d ro paricn|. nom bw E,E FlatjE 

(Benlddo, Bellz, Bcsri, Clsici, & Ftu, .t al., 1992), Tt. lj.t bctwd high lcvcls of 

dpBlql tulim {d hthd Eh+e Er- ls b6 retjc.i.d in sarl culrlc., 

includihg Euopeo courriB, lh. Unit d Siare!, Mqico and Irdia, 

I! Mdi@ .d Indis, loycva, Ebitid ofp.optc with S.htopl@i! &d ro 

rcoE rovcr in @6uc ofexpr$ed cmtions lhs do rheir couier pair in Ewp. sd 

Unned 5L16 rt€ sE in Ud.d Si't.s w@ 6?9/0, ir Bntaj! 48yc i! M.n@ 4t % .d 

h India 23% (k@, dkjns sitvo, sdta.a, & Telt6, 198?). 

Kuipas (192) hld Bicwcd exprBscd .mtior lludi6 @icd out in E@pa 

These includ€ Fm out coft studi* ut $rc i.t@ddor lturti6 for parholoei.! o$s 

thm SchiaphMi4 Bnct srmqly jn poi s i, givetr below; Ll@el (1991) in Sp.ir 

Epond a Fl.tidhip bdw€m hieh E.E bd &lrp$ in S.hiephMia (Cned 6on 

PlulM rd aseilrs (l99t i ciLd ,ioh KuiF6t I_.n & r4, 199) foud rhal 

tution.lly oyd iNolvd mib* wft Frc.ivcd ov.rpbrarive blt hld low @ 

bcn&ir whicn bd b ctaF€.L! oul core snldi6, SriElir& Tdrarr thoh,q Ncwby, 

&d MonLgu4 (l9l ) stldy ws onc ofine aer ,tudi6 whicn failed io fild e, 

.siation b.rwq high E.E !d €hp& (Cn d rmn Kuipa4 1992). h co,ctuioi 

I

howcvd dc ou1 cone 3hrdi6 ieluded in tnis Eviq co im th. notion tn.t nieh EE k I 

rcbut Pr.dictd of rlarse (Citcd tm Kuip6, 192)- 

To Nerlion ti. caBal ah$o.ibip of dpssed €mrio$ in rl.pe of 

ScbiephFoi., ! Btudy ws onducred in Ire by Kdn nd To6bi in 1996. They @itcd 

eighly sa Ftior3 &d as6s.d thcir fmily rE$d oo Ce$deel Fhity 

hlcFis Schedul.. Tney foud or|t 65 (7470 paieft wqe living wirh a hiSh .xpG!.d 

@tions Ehtiv.. Amns lh@ 48 (73%) hrd I Fl.pae duing th. niE @!rh fouow up, 

whdds only 5 (22%) had &laps.d fton low dF!$€d mtion fmin6, Th@ i5 . 

gewinS body of litd!fift whi.h ruppo.r thc cxpcred cmtd s . p&djclor of 

ELpe in paliatt will Scniaphnnj!. 

Kdvmaeh (1992) qiaBivcly Eviwed 26 mdi6 dd up d!r.d fic role of 

dpcs€d @rim in setio4 pGipir.do! ed r€ahat of Schizopl@is. Tde 

snrdiB compri.d on 1323 patidr! ed ddonstr.icd inm.d didelc. for rh. 

o'pone@ ofE,E ad lub$.nri.lly pr.dicdlg hiah6 616 ot rct.rse ?0e,6 of6e 

Epond st'rdi6 lound . s|.risricstly si8li6cer diftm in rh. et@€ El. ofpsriab 

in hign E,E 48olo a @nporcd io low p.E dviomdt 2 t%. Ttb iftliat ! a v.ry lBong 

.ssiafid b€rw6 nigh E.E ard .ch@$. E:p6$d mdtu ddmi& lh. EI.p6e 

tircugh itl .iI66 on @orioro &d sFpioh cdlrol_ A Mct. o.tysis of.tda tom 27 

E.E dtldiB (Bltzlafi& E@ley, 198) Eponed ! siiflcdr reciati@ b.1v6 hign 

E.E od Scnizophhj! elap6i. 

ln eoIho sludt $d€ ws 6 sigificMny hiehe raI. ofrekls in p€ijdls &on 

[iC E,E smup . @rp&d ro p.ricnb noo bw E.E Elmivc (B.rr.dto, Batta Blxi, 

cl.rici, & Fmr, cr al., t 992). Howeya, Montcrc, Ba€yto, Ruiz. pu.he, ed Adan 

100

(1992) lound no asoci.rion betw.er Elaliv.! !.8 &d elap6e nrc !t 9 nonrh ud 24 

noDlh fouow W study with &hiaphMi! paliats. T[.y foud tur lbe di$dlinurid 

oln diali@ {d nor going for erk w* .5*iaied wiih Etap6! doag l[c high E.E 

Ehtivc gFr.p of pati.nrs, 

Ar iDporlDr f&1or which @unr. for rhc hellcr fmily ruppon n lh. .rhtuijd 

rcbdves nElc for ilF illns. Mdy Bedche6 have invclrigred ihis. HnisA Dadd!, 

dd Shid (l998) Nsd d. atEibudonr EtadG @tc for rh. sln!,rm of 

SobizophMia. E4 ctr€ giv.6 ofpatidls pith SchizophMja w@ inrflis.d. 

Atribution dDt li. srtnploh l* th. cutt ofpadot Flsiliry nllr r!& disila. 

v@ N@irted wilh Uide howledg. .bour Schi&phtnjs, hieb E,E ed p@ copilg by 

the Elrtiv6. This w6 sub driald by olbd e!@n6 &€ B06!0, Ulslin, Bjorye 

dd .s$iara (199?) ad Hmley ( t 98) rcl.riv6 lnribur.d rhe srrplos h hraDl 

@nlrol ofparidr ed wer. not due !o disordd, thu elicil fjriciu fron El.riB sd 

bi8he dc lo.l olcnrci5n n@ lit.tih@d ro here . Rr.r.r 

Efffc&y of fmily ranaeot hs ba cxmined with mirority popul.iion de, A 

gowiDg b.dy of lilmluc indicar6 rh.t c€tuh sio cultu l cn@taislica 6h|M in 

lMy oioodry fmni6 nom rdilioMt sietiB my b. bcneficial !o pltiaL wid 

SchircphEnir. Tiis hylorhBir sl.m.

indutializ.d out i6 swh a D€mlq Cahoslovak[ tle Unit d King&rd! lh. 

Soviel Udon &d lhe Unild Stals. 

Re&d.hc6 nave id.nidel . fw cndacteristica i, rhe fdily mmb6 tom 

lhe b.dirional cdtu6 which a@unr fo. a b.ns pogtuis. rn* .b@rcrjslis 

inoludc th. dprgdd of lwq oilicrl ncdb rcndks &d ls blme wodry ardbudos 

towdds poliqr,, SFard support arld conBior aod $rongd spiritud 8d rcli8ions 

l$ler in lbc fdily. Smc |€@h sugg66 rh.l t w *ps6!d mtioD elatjle 

posF$ cErir pqlonality chatuteri ics, ssh e Srdt r fldnbihy (H@ley, 1998) &tt 

get.r pDbl@ slving .litiry (Clnbl6s, BrF4 Ait !, S0eL€n., & H@1., 2OOD 

slich m.y help dd in copinS wiih Scniz@I.fdja i! mrc ldlptire &tt supponive 

Anorhd f&ior tld ny @ffibub b bat r c.@. of iln6 i! trldiri@al 

s@ieti.r (like ou) i3 fmily cohsjy.ness tnal plays a nore cenral ble in patidls lifc 

(tdcy, 1989; W.is.I, | 997i 2Oo5), tr a @dt srudy W.isE!, Ro6dd, KrD,i.i!.!, 

ed Arret (2005) foud rllll g@te ! pqsoD pd.eivc! his faoily s 6h.riv. ed 

supponiv. DG it5 sb.wr . b.tr.. gd.al mtion l v.U b.ine for dE fdity .td rh€ 

palidl. Th. plti.nr wlo p.rccir€d licir fdily dvimlllMt 6 rupponiv. 0Ey dispt.rld 

16 sev@ synprom inchdiDs deturioB, taUrcimlid! dd disorgdblion in sp€h, 

Ukwie in Sctizoph@ia f&dty cli@r. ate b!v. e inp&r on th. @@ of 

child hood affedv. illn6s. Hish €xpEs.

2.3.1 kycbo.duedonEttr.6irdEnodotrt.!dR.l.pi. 

The Esesrh on .xp6ed mrioN hr5 docMare

ew6 prtim|s n d rcl+red i! lov qpr6€d md@ gorq 6 @q8!d to high 

exprsd emtid goup. Th* dlt indicard tnot r€dulion in Fl.pe w3 sutaiMbtc, 

Tn€ inrcddtion tmk place in firsl ninc m n3 but efieck n prcde€d l6ted .v{ and 

cighr tts. So n cd h. @mludld rh'r f6r yls sn6 dis!a.g. i3 a cdticd Fiod.nd 

.dvdr4e saiD.d duing tnis pqiod co be ssilircd Thi suggets rh. .xrty 

inplehontalion of p6y.ho @ial irrcrvendoB i! @c bse6ci.l ed hav. long tsdng 

A sronS .5sinj6 hs ber 6rabli6t d bn$r6 toclof qptBsed dmii@ 

dd tnc out @nc oI SchtophFnjs in lslidts living wilh r.iariv.s (BoM & Biet, 

1968i 1972j vaughn & l.4 19?6; l98l).rhis did*c w6 d.rive{t fon tne studia 

condulcd by od. I i. filrha ippon d ir $m othd lnrdle Imron d h@, 

Tuid, Bo@wdouglr Vaugt4 Bsu4 pr@!ddu, W.tls, .d FE@! (1989) 

rollow.d up lh. pdriqtl &d r.ldiv€s of Schj&phFni. paliqB wno p.nj.,pat {r in ! 

MFoll.d Fill of behaviost fuily int dalion b,s.d on rhc cxpGs.d tution sr.tB of 

then Ehtiv6 for two ,ts. ?3 pati@c poticip.r.d j! $n $rty_ h&!vari@ h 

povid.dforth.initial9tu h!butallplddcw@mog.dbyrn i,clidc.ti.utorI 

paiod ofrwo t€!6. P.tidr werc rl& Setting n.uotedjc nedicine. Tt ee ridlmenl 

snuF eF ronnc4 iigl E.E cauaion gIllP, .@bol AoW ro g€r rcudn€ aqlMq 

low E.E .dqrio. gbup. Att fhiti6 iD h€hlvior in0crvcnrior Eup l@v6 

inteP.nrion lor 9 mnrhs ed ild wed in @Dt!.r on ,hoDa Th. r$dr! indtcd.d tlut 

rhe paricnrs wio reivcd b.n.vjoEt fhjty inln@tion h.d towd 6re, or €hplc and 

readnj$i@ ths parimt tom high E.E ho@, wno @civ.d . $on .dk tio!.I 

pbgl@ or ourire lrot n@ri the rar€s ofEhplc in rh.e two 8re!$ w@ smc 33% s 

t04

cornprcd ro mrol. High E.! goup who F.iv€d orlyourin Eatrtr@r rtE rlr!6c q& 

h . 6nr.llcd Eid of *ial irt.darioD wil[ rhe fuiti6 oI Schizopbmia 

pdiots rt high risk oI Glapse, by LelI, Kuir.s, Bqkowirz, V&ies, ed Snugeon 0 982) 

p.tcnts b.tw€ rh. ag.r of 16 md 65 ..tniiild in hoqnal ed who had liv.d with 

Elrriv6 @nriruBty for .r l*r rhG irclud.d ir tnis ,rudy, Th. 

'Mr!! 

Ft.dv6 

'@ 

who hld the @sl @aL.r wnn rhc pltiar Fid !o adnjsid i! loqii.t l4 5.1€r!rd for 

shrdy. Of rhe 24 patiai! dd th.ii fuili*, tbc hslfss @donly sign€d b Dutire 

ce soup md lh. orhd hdfedv€d 6 p&kag. of locill inlcnarion!, Thb comislcd 

on . psgtu orcdMlion lbout S.lliofiqlr i! E ily s*iotu wjlh EtadvB tud th€ 

p.rid! Edocarior c@LLd of fou lanc o rhe dioloey, .r!pro@ @Ee, rsrrnat 

od hDagmd of Schiepb@ia AI pod@i. ir d. trial wcrc foltowed up for nia 

oo l's .nd di&harge, Irc.elapF 6lc in thc @nftl gbtp ws 50p,,6 cotupsEd wirh 9olo 

in expqimral gDup, tlc inr.rydrion qutt d h towcrirg $. r,.! ld.l of f@jly 

llmb€B, fte ltir.d .itu of llE p, w@ rcniaed in 7j% of dFiMilt gmlp, Ihu 

n ce be @nclud.d rtlr ihc Farlge ofsid incr€dc pDdu4€d I sig tic.lr 

rqlldion in E.E lev.l tutt elr$. mre of SctizlpbMj. 

h tuolhq lrudy by llfi Bdtowiiz Sh*it, Stuchaa clss &d Vrughn (1989) 

pati.nk qnh Schizophhir living in hi8h colr&r wirh cLrivB n.qng higb .xp6s!rt 

@tio4 rc @il.d for . Ei.l of *id intdv€.rion. ft. !.leron dftdion for rhi, 

sndy wa sinil,| 6 for ptviou slu.ly. 24 patians aDd th€n fanitid w@ @d.oty 

4sisn€d ro two grcups, conlistod on eduado! ptu Imily tnqlpy d dkaron ptu 

@lar,v€s gloup. Ttey conducred rwo lri.ls !t rwo djf@ft sncr, Tn paiars in rhe rwo 

I05

tus did nor dfid sisnificedy on d@g|phic ch{rcc.irtica md rebnv. tun|g oi 

E.E subjers ** drdotr y si8l.d !o two srcuF. 12 fsmiliB w@ Nigu.d !o fmitt 

derspy and I I lo !€lalivc6 goup, At the ninc mnilt follow tp lhoe *6 ! lignificdi 

Eduction in ditic.l @@r! for bolh geu!6, . sigtriic$r EdEti@ jn hdritity for thc 

Ehtivca grcl4' and siincd wmth lor boll.l 3E@8. Tn* ws m significmt 

redu.tion ir ovd inblvenmt lor cirhd slr@, Th€ two 

'E 

rctap.c d1e *@ 4 out of 

l2 (33%) itr dE fdilyllan ysmup.!d 4 oul of I l€6%) in th. El.tiv6 goup Grff 

dd coll.ognc { 1990). tn ollla gmup ite ret.p6c 6te oyd nine moths in rhc fdily 

th@py a@lp *a 3o/a whiL n B | ?% in rh€ El.riv6 greu!. 

F.mily plrrho edlcrtioml intetuato!, ildus ,.tape in plijqb Mrh bipole 

disordd Md lowd E.E l€vcl in tmily tlMbd!. ArFng fmiti.! of &hrlt3 Mth 

Afreliv. died.Er pEtinjn tr qid.nce na !uss6r.d tiar f.mity Frrho .d*rtio! 

is efetivc dd fqili6 fbd psycno cducalionrl intddiions lo bc h.bnn (Ad6oq 

Reis, & HogEy, t 986: Chria C.t?ar.r, H,!1, Wod, & cticl( 198; MitteiE & 

Mil}owiE od cot&t in navc foud fmily Frrho de.ron !o b. .fiative jn 

r.drcirg clape E B @ag rinc wirh bipots disds (CDl&i.in & Milto*ir, t94) 

ed il's g€nerally h€lpi! for pltiftr ed d. fmily iI coping wiih dris disrd.r, lqniDg 

lo @@hiar. with @b orhd ald in d.v.topins plDbto etvi,g ,Farcgi6 (Miltowitz 

Simjldly, Frisi.d G.v@i, Cdrotell. dd Sotdoo (t 996) docwr.d the 

c,Ietivde of sirnplc du.donat Bion for Friol wnh Aipole djerrtd. Ajmlq 

Frist d lhd cav@i, (1999) lnd Frilrid, Cav@j, dd Solddo 0998) havo lhom 

106

posniv6 finding Fgdding llte emc&y of psylho .duadon 6 an adj@liv. 

inresddon willl patients and fmilid of Bipolu disrdd. 

To D16u€ rh€ €osr efrectivds of fdily i.t ryatior h patiaB wilb 

S.hiepnFria. sfidy M @i.d byTrmd, tlwq ald B@wloug! in (l9l), E3 

p!(a15 dd lh.n frDily rdbs wd Eruii.d for l!@ t'ih. Tne pdticip&is w@ 

rllocard b one ofihe fou ft'tnal! @ndirio8 sording 10 6en E.E ldel. Two 

grclps s.ivcd behavior idflqrion dnjry !o Fducc ihc E,E 31atu dd eB.quody 

!o low€r r€lapse Ble. lhe inrflmlion l6Ld for 9 month6, o!. greup E.iy.d a slDrl 

roline ft.tnent. The paddts who liv€d wilh rehtivca of low E.E gmup reciv.d 

.ducation in im ssios i! addilion lo butin. cdc. Tles ercups w@ nrlhd 

c.t.gorizd into rhE srcups. High E.E inr.ddti@ golp' hiSh E.E otrtml gDup ed 

lo* E.E @ntlol grcW. Th€ El.p& 6te wfr l27a 48% .nd 2r% rEt€tirely, l[e 

in.flolio! Fpotied a ds1t4 of 2?vo in nM @sr pq plriar this anonic bacfit i! 

coNiddcd s F)cho sid intddtion b. e inr.Sbl Pln of EdmnI pld, 

Tond6, Mares, E ommou, Lmvich, Kddiv, dd SLf.nb (2000) .Mi.d 

our . lrudy wilh thc objetive io loow lh..ffi@cy of fuily i erydti@ when coDbincd 

with individual pltlho eiuational ftatMt and $coldly if fuily inlmstion low@ 

E,E ld.l in the fdjly llmhds d.s ir hrv. sy politirc !ffat or p.dar .o palialt 

tom birh E,E anni6 s@ adly sjgn d ro two tqrndt grc'p' otr gDup 

@iv.

for $c next two ye.$. Clioidl outcofte mmsu6 @npd*d ofEhp*, G 

hospit liatiotr .nd ol€ pdfolfu.c w@ rhe si.l our@, Tl. cul5 idiqt d . 

sigriffcel dell4 ir Elap* ed rc-hospit liztion Ete h fnily eduatid grcl4. 

Fimily inteodtion .bo found io poritiwly a$ci.t€d with w.cd noe hiC lo low 

E.E @nC @lativ6 wno g@ ag.gcd in ftltbcnt. Hieh E.E wa fo@d to b. . 

prEdic|or of relaple but not ofrhospiidizalion ov€i two ttd follow W, R6ulis 

suppotel lhe ibpol!@ ot fdily involvml h dE EamE pld, 

Cognitiv€ b.havior ths.py i! a @r&onot ofp6rcho!@i.l inl!d6li6! Md 

navc pov.d cfiic&iow wilh pariols of Scbtophmia dd th.h fdili6 io lda |I€ 

lev.l ofdpGsd motios md @n .q@tly ro r.du@ FLp*. F![oo4 Boy4 M.ci[, 

WillhMn, R@ri, Moss, dd Cildtu ( 1985) conpqed hohd-bGed b6h.vioBl 

finily rh@py (BFI) ro clinic b!&d i.dividu.l p3 rholheryy. Pltiars w@ &lct d 

b6ed or haviry hi8h dplw.d hoIioB ehtivc!. E.navior feily lhalpy pDvided 

edeltion alour th. ilh6n @tmuiqtion shll! tlinirg 3nd prbld{lvirg lr.i ng 

loth.wholefrnily,iEl'ding$.p.!drAndnilc@ hxth@wft sqd 

aduntag.! for patiol6 lrsted in the BFr grcup, iocluding fewo strplon 

d&dbadons (6% v6G 44%), indes€d ffii$io. ofsrbprotu 6e/"a@B ztt) 

md Edu€d nbbd oa hos?iLlt lios (11% vc6u! 50ol.). Aid 2 t€s, lh.E @ inued 

!o b. . p6itiy€ cfiet lor lhe BFr conditid rcg..din8 srrplo@ sdity Mth El% of 

tic BFr pariall tvoiding ! djd da.€r6aij6 @npar€d lo l?96 ofitrdividudly trsLd 

t tf, KuiFB, Bsl@wila !d Snlr-n (1985) @q!r.d rh.n vdiot of fmily 

intcdarion 10 Dudnc ouFotiar ce for p{ticn$ wno lirrd with or bld A.qu.nt co &r 

108

Mth elativB who w@ hich i. dpt*ed rmtioa (E.s) a ruu!.d by Oe 

CanbeNell Fmily tltfliew, Ih. fmily inrdveonon involved both individul lc$ioE 

.nd nultiplc fdily sppon 8ro'pa. It wa .irEd al Foviding .dalriotr. redeing 

dpl6ed dotion in th. f.Dily hd ircuin8 U. p.lial" indct@d€a€ tw higt 

expEsed mtions rclaliv.!, DuinS tte ffti 9 nMtt! of trstmcnt, half of the pliidt! 

wno @iEd outn! @ r.LFc4 @q!r.d ro 896ortdri6b eh@ fhiriF @iv.d 

ilt*stion. An6 2 ys, th@ ws a 5@o rchpdc EL fd 0E faily inrqvdri@ 

onp@d lo ?57o for the goup Eceiving lrstrcnr s uud. How*a, iflh. drt e 

&ly2ed l@h!g ot y arp6ti6r. *tD @tinu.d lFdiclrioo, elrF. rr. v@ 20% 

v6B . signilicet diftu. ir flvor of fmily iota@ti@. 

Hog.rty, And@n, Rois, Kohblirh, GEdwal4 ,!vna sd Mo

ln eorhd study by rh. .m. Beehcc (tlogdy, er .1., 1997) uing ilc smc 

c.iteria and sinila tobnent grclp6, in th. nat yee following lhce ftrrnd!, 4e^ 

paridts in $c nqlidtid orly 8rorp rchps.4 @rpared *ith 2f/o i! ln. frst two 

p6trho6@ial iliddtior go!p! dd m o.. in th. erclp lLal @civcd both individul 

shlls trainine dd fdily ori.nLd ihqrpy. In $. @oDd ,€{ of follow !p, th. group 

ibll @ird f@ y on6r.d 0'cnpy@rinu.d ro fet r|!r d!! did rbo* vho 

eeir€d modiotiotr alon . 

Aroth€r Eial of plrh@ci.l ilttutbn fo. cls of p6plc wiih Schtiphsnia 

*6 ceid out by BamwlouSll Tdiq, r.*is, Sunvoo4 M.hwding Quim, od 

HarJin (l99). This study oid.d 10 w th€ .fl@tiv@6! of abov. Mn@qr 

inld{tion with a goup of .Am who nld . low qplsed @tion stltB. TlF subjets 

w@ idmtilid by ffiing thc hoepiral .dr:isior twds of r*o NHS Mbl hal0r 

uits. A lo||l of7? panicip€nts w6 seleled thcy w@ Endon y .ll@.red 10 rf,o 

gnups. lswhosial irtewcntion ercW GGatnal grcup) @!i6rcd of38 subjdt3 rnd 

lhe fanily supporr gol4 (Contrel gretp) nunbs of suljets wa 19. rn int€Fdrion 

t@t pbce for 24 wl(s ard r6ioB rdk pld. ir c@6' hotu, prtidll dd c!@ in 

lralrnst goup wcc olf€ed spccific pstlholochl inlc.htion, Thc f@s of 

irtcddlion bt5.d @ &lativ6' crdinrl n .&, An6 3ix !o|n! tuUa |9, lhc nallm.r 

gFup nd few.r ElaF6 (4 @npa&

ncnb€6 b63e c.eb also r.veds ltrt lmily inrwdtion .ining to €obee fdily 

comhicltion &d pmbld $lving *nb cd lowa E.E lacl, tldM s&nieion ed 

rclaps. Fte in chronic Slhizophrdia (F.l@n, Boyd, & Mccill, 1982j raloof,, Boy4 & 

Mccill 1985; k4 l99l). 

A pGtrhosial inlewdtion .ihin8 lo f&iliiite itrtddd m.s th. EIltivB ol 

Mldlly iI paliolr ed to !rcvidc thm howlcdge abod dr. tutue of illcs! ws 

inftduced by Xoip.!s, M&Cdthn Hurry dd Ha$.r (1989). All El{iv6 of cumdy 

atE.ding tn. ndicd heal.h 6eNicc w@ invit d to panicipal.. Relativ* v@ of.ftd s 

incFcnve education *ior in rh.n ho@ ed hrc. they e@ invir.d to peticip{. i! . 

m.thly grolp nerilg ar |Mral hdlrh cdhc. Th. r*ion l!5t d fo. h.lf D hou .d 

beld nont y in .ftd nooro. A diFclive but nonjudgmdrl stylc w6 idopr.d !o &€ 

clltiv6 @uld fcl te ro disq dificdt issG, ElaMrs of ihprovirs @tMuierio 

stjlh ed prcblo slvilg shlls wae u$d sd il ws trioi !o .nha@ lleir @ping skills. 

R.laliv6 anddcd tcn nedrg! on av@ge, dd e&h nedna va aftdded o ry@ge 

by sir Elrriv6. Ti. rEtings wft tabimr€d .i6 t3 @nrh!. Thc ilr@dtior w6 

effetive at rcduirg E.E ed ioprcving fdily iohtiodhips ed io prcvide support 10 

mor.lly iu Ehriv.. Il sulporr.d th. vi* rhrt lhtu gF of inkMlion 6 linit [E 

d@gjng md disbliry ede|! of long lan illn.ls ed ce lqpon 6c c.M in $e 

Th@ is a wid. ArEd int.sr in Fj4ho.dwation pogtlm6 for r.bric of 

patidls Mlh Schidpltreai! bn th@ h6 bED d v.ry lilde irv6ligali6 of1h. .fi6is of 

prcviding edudio! !o patistl lbour d.n ilnd . 

Prs@dy tn@ h gowirg @nsd6 l|.)ar difr@r pstrho Mirl l[q4.uic 

lll

p@edues h€ @mbiDed in [Etndt to tultrll thc !€€d5 ol pdpl. will hdbl di&d6, 

r€ping in vi* lh. n*d, Fad.z, Cisld€z, Si& Cdia, Sd.hcz, snd P€ ( 1999) 

cei€d out . stud, with e objetivc io cx@i& lhe dinical ldlity ofa i .grx.d 

pelag. of F)ahosilt inrdcntion .rDlicd !o ehizphtuic pltio|!. htall, 46 

prtidls wd€ s.ldted fion lhe mbrd hc.llh mnEe Cdabria, norinm SPdn. Ofth€$ 

28 Md. up th. teat dnt eow, wnich w@ ndhei dividqd inlo fou sub SrouF of 

clilical i armtion. co rol goup mFi..d of l8 pltidls wno peiv.d onlv 

nedication. TIE cxpqimilil CDup @iv.d clinic.l inLrvdtion ircldilg foB 

mdnes of inte8r.6.d pltrhological trdotmd! conbircd with two nodules of 

Fldoedsation Dd feily Behaior Thc6py. Cliriod ch@gcr wft moru.d wDg 

Brieflty.hiarric Rldng Scale, (BPRS) &dc of S@id F@tioni!& ed t n$e of 

Gd@lStrNl.El.Th.lbilyof qFinMt l grclpPlriob!rl. .d24drtrp.ulic 

ssion!, lO psycho edw.tion essioN md tlt ssion3 wd€ dcvoled foi comulcator 

skills sd prcblem lolving lzining Fmily Benlvid Thd4y wa a&led b slrei€lha 

rh. coping *tu of lhe rclatiYd. Tnc adysis of pGpod 'ss4tmts 3how€d 

coBid{rbl€ inpovflol! in qpdilMLl erouP itr Eg.rd 10 F doD.tholog/' ui€tv 

l.vel, oo8'litive md $oitl fectionin8, fmity bud.n md fmjlv coPing Thd w@ 

siglificml intov@or! h thir 8roq s @tpdld io @nrol SreuP 

|2 

Thc cttls ofthis 

study@nfmllcaw€riodtyof i .gntcdpet|8.oft6vcb.sidinlcF@ti@will 

Scnizophftnia p.ti@ls ed th€n f@nis. I h.ingt clinicll ba.fii5 fd lhd 

Uslu,lrdcA aid KaFi (2006) inlhen udy 6e!s.d th. e ofravcho cducatiot Sroup 

pog@wilhp€@tsofchildrdwinl@in8dislda Thcvob@.dit eff4t!d 

.xp6cd @dorl fmily ietio.iry lrd on bch.vid of da child 8I P.ti6q of

childr€n wilh lmir8 disrdeB wdc r.nl|omly a6ign.d !o two 8reup6. Oe Iroup 

Mdv€d psrrho €duoalion u.l lhe othcr gbup r€.iv.d lc.trndl a u6ual. All the ih@ 

depdddt veiabl6 wd mels@d lhrclgh r eni srlctu.d iirdiq at b6e line dd 

anq 8 essior of psrrho ddualion grcup prcgm, R6ult lhowcd ihai pMrs *ho 

audded thd ededion prcgm djffqld si8nific&dy on hca@ of crilicilr4 qmlh, 

positine Endts ed ova all .xpEscd mtioN, bul rct on p{c.ivcd fmny nmrioN 

&d child behavior Thse lindinS lulgsr rh.r psycho eduotioo p6grm could b€ 

€Iletire in h.lpilg lh@ pMc !o 6t!bu!h a ma posiriv. mtior climl. iI lb.i. 

Elationsnips vnh tn€i. childEn who hnv. l@ing diddd wnicl d b. ir.tba hclpfi]t 

2.r SctlzoDhnd. dd Frolt Butd.! 

ThB panicule *dd @nlliB !)4rh6h of ln@nE on lhc budd imu@d by 

rh. rmiliB in Ebtior ro tmLl illng of lh.ir El.lirc. FiEr sd of .il

nHnbeE ofi onri@, clidcal guidie..!d suppon d Det, n Bd|l ir ispovcd 

outcorc for dF pddt Dd fmily. Ilis ll:.eh !'4Fds l[. iql.|Mlrnor of FFno 

edealion l gui.Llia fo. ad(t*ing $s n .d! of fmily lMt6 (Fatl@4 l9E4i 

Pekkal. & Mdihdcr, 2005). 

Scvdl dpiric.l lrudj6 have docMoicd ihe qtanr ofbudq expaicnced by 

.h€ fdiUs of Frrhi.ric prti€ds. h ! lfudy with ehizopbmi. pali@rx M&d.lbor. 

and Follal (1961) EFn d rhe dcce 10 wNc[ fdili6 w@ r6t ict d or dimtrh.d by 

thepariql pr@nc. ir hom.. Fiiiy-fvep€Eal offdili6eft eddjslubcdin&ft 

way and 2% of r.l.liv€! reporled svae str.5s. Th. @ncept ofbu.dfl h Lm of iIl 

cfers on cdcs, duo to perfmce ot vdiou Dld w!! ff$t intodlcld by MiU6 jr 

(l 2). l! Ns srudy ofFy.[irrdc p!tidi!, pr!c1i..lty al vft d $ue of ui.l,lo 

den dativd Only 12% eu*d tro dificutlj6 wnib tuE rhd 5(I/. wcE derib.(t s 

Cad rd Srinsblry (1961) eein€d rhc burdn ofettlerly p€rrhi.hic p{iotj 

b.ilg carel in fi. comujry. tn $is study 60"/0 of th. fmiti.s apaieio.d m idprcr 6 

th€ mad belth ofottcr houe hold 4hb.rx, 3t pftdt qpaiac.d dbtuption in rh€n 

leisE ed sirl *tiviti6 rnd 29 Dq n cxpdiac.d eme chegE ir d.irdtily 

reutiM. Ir tudd rludy by thc s@ G*h6 dm$ two lbird of rb. fmili6 hld 

been *p€riencing h.rdihips b@se oftn. paric dnon md jn de nnh $. burdd 

wine sd hjs coUqeB (l9s) follow.d I l3 p.tidj wirh Sctizoplrdj! atd 

iri$hdsc, for . lqio

$ni&ptenic M ftpoftcd tb"r |Myof rice p.timrr caE d boda.t to wGG 

dtlre$ to rh.t fadili* by tn n b€havior, In Z&it, Rcvd, and Pet@n ( 1980) t sludy 

majority of oaogiv* reponed leelings of eg.r, mbulsfidt, guil, pain, luficring 

fea, d@csio4 s[ain ed disnfort. o'D of rh. m1 nequody repon d itq$ 

elicitinS thce nodoB wft lbe fd of tuturc d.t rioation of the p.ti@i!' b.h!vid. 

In HainS ad Hmilr@ (1966) sidy, 8l% oalh. Flariv6 of Mt lly ilt p.opt. 

wdcjqtg.d by |h€ intqvisdto n vc adglifldr obj*tive bu&n,60q! Epon d $e 

subjedvd exFia.e ofburdd and l$s rhs 20% Elon d wq subjetiv. burdd. Or 

the I25 familid ?2% erpr*ed felinSs ofbeing tripped dd 40% expr€ssed f*lings of 

eenthenl. Th. mlr f.eq@nr u,?. ofobj@tiv. hrda Fporred w6 th€ cotulirr 

sup.ryision rquind by de pati@t. Th. prti@r'r dirnprive b.havjor or iniafmc. wirh 

si.l rldituhiF wa msr c tt€ndy Mi.rcd eith felilgs of burd@. Mo6vd, 

s*6l sludid @nducrcd by (CE, & win& l9?4; Ml8lie, Mfe, Fjonlo, ct at., 

2002) h.ve coniim.d Oe norio thlt f@ily ffibd Lnd ro p.y a .pricd Mth qp.d 

lo |he buden of n.inr.inins m mtioelly ill Eladv. Mtnin ihe hone. 

In a study of childre with mtioml disd6 such s .tl@iio! deficn / 

h}lslctivity disdcr, seriously @doDally disturt d ed ltuins dissbilitie w@ 

ft?oncdly .ssilt d wi6 g@rd pmral 9lre (Floy4 & C.[.ghd, I 97; 

Yatcheio(I, K@ Fri*tr, Cordoq & Kimc, 198) 

BhaStdMi dd R.vel (2003) I:@u.d $c sdiry of bu.la qpdicnc.d by 

lhe fmily ncnbs of palidrs with onl sad oDphrtngqt cmq. Aeording ro Uj. 

rarlilgs, finuci.l budetr mddimptio! ofbutim etivitiBdcoedhigh indic ing 

bEda in lna a@, Th* Bdts e vcry much in cor@rdd@ wirh firdirer of fdily 

ll5

uds ods qith S.hjbphMi. pl1i.n6. 

vaG. &d NonhoH ( 1955) .nd t ff ed @ll..gua (1982) h!v. dcumatcd 

dEl tne .da oapatiot wi$ S.hizophnnis hrv. . fd or no sial acdvili.s .Dd thig 

@nrictioi n.y cnhdc. whd th. p.ri6r i. .lddly. Thi, fbdjrg i. rls Epotid fd 

sFug of d.tE$iE dierd6, if iuns g.l! chtuni. (F.d&r, 1987). 

Fi@i.l l$d$jps alo h|vc bca EFond in a lwta of shrdi6 {ClalM, & 

Yrdw. 1955; Milb 1962! H@iry. & Hmilion I 966i Roughl & Aubry, 200q, Ilt* 

fr@i.l dimcd(6 rie bdre crinS ld a plddt who hq pdiltat Flrhirric 

djsdF, limitr thcir so*iag opriti6 3!d dEy hN. 16 opportDity &. . job wirt e 

.dequr. i.@m. lf $. paridr *a tn. din hqd wilw .!d du. io hi! iuls h. i! @i 

.bl. 1o wo.l O@ th. probld gcti av@ Dd feily .ulT@ ne. 

h &m !ndi6 wirb plridl! of had injury, rh. cheg6 i! p.ndr' mod &d 

FFulit, & Effrd b a bunl.Mm (BMr! & McKirtry. 1983i Btuka t9l). b 

B@rs Dd McKinl.y 0983) 3nd, ilc plri@r b.hlviou ws rh. mb .5D.ct wirh whcl 

tn. ELtivo f.t $cy @ld lor copc, Thjl ielud.d Fridr.' Utlility @.fsioA 

inibbility, dlm.ding bchavior .!d For slep. In Oi! rfudt thG pari..rs bch.eior 

lcoul.d for or. lhitd of $. preblm rFon.d in follw !p 6. ye blE *tEn @r 

pdblem vcE llraty @lvc4 Th. p.tid|l'mtiord ud dill h.hlvior, in 

p.rlicuh, chag6 in p.tioi!' Flimlity, iDi.siry dE fmily'! F!.p6o. of budo. 

Bldd on Elative of.oinS for ihc old 8d Mt Uy ill h$ t@ sriowlods.d 

ror quir. src ri@ (Gilh@|, 1984i zdir, Rrv6, & P.r.@n, l9E0). SacEl @ai 

sMi6 ol Dant lly i[ p.ticnk harc .ls 6fidn d Ihll burt r or El.rivd i! quir. 

qlosiv.. A lon8jludi.d 6ndy by o8!n,a W ihr, Dd |

closc @loriv€ ofpaliots wi.n S.hiaplMi. dd oord pslrhosis to fnd difqtug! ir 

tinily burdcn tud participstioh i! cdc bdt*M sub groups ofrclotivB. The Elstivca of 

pad.nts with Ail4tive pltrh6is reponed di$L?tioD in l.irE ativins n@ offo rh4 

othlr sub 8rel46, Frcn the rchriv6 grcW 6!oa4 rt9on d mrc bEda€d th& th. 

Th@ is dpl€ *i.tetue indicativc of plofoud sd l@g Lrrilg .tf6rs rhlt 

ment lly ill plriol3 h.ve upon othd fdily mcmblR (Fadderr 1987; Scbde, l9m). It 

has b..o ob$fled lhar cors c rrally n is $e fmjly or kin e@np @ng whon ndral 

di$d.r my reconstitule or Fvag€ peeoal dd !@ial ellrio$ (Ari & Bn.tq 1988). In 

El.tion !o fmlly burds ,qtiB 0 99 D sug861r lhd Hispeic ldilie @nc.ptudie 

mntll iun6 on | @trtinllm and th.y @cpi rhc ill*s .!d show hoF for r[c turE, 

TBlr &d G&u.he (1994) reortad thar Ani6 Atuics s!€d ro bc ls rdd 

ofdisdliv. d Flrbotic h€blviorq whit. E@ Affiicu w@ 16 iol@r for rh. 

patidrs *ho nEde e mrk Elal€d co riburior ro th. now nold i.a !.e.tirc rt?€ of 

Magliso, Faddeo, Mrdieos, &d !$@iar.! (1998) fomd g@lq fmily burdo 

in Ibly Ol!e, md Ponussl {d lsq budd in G.@y and Brirain. WijinS!,rdd, 

Scldc, Ko.ra e@3) rported a gBla burdd in troly .nd Bnlin @n46t!d wnh 6c 

N.th6l.!dx SD.in .!d D.i@d. S. thjs Gilar! d. .rlDic di6qw6 .nd llc cut$nl 

oncn|.lion whjch nay ncdial€ i[. subj*tiv. din@io of fMily burdo. 

Ar fr a thc awialior h e@der of th. p.ri@r &d rhe fMily burdd it 

coaccn d, Crad ed Sdtubuy ( 1968) r.!on d no rignincdt Eraddship, Rojck ed 

Heidor (200D nowas repon€d filt lDily sft$ l.vck aid bu

higher if n wa t tuI. poticnl, unenplolrd dd Mied, rdsg dd Chuc (2000) !l$ 

sqpon this wh.n rh.y Eporred 3ininan 6Ddin$ rhlr sDle pari@t fe woe In.n 

Futha suppori for lhis fiftling coN fron S.uf@ dd Kul6 ( 1996) who 

noted $al relaivd of the nde p*ienr Mth SchiephFni. r.poned mrc lociil delicits 

lhfl for feml. palidl. Ar inlori.nt point 10 tulr h@ h that lbe gddd of cdlgiq is 

al$ v.ry irFtllnl 3incc rhc Liort sna of pdnry @ uting is Mr ond Frfomed 

by mtnd daughla, wiv6, 3isi6 &d olb6 f@d. Etrli6. 

som invdie.roa r.poned m ditf.m. in tevel of fomily distr6 bctw€.n. nor 

orgdic psrehoth disordeB, @od di&rds Md uiety dierd6, whitc ourd studi6 

Epon a panen ofdifl@D4 i, fmily budc4 Fnicutsly who nrirg pcirive ald 

trcsltiv€ synptoE (Mce, W.bb, mfid, 1996; Provdhd, & Mw, 1997)_ ft. 

living satu.io! or si.l elogy of dE ho@ @vi@mdr al$ pl.ys e irponer FL i! 

clinjcd oomc of illn*r dd qF of fmily bud.n (Btum & Rulrd, t966). 

.ldttiN dd S.hmmhq (199) invsiigaied buda in fmiliB with pldal of 

S.hizopbmia dd d.pBiv. iln6!- Tle mir siD of iheir lB@h ws 10 inv6tigate 

ll. Eraddship bct*d p.)G.lDsial ed culrlnt .sFa of d. dFi@ of Fsi!!.nr 

ftnnl di$rdd @s dilfftl ertric .nd diagnosric gbr4s. Tnly cglrd.d fdily 

buden a behavioral dimcdti.! sial disroplion &d adv@ effers ofilttrs6 on fmil, 

All these doMiD w.F ne€su€d uing r sal. dw.loped by plrrl Weyna, .!rd HiEh 

( 1980). Thjs itutl!@l |iBw rh€ subj{nvc .nd objeriw bEda in alt lbovc 

Datio&d do@in5 Atulysis of v{ia@ foud @ d91i6@t difidrc in rh. 

'fu 

soEs a@s trew6 ln. patidr,s distut d b.hrvior. I! rop ai.d iid i, all cDl4s 

'n 

118

we ln. palial's ntery. llb {s ind@fttledl of c$ric Croup o. dia!'l6is. Ibe mly8i3 

slowd thlt rfcr nis.ry, worryine ed wilbdnwll r@ subj*dvcly p@iv€d a hieNy 

disr..$ine in E@ArMictus. For rxi@s wi$ dctFsio! wolryin& fdgeltulnBs and 

wilhdEwal we@ ielueidy r.porled. Rclrtivcs of Lltino with Schi&phrenia wft hucb 

@nchd witn odd idd, uad.i &tivity, forydtulnd, iri&liliiy ed inde.isivd6. 

Th€ s6ond do@h sid F.folfuc, objetiv. $d snbj-riv. buldd, pdliql virh 

Schi@pheni! snowed poos sooial perfoms@ the depr*ed plli.nts 

Rcladv6' subjeriv. disr* Id shl dcfcit! wG obsd.d nFlr sipifcdrly 

for fi. Schiaphrailgbup. For lle illla dv@ cfrels d oth€q el.riB reon d 

lhar living Mth a patie.t lufleiinS Eob S.hiaphMia hav. mEh adv@ inl€Ecliv. 

eilcl .nd the opposile we true for lhe d.pBd grcup, i! wbich cD$ ovs inta.crion 

% ob54c4 h sur[c d!r. rtovEd lhrl rh@ +F...d r su!€r! jr] sinileiy ir 

rclrliv.t r€pofli dd 6ponc lo sl4rprom rcllcd rtFs ofbch.vios, ed n indicarcd 

thal bchavionl irpa.l of pdliglal Mt l iurcls w6 sinitd .cM! diagtrosric Md 

lik€ chredc l@lal illn65r fdili6 of plridls will Htv i.farion, sna rbc 

s@io cullusl ej6tion oflhe victim. p.ti6t d! w.ll s tE fmily is lrigEariad f@itic, 

fel guilty dd b€lpl*. ttc fdili6 of rh@ p.ij6B f€l disrrq!.d d@ to los oflM 

ilats by rh. p.ri6r and rh. cdc |!tcs @ frdh.r burd@qt dE io sFts ofEsrrqr 

To ms@ the burdd incNd by ll.tc fdiliB oI Hrv patdls ! 5$

Th. Fmily Bmld In@io Sch.dul. (Pai & Krpu, l98l ) M us.d 10 irLnli& lbe 

v{bu l@ oap@ived bud6. Aeording io U.n findinSri lol3l burdd @Uil be 

clsidd s m burden in 3 (lo./0) ofth. rmili6, nFd@ic burd@ in ? (23v0) of 

fdili.s ed scvd buden in 20 (67'l.) of th! fnili.' Of dE diff€Ml tlomd6, 

disruplion of fdily leisde w$ the Mxihm followcd by .tfet on mot l halh of 

othe6 sd nndcial bsdfl djstubed emtioDal llrnosph.E a1 home wa evidsced hy 

tn€ efst on fmily inleractior3, indicating ihe functional al home. fte slluch$l ed 

nDcdonolirpdmaloftn fmily a. onwa rcoet d in lh. inpln€d irt rFM.d 

Elarios b€twq neDbas- B.havioral dirnrbsc. wd .l$ rpon d lml8 l[6e 

potiall. ftu, iirrbility ed violmr b.h.vior wa fosd in l5 (509t pariat dd 12 of 

rhe aiftat viol@r b.haviq, *hjch &!d.d in aeurg ofdisnes .!d b'!dm in luily 

nH)b€6 oflne p.ri6rs v.ry lik.ly !o bc foud i! p.ricnb with S.hiaphmia 

To expl@ bBdq relft.d 0o @ giving in Ellliv6 ofFlidrs $th 

Schiz.phmi. .d reeived slplDn iom Fofei@li 

r siudy w6 @dlcred in 

NonneB Ceneal and Soulnm ldyhy MelioDo, Meeo, Fiorillo, MrlargoL and 

Cumqi (2@2). M study wd tri.d olt in 30 lt'lis @ .1 n..th &dic6, Th* 

cdte6 we@ Frbnny sel€cr.d k.eping in viq rhc 8@gEphical lstion ald popuhtion 

dosity of dre archlMk @a In €ach seryic. thc paiidk Bdple @osisr.d of the fnst 

25 subj*ts who tulfilled tn€ diagnostic cdterior of DSMIV duilg th.1in poiod of 

Ju€ to Dadba 1993. Sludy poplladon liMlly onsilred o4 709 t6rid1s dd tn.n ky 

relai!6 for erh coffalirg p.tiftt5, who nEt rhe orhd inclsion crirqid also, the key 

elatire B6 also stcd to Fnicip.t ia rhc $udy, Patioc asli@t wa don€ on . 

nmbqof sales r€l iv. w* Gt db liu th. fmily pDbl@ q6tio@iE md wial 

120

n l wort q!6tiom!iF. DaL aboul thc intendrion provid.d to fmili6 wu colt@rld by 

t!€ prtlln or@ $h€dulc. tle conpdier bcr*@ lhE gagDphical aB oo 

diffeEnl lcales vls omisd olr by tullsis ot Vsi&cc, Acconting !o e.lFis p€rfonD.d 

on iolll srple, 9?yo ofel.tivd r.!one

illn $ or tltcir Eladv.s. Accotding to ihen ffnding, thc ce givcB wd! b.ing afi*r€d in 

I nain asDdrs. lmilies f.[ hary ercri@al bNdea !mif6r.d 6 ui.ry md 

d.prBsioD, lh.y f.lt dis[* !d w@ mt .ble ro Elq @u.q@{y bc@ isohrld a.d 

felt fruslralcd 60y. oflhe rehives einibited Uls morjoN_ 62% of fdilies Elon d 

fintuial burdd wnich 6 du. io p.tidts udptotmot and fd de dling expd& of 

F.rElar hc@scd wdt lod .ft.r rhc ilns ws r.ron€d b, 99o ofrbc &Dili6 78% 

ol0F fdilis felt lhey w. Bpo$ible nering ![ n.!d. of ih. patio$. Mljorjly of 

th. cG giv6 h lhi! nudy w@ ptulr. This sludy al6o Fov.d thal ce8i6 of 

p6tlbotic p.rids bd loi of3ubj*riv. oDd objerivc bEdo, 

MBa, Webb, Pf€ifle, ctadi, ud rrviNor 0 996) invclrigaied lhc budd 

pla.€

od . sndy wir! aim lo inv6tigate the @Rlrrc of fmily burda in ptrids wilh 

schtoph@i!. Thcy lourd lnrt burda feio6 rd Mi.ted with syrDlom edity. 

ProbLm b.hrvior ws risnifi@dy eh.d ro politiv. sFploG but ilpaimnt in dlily 

adivides and fwctioning w6 pGiliv€ly sloci.t d eith n.Cttive stmptom. Roict, 

Iteidq, Tomi, ud Ang@eyd (2006) d$ rcDort dE sinild fildin8B in $.n *udy 

wh@ hishd positiw dd negBlivc slmploD *cc .lsiaied win 8E r.r ld.l of 

Gtuf.K Cotc, W[els& Clinch, R.rtu, E{1., {d 6la8ll6 (2004) shrdi.d 89 

cd€ Cive6offdale padots{illl ldvdcedb@si cdcq, Tn larPl. ws rdqit.d 

nom tuo ccDl.B in Ont.rio. fte mil ce giv.r iddlili.d by patiflt *6 irclud.d in 

this study. C@ ljrc6 wcF ssed or a p.rfotuc. slafrE ind.x, thc H6pii'l Adi.ty 

&d D€pBioD Scdc dd th. Z{irBurda llvolory. T[.6!lts i.diot d tr burdo 

m lh. @t itrpondr pldictor of bolh di.ry &d d.tffiioq 6tl6 ce giv@ 

repotud an adv.sc imp&t on tnis worL 77olo r@oned nisine their work ple du. !o 

c@ eiving roponlibility dd finbcial burd6 rcponedly ws v.ry ffit d du !o 

A udy of Pttrboloaisl W.[ bcilg of dc rcl.tic of ftc Fti@t! 

t23 

wirh d@lis 

by Eagl6, C6ig, RjwliM4 R61al, BaIi., !d B.$tr (1984 foEd lha1 . 8sl 

Djority ofth. r.lativa of tnse paliat! e s!6F4 nrhd $d p6trhi.hicrlly 

distubed, Rcl.tiv6of$eep ients incu a @6id.6ble st dn, Wdg; Tui, P.@q 

(lca &d Cbju (200a) Fported lhar rcloIivB of palidls Mtn na1.l illn !r f@l @edy 

burdmed and hld kbu inpa.l on @t l hqlrh of @ gil@ T[c S.oni6h 

S.btophmia R.3ercn Gm'p 0937) &ss.d 3l Fhtiy6 ofFrids eith

Schiepheni. who w@ Eu.lly r.5loBibb io @ lb* patidts. G@sal Hqlth 

Qu6rbMiF sd S@iar AdjBlFnr 5.116 wd !.al a essrE r bol. Th. cults 

indic ed $at mF thd 75% of Elady6 had a ptubability b.ing ! pstrhi.ttic ce 

thcrelG. Tl'* Ektiv6 tle rhowed mlcd itrpaimt in sial dd l.irw 

,ttivilid ed this ws Elat {t to lh. tynpton sdity of th. p.tiat 

The studie! r.porled in .cx1 sstid @ lbout fdily ptfho educarion.l 

int danos aioin8 to rde fDjlybu.dd ud ro ierelc *i.l nucdoni.g of pad6r 

2..t.1 Prycho.dlc.do!. F.tr lt Burd.d 

Y,]@guchi Tltrbashi, T.lEo, ad Kojitu (2006) coldrcr.d . dudy ro 

cxmln€lheefiskofashon tcmp.yrho edwrtioh oo retaiive! ofpotials it 

S.hiapbmir. Subjet w@ Eruir.d dlm rs hopir.ts, rr.brthi Hogird md Om 

Muicip.l Ge@l H6pilal Tokyo, Iapd. Subjek \@ rhc 46 Ehtivd of hGpirdizcd 

Schiaptmia patidls. Of tn6c 32 w@ lhc mdffi of rh4 padd* Thqc etdivd 

anodcd fou Fylho ed@rio! sioE i! mdri fdily enilg in @I groupc of rm ro 

six people in s 8rcup, I*vel of uxielt llbjeriv. buder sd djsEes w@ mdsur.d 

Bing *lf adoinist.tEd rxilg srld beaft ed .Or rh* *jG. tact ot.xF6.d 

crctions ls a!*ed uing livc dinule sp@h sarple, Aat}lk ot&c prc .nd posr 

I:Mc o! rtclc erls denNt&d a sigdficml Edkrion in soB of uidy sate 

6 *ell s on fdily bur

h.r f6ily p6FIF €dsdo fly hlE gFrq.ll*1d @tion l !!r! oath. ldoriv6 

!d @d.quddy my p6qr Fl.F! i! p.tiab ea if n i. of 3bon rdudiotr 

AOir5dr Dai!., Coi., H.rD.r, Gilrmu, ed ,uicc 095) 3nrli.d thc ilp.ct of 

.dw.rion @ si.l b.h.vior .!.1 q!.lity oflifc P.tot' 14 ni.hDly.!@t!d ao 

cdslri@ gFup lrd 6ncol !rup. 'ftd. wlD .!od.d .d@don groq h.d dgDif{t 

iB 

in *id fu.tioiing dd qur,lity of lif.. Tb6 w! . liif@t irprlvqMl ir 

nunba of sid @tactt .le, 

Th. Dui.t N.riond s.hizoptMir fbjcr irv6riS.t d th. .ff.ct! ofarly nDid 

ud. t@ lolgitrL|€tion.na llt. fin! lign of p6y.tdi.. Ro6bu4 vdt L, 

H8d6, K@ds.!, K.6rd, rrga, &d ollqgu€ (2005) edEd to !0dy l!. ol|r..ft of 

tso dilT.6t fdd of irr.Mrioru, whlthd r'qportv. FjdhollalPy 

in .dditioi to 

ftrnnd a uul or e iltcgnt d Fr.tedd .nd .du.tid.l rarlEl Fo8'i|EE 

codd itrp@v. lh. @w of ilba r @ry.rld io tanMl r ued. S@trdly, lhcy 

eerd to Lnoe muld it inpd. l[. F rhic ed Firl fifttiodir& A torrl of 562 

p.rid! w@ iEl'd.d iI I[. dud, of rhd! I 19 p|riat gpt latfta!.r u$.1, |399@ 

i! supponivc p.)rchod6p, gtulp .!d 304 w@ ofald ilt'g .d tMt ARa @. 

y.r follN-up rl@ wa m liificer di{fatu in inDrovqmnr ofsid necddils. 

Hovffi bolll ilr.voti@ liifatly inpowd rh. p.liar'i GA.8 fielid s@ 

ne lhx [stEt r u.url. So il 6 bc @lud.d Ud Frrhosi.l iltqvatid my 

inForc th. olr c.m of SchiaDhani.. 

Ch..s..d Cta(200s)@trdutcd..t!dyio 4dut thc d[@ti66 of Frbo 

cduc.non pre3m wirh fdily cr6 ofp.li6n *il[ S.hiadrai. in Ho.g Kdg, It 

64 feily nmh

.xFiftntll .!d rhc Miol CDup. tlt. qpqiMr.l 8roup @iYed psFto cdellio! 

&d conlDl sroup €dved reuiile ce. Out cotu m*@ irclud€d, fanilv butdcn, and 

elf.fiic&y, lnd percepton of @ial lupport, Th. $t!lt showed lnot qpdiMld greup 

hld m& lr.tinicdly sigd6@1 nlprotMt on .ll tbE .bmbs, poc.ltrot of bud@ 

ofcdc, elf.tficrcy ud sial srppotr. Thi! 3bdy dpporr! Ihe F}tbo .dE lion a s 

.fedv€ i dvdtio. and l@o@rd5lirt Fttrho.dE 

liotr shoold be i@rFdt din 

Lik psy.hhEic dierd€6, family @mb.s of thos with Bordd lift p.mMlity 

dilord€i olld 4peridce buden, depr€sion, lo$, Eief ed otld ldn

incMsd tlE pc flbily @leling lo posl fhily @seling poet@ RoulL idls 

indisl.d $d nom pE ro F5t th. l|@ se of dl ldily uil! 6 burd6 .s@nr 

$.le d@&d and lh@ w6 . ildution in gri.f eoE dd tutdy sor incro$.d Itre 

fmily @mclioB progm povid.d Ecd.d inf@tioa *ilb .!d rppod io rb6. 

fmili*. Th. dd)6ir irdicald a E[ s foilid .@rt d rh|t by ..qui.ing th. 

iDforBltion alour dhord6, l.ding nd @rio$ &d copiig skilt* My irpoi.nt 

.s?ers of fDily !|Mbqs wcll+.ile iqond 3ignm.edy "ricn sg86r tbc 

inporlme of tlrc.c iype of dualioal !rcgm, 

In eodd rildy ofsinils lild Dno4 [utrr.4 Stlwan, Buda4 Bowr! .rd 

(200a) $aned ! l2 wet .dMtion co@ for frditie. To 4mirc rle €ffcacy of thit 

95 fmjly nemh.B w@ mlled dd €duard about $e @nr.l i|llB. Ilc &.u ,s 

io erpowa fm y D.dba3 lo L*1. oe Foblm ms dw lo Mral il|6s, .rd ro 

drk. thd .wrc ofbuda whi.h i5 c.ued hdaue oI ilh.ls i, fsmily md$d bolh 

oubjetiw ed objativ€ md how to dql wirh ir An r iliriat | 2 *..t Fycho .dwrid 

fmily Mb.r q@ folo*rd |p fc sir l@th!, This pbgr.mc ws folrd ro b. 

.f@tive $ i sigrificdtly rcduccd lhe subj{ijv. burda &d arhm.{t dD 

dpowe@t h fmily nFnba' It rte 6ulcd in irpFvgmr in loowt.dg. ,!out 

Mt.l ilh6r .!d d$ irpovcd rh€ lelf c@ of fmjly ljmb.F {d FdB.d thcir 

wori6 resoditrs illnes. No che8. w6 rEpoild in obj4riv. budq. 

A srudy ofp.rcho wid inravarios *ir[ por€r& of S.hizopnMi. k 

@ndure

@nt xt lo s pc sd post psrho sooi.l inr.d.nliorl difi.do6. Th€ pl&. ofstudy 

v$ r colm@iry 4iee (inpltidt idi@) qcluiv€ly fd p.tiots with S.hibphMit 

30 @n56u1ivc p.ticfl! ed th.n @nDdyinS fdily|rmb.B *@ in lud.d itr l!. 

study, The pstrho sial iDteFdlion h.d IMy i €gra&d trerln@b @!4bnois 

sqe!. for p.riac lrd th.ir fdily m.ob6. P3Fho.durio4 $ppolriE tt€opiB 

wdc Oe conmn codpono6 for both gFup3. IhG w6 a wilhh a subj.ct daigA 

wilhout ! @trill A@up. Fd sdffir prtpos PANNS q .dnilirt@d to p{li@15 

&d cdc giv6 wa. aes€d oi fdily buntd sL !d p@civcd qutity ot life ert., 

All isti)!@r5 qd. .dDintieGd rwie, fisi rt lL. tire of fGt fouN W, 30 dlrs aftd 

di*hrsc nom th! cdlr.. 

Relults ftv.aled ibat lhd. ws d sLli5tbdly signiftcel r.ducrion in burda 

5..B i. .ll In. din*iG of dD buda and i ar.rrio! ovd.ll qu.liry ofliG $@ 

vdc inc@ed whbh indioal.d thc enhac€d qualiiy ofli& in cd€ giv@, Sihihrly tha. 

wa r rub!&ddd Edlctid ir !y!I!'roE sdig !r PANNS Dci inr.d@1ion. ftig 

prcv6 lh. .ll dd bo.fr ofconbinirg FlEhosi.l ilr.ddriod in rqrn of 

Amrb6 nnrlomiat @tulttcd Ei.t of funy b.,cd i.tdsrim for 

Scbizophmia padlnts in chin. us cod@tcd by Xiong, philips, Rutwd, euingingi, 

J. Kl.il|fu, ud A. Kicim (t994). Sn.t ll)E p.lid5 itlfllin8 rhc di.gn$tic 

cnErion of S.niephmi. &cordin8 io DSM It ,rd r,ho w@ living with thcir fuilid 

w@ @lled dd @donny signcd ro iwo ercup€. On greup @iv.d oily m.di.aiior 

arI rh. ollqsorp hld. fuily bsd inr€Fq ior sdiclt f6ur.{t d rbc tu.gmr oa 

$cial ed occrpltion problm. ncdicalior magdenl, fmily e{tuoalion, fabily grclp 

t2a

neeting fld cnsis i epcntion elc, Oooc a no n, 45 ninur.€ sdlion we r*m. ?atidl! 

e@ 46sqt ar 6, 12 .nd | 8 mrth. follow W6, Along will de.d Frnoplttotory 

d'edMionofth.eodotift vq allo longd b lbe exF.inulll erelp s coqaEd to 

conml grcup. Fmily i ddtion ws ats s@iarcd wirh rigjtic&rly low lewl, of 

L..1, 5.16, Deez, cind, dd Lral (2008) coduci.d a sbr(ly il wtlich info@t 

c@giv6 ofp.lidts wirh S.hizoptmi! s@ i! h6pi'tl s@ fo osc+lp for Dift 

ndrhr Tl'e @eSives wcF 6s6s.d !t lne b.ging ofrh. p€rthocdrcoljon md at $c 

e.d oarhis iotcrvhrion. Cegjvd wft es.d !t Zejl Scale ro El. fo. burdd. RButt 

irdiotcd th!1 pltrho€duarior Bullcd in signifi.dr rEdmrio! ofbftla i! rh. gmw lo 

6eiv.d pswho.dlcation q conDd.d !o grcup who did not @civc FFno.duotio.. 

Like S.liapbqi!, pad@B wift At"-hcine\ d!.e a ,t& h.i!g br.d ana 

by thci. fdily nchbqs strd Epon dly ln6c G high ld€b ofscjA distrq! e.t 

dalson amr8 rb€ c@ (K!igh! Lurly, M.@fll1, t9j; Don.tdso4 Teid, & 

Bus, 197; Hal.y, 199?). Shrdi€s nlve d@orrll€d thc ba.Iil5 of famity 

dlrotiom ir tdtr of inpoven p.rrhologic fi@tion md dchy ir nbin8 hoft 

placea.nr for lbc a!trffi (Brodlry & c6h!4 1989; Mnd@!, Fhjr, Srcilbqg. 

1996)- Ths alleviatine buden .nd dinr6 in c@ giva3 noy hav. irpor& .coonic 

sid .!d bulMi|rrim inloticlrioB (Mi!€Itu, .t al., t996). 

To evalu€ d. .f@riva.!d ofcognniv. Behrlio,lt faoily i,Lodtion l,o 

qruc. lhc bEd€n of ce ir c.tts ofparidr. qith AtzlFind,s dise Muior , 

DonrldloD. T@id, md Bw (2OOO) @dut.d a fudoDize

intdaao!. fis q6 ddiv.d ed @dified ft.d lle cogniiiv€ b€havioEl fm y 

inteFalio! d.v.lop.d fd de tstrnor of s.hibpbMir (Tdia, 1989j Bmtrclougb 

& Tdier, .t aL, 1998). A! m oul coe, rhe i dqtion signidMrly r.dued budm in 

clrs ud b.brvidal dbfilhmq in p*ie|l. 

UnUk fmily ilrcdotioB Bed wilh &hiaptMis pltiaa and 1hen fMitic!, 

fDily ilretu nlion in AtzLciM,! disce d.'6 noi ain in bducdon ofrtaF. nG in 

Aldcimst blt ir focuB @ crbdim ofca6 bud4 Abidowjlz md Coun y 

( | 989) i! thcir sturly o|fa.rl duation ad sppon k, ctrdicaty it p€tiors living wil! 

tnct fdili*. TlFy used a srr6s coping frme work fo. rlE fuily tumbd. Illc 

pogm ain d 1o foc6 on pevidin8 infoddion .od tmwl.dgc for @ping wiih ! 

$hiapnr€hic rel*ivs. Thc inlwaiion raueht dd tEin d fdity mcmb6 uing 

probld $lving beh.vioDt ltr@g.lMr i.ct iq!6.tong with @itv. Fb.!6€1,Ihe 

sarPie wa srujled rhough fou comuity me al h4lrh cate$, Tobl fony cignr 

fqily IlMb6 w@ iFlded i! rhis !n!dy, lrd .qualy diid€d in 10 iwo gow6, 

exp4ndrd dd conEol resperivcly, 

Thc fdily edud@ sol9 hrd ,n wcuy 6io4 two tou tolg- Tha 

sessio.s povided jnfo@tion ftour orc nrtw of IMLl iltn*s, irs lyDpios 

m.dicatiq, @npliecc .!d sid. cflell wft di*q$.4 prc6l@ elvjrg skils .d 

nd.aging patiofs pbblm ws als !dds6.d, Th€y ucd ! n@b.r ot @s!r.s rDst 

'nr.|qtid, 

lile didy edc Et riv6 disn* s.dc ald !.d. to m!@ !.g!liv. 

f@lings low.r& p!ri..r, R.5rnk showed signjtjcddy 165 miery, L$ disrss ed 

fMily disuplion i! rh€ d!.*io..l .uppon goup. A mrt.

Ebalir, KuiFd. dd LIf (l984) .orcluded lh* ogoging rh€ fanily ir tRrMi j. . 

g@d pretic., b@ae rclativG do not f*l rh@rening md pnvid. wfin b&mtio 

for ifilr thopexic wdt. Tle p6jrbo .dwrioo bad a positive itpe.r or fDity 

Th. ndt s€r ofsludi6 aif.d !dinrdi!.] chdg6 threu8h lrrho edud6 in 

Imily mdbd! of psyciiardc pariar dd al lor8. cne8. ir @mmiy aniiude 

row&ris Mt l illtB. The .rdMird chie6 e lcbnrl in &

stils- R6ulrs .r pct lsMt dm indier.d $al 6m y .dEariotr boughr significdr 

chmed in fmily tuldioning i. dpdinql6l goup. hoth io Schizoph&nh &rd ned 

di$.dq potiars. Similr clag6 wft r@on d for fdily !nitr!.s !ow.rd! lmldly ill. 

Conp{i$! of fmjli6 soE in @gct@1 sldll. .le !!ow.d lienificdt 

chde.s for qpsimalrl Sbut of bol[ p6y.hoprttologiB $d paliore rdjsrndt se 

.l$ show rrEd toward! in4rc@r lhc &rulc indicar.d rhrt and pd)rho .duaridrl 

ideocnlion, rhe fdily envirc@nr had com. mor. lol.r$lc, s.t it sult&dy 

iqbvcd rh€ palidrl sci.l .dj$Enr. 

Hu, Chot Hweg &d Wei (2006) studie

tbc s.od !|ey rlaotrs i!di..rd . &sll i..@ i! bowLdsF &ou ffitrl 

ill6a It@ w.l@! !C of ft.rntb.ls.id FjeliDg difttdd itr tb. M*to 

@iv.d .du.rie Sihillly plriaa in th. .dcrrid @ E b |re @i.l dti.l! 

ud nia&hip win ei8bbor *b@ r dtoh did D! Ssi.l iltlrnlb! ofrh. botll 

cotr',ruiy deDbctl |.d p.t'@L w .Lo ahrrl vit coo||eity cd!.rlio 

Kouti. ud l{di.M (200t E?on d dn p.ri6l. will S.bjapbMi. wto h.d 

p.nicip.t d in Eh.bilintivc !d oda dqrtor& r.dviti6 rloxdd d inPr!rc|Ea i! 

n@dqils lorl .dl dF ws . lubc.nlid d..@ in p.Ft @id !d @tioo.l 

!obl@ vhicl 6nv*.ly oduced b{da 6 f.Dilr. 

h u.n rnD.ro dmin. rtt! froili6 ofD.!i@! sit !Hr.t illlg *ho mold 

p.dicip€E i! sqp nmily Gd!..tid entAop d i!divid!.| &Dily @&l|ti@ wold 

ty !o G& mE Eilt & fd cd!@ity Riq tbe lhd. i! th. 6!tol gdD. Ihi! 

'ir

pmfdsio.als al bsc lire dd six mnrhr rt6 tmir.tion, No dif€M6 a4 foud in 

1he ext@t of fdily nd$6 cod&l wirh mdlal hcllth pofdlim.L in !I tn. lhR 

gow' Neitho oflh. cducalio@l ilt rydtion Aod@.d &y .nsg. in b.havior of 

fmilies senns belp and advic. on b.hllf of tlrct ill fmily mmbeE. TtE E6ul$ olthis 

shldy indicated thai pteho educrtio. did not povidc sufficidt hclp, 

Pollio, Nonll ed Foslcr(l998).oodel.d aon d.y wo*lhop for lh. fmili€s 

wbo had a prri..r Mtn s.v@ Mirl illics. Thc objotivc ofilir worklhop w6 ro know 

the pFblm ald !..!s of th.F @ givds ud sordly, wirbd thc pbvided 6nny 

Fycho edMlio. 

'nlerdrioE 

..b!ss rh4 i$u.r or tur. Psniciporls wd Broir€d 

rhhDgn almDMall and @ @iling 10 th. p.on who had 6t ctcd to rheMtal 

h@lth swic6 in rhe p.st sn @nth!- 86 El.tiv6 of iH'allt i[ pae6 prnicip!&d in 

this mrtshop 355 it os Gl.tcd ro pDbltu wd 8hdt ddd@ .nr e!!ris*g 

done, s w.ll a pDbld cdcSori6 e@ id.rti6.

SchiaDtmi. ir . 8yD&o@ whct dDcl Fri@t dd th. fdily nr6$d in 

dit@ way.. R.hF€ e rqy @t|l|M i! Oi. iU!..!. D@ io i.FEd Fl.p.c |!@ 

pnidE ba.@ iF.p..ir.ti!g.!d E bLlotu 8.t ir ou |friE.rd iti!c.|e. 

lot ofbddd d fdily, S.vr.l nodi* bN. ddd! d 6ir buxt6 on frDily oEnbdr 

which lqd io . lutu of n Edis oul @G, lucb a 6!eid F!tla!., sid 

ilobtio[ .!d lsllh Fobls, Ar Ejority of th@ Fli@& UE witb dEir foili.., 

twh .k .!Nr rhri Fti6r. livitrg will NC qFE .d @tiou a.bili6 t vc trm 

Elrp6a OE fi. Fn 

n b! h6 r!.lizd by aFi.lcid .liriciro. .!d cxFB i! th. 

6cld s w€ll ! in lishr of t* findingr rhr t. irvolvoEr of rdily n6bqr i! 

tann@r pLtr ir 0F dic &.d of lh. ri@ to t!ea. tb.c p.li6|! .! th.it hoc for . 

bnra out @E Foily Fjeho.detion br shoh b@6cid t!l. in tbi. t!8.n1 

EdMting f&nily !srb6 By Ditig|| rt &ir. ofbadln.!d i.gaivc od cdE of 

.tE Nu|r@u !n|li6 inmidd lDovG h.E t?o.rql th. t!d&.d nr! of !dS. i! 

Fli@t 

wirh S.iiapbmi. wha fanilid w@ involn4 .nd rhly srt d i! dli.@ 

Mrh clinicie in !! tMr ph..d dunld rbour r!. iuld.dl !e.8c!brof rha 

p.rid.. Pr)chocdqtioD.l ilrchdou b.lp i! loEius t!. high qrBd mdM 

ia ADily vbich in on i$d$ in EdBd clr,8. 6L, ft .bo b! Flrrs i! rldEing 

burl@.d itrF@ing t[. qurlity oali& bolb p.tidr &d 6c nniu ltd. i avdri@ 

3lootd b. r Fn of Futirc EarEr in aqy Fy.hirric &r up. 

t35

M.tloilolog/ 

Thi. chrpld qplains nerbodolory of$. nudy, tt b.gis wirn E@l'!@t of 

$nplc, dplaic .Lsigl of lh. srudy. Th. farc of tn. suple .d ch'E&ristis of d. 

edlPlc dc dplrin€d D€bil of rbe M@ !t d fd 'lscffi! inidtutidi.g&dirg 

int rv.nlior u$d md aDaly tne po..dN 6cd !o d.lidd thrl bfomdion be b.€. 

Patienls md lhen relalivd w.E Fcruilcd lion lhe out patiot d€pel,ml of 

psrhislry ui! Moyo Hslnd Lrnorq which md!6 rade out d6 @ic6 drolgh 

out th. w..k ercept for Sedats. All thc pllicot3 i&ludcd itr rhis study w* gclting 

rrqtn@r on our d@. bsir Inirially n B dh.d rh dat. eill t6 couer€d noo 

pslthirlric uils ofll t@hira horpiLls lilc Mato Uospit l Sn Geg. Rd Ho.pir.l, 

S.die3 Ho6pit l, Plrjab Insitut of M6t l Hc.lth .nd loud.i! How Lrhor.. bll 

bdre of $e following t€@a il could mr bc mtdializcd 

!i ws a l@gifudinal sMy, md follow up€ w.e initislly or wetly bsi! .1 

dil|.Enl bospir.ls. Pltien$ did nor tln !p al tho lixed .ppoinnndb dd n beam 

practically diffcuh to llrmge follow ups rt diflcmt hoAital, A1 Pujab Insritute of 

M.ntll H.alth ed loht i! Hoe, mjontyof rh. p6ridts wft choDic paridE dd 

m3t ofthd v@ in pariqt wilhoul m ecolreoyinS rclaliv. .!d Fjdity did mr nc.r 

lh. iftluid ditdiol b lwo fmthe pdio

condd tnis study ody al onc l@hing holpn.l ed a privalc clinic, 

ftis srudy had between dd MIhin group mix.d dsign, TheF wft two goup6 

i.e. lr.rtnat goup th. onc who @civcd pstlhocducalj@ od @nEol gbup who did not 

reeiv€ psldoducation. Howdlr, lh. rwo sck of P|nicipec wlr 8ls Nqs.d twicc 

i.e. pE psycho.drc.tion sd r6i Fycho cda.iion inicNotior 

smple @hpdsod orI pati..t borh n l. (D=53) sd f@.L (n{6) ed tben 

Gpetive f&nily nmbm, 49 Fti@c Dd rh.ir G?erirc rbtirB *d imlu

2, Abe of .l@tol or of

Frge L ThG llos ch.n of No. of pftic4€'li ii duilg duDg ditreut drdmt sEgs st gs of o 

fhr sdr& d*13.d ot lo ld.l, 

139

tqqhb d,a.ad.trttk! dt . Faaa 

P.'rh..dr.dd N@?.F!..datio6 Vdq p 

Cnup(F49) Cdrp(F ) (t/FiMr) 

Md. 25 23 

rs rc a D 21 rt 

M 25.t2 27.35 

tD 7.A 7.4 lJ3 62 

R!8e(i! Fr) 18.45 l8ra, 

lr15n 

2d lo t2 

ldE6 

4h75 

No. ofsibli.s, 

5di;.0rr 

fot3 

fta 

f2z 

G365 

+7yy 

E-to 9 68 ',10 -9't 

Ui€lpr.yd 6 1 

Wo*iDg 5 t 

ll*wctlg 44 li! 122 25 

uPioMildlc ll 2t 

uPiofda 27 2t 439 .ll 

Upioolrlrio tt E 

M tat4.!t 2325 29 

.tD 2491 2,7125 1.6 

t{l

Mtinu€d Tobl€ 3.1 DmgEphic ch,@lairris of ihc p.ti@13 

lstrho€dwltion Nor Pdtrho.ducatior vdc p 

cow(n=49) Gmup (n-50) (r/ Fi.td/ r) 

fl 

s.D 

t2 

15991,84 

334,41 

l0 

33 

I 

I 

39 

2 

8056 

6160 

l0 

35 

5 

3 

,.61 .10 

.55 _63 

_16 t.@ 

Oll of9 palidc, 5l wcrc m.l6 $d !6 cs wd. f6ul6. M@ .g! ofmle 

pdidll w6 2&@ y6, (AF 7.74) &d n16 lgo ol fmle pdtidts s 24.22 isrxr 

(S'F 6.1l) and t.y mCEd in agc 1845 ye6. Majoiity of thc padds in bolb goups 

had l'binl onler dons th€n duings- A! for s lhc palioC! .duqtion l.v.l ws 

concden on€ third w* mhiculrtc ed ihcrc ws llnorl h cqul proportion lnat ba

llillld lsbo6. Th. buir6s|H, cldb, studcoE od tehnici$ wft ddo6t .qud i! 

nmbq. M.joDq of lhe patimts w6 living with rh.ir pa@ll wnib a sdll nmhd wir 

livirs in $ei oM housc hoLC wiln $en sDou.s ard a f4 ot lnese palioc \@ living 

witn dcir eiblirSs. Ddogaphia chd&tdidcs of th. f@ny Mb€B nM bd 3hoM 

'rtbL 3.2 D.noAnphi. ChMterittiu oJ Fanilr ndbat. 

l5 

34 

A8e of th. Ehtiv.s in rqj 

42.24 

SD 

I1.,t6 

18 

l3 

l3 

3 

2J 

5 

5 

4 

N6-Pitthocdwati@ 

t9 

3l 

t2.95 

23 

20 

l0 

5 

5 

.59 

.11 

2.50 .2E 

l.t4 .66 

ftc m@ ag. of ![c panicip&t Elsliv. *a 43 y.G, r5F11,4O m$ of lh6. 

c@ givs Ehliv* *se fqml* (md6, sirlc8, d.uShtd). A sbrl pbponjon of 

lhes relativ$ sse siblinS! ed aSrin ! small nMbd w@ spolM. All of the rcl.tivo 

w.rc liviDg in lh€ sme houe nold. Ar fd a lh. .dk.tional ldel of lh* rcl.tiv. we 

concm.d mjolity or tne ddivc h.d prirDry ldd Gducadoa .bout o!. tid hd don 

t42

n.riculation ad a vqy rrall rurbd w@ .ds|.d up ro nct .'s ld€I. lstidts of 

bolh sDups nad iddtiql ch,rurailtiG. Non. oa th. pldncd difc!€d sbditic.Uy 

signiflca.lly bdw@ ll|* rwo got{.. 

lJ A$6mlMed6 

At de tift of iniiial 6esdr . hirEuctued d@Snphic &d illn€$ FlaLd 

chdcl.rislis qu*lion.ir w6 pFpdld to @ll@t idorutron on ddogl?pnic 

chlscrerisric ofthe pade dd lhe partioip.tinS rcldive G@ Appddn- B). Thc 

qBtiodai€ wa dsigned lo ollecl irfomrtion aboul agc, !ex, educalioml level, binh 

odd, nmbq of siblirss, mital slalulr nM66 ofcniurE4 ecupatioA rld 10 !e.k 

d.6ils oflhc ifu6 {age ar ocet .dhf oldnisiotu, ndbd ofElaFei Ilbny 

nturory of m.ral ilca eic). The foll@itr8 ade wcd o$d for .sstss|Ht of Ftia|! 

Pdltlv€ u.l Negrriv. SFdDm. S..1. (PANSS) 

Positive dd negrrire sFdrere s.1., PANSS (K!y, Oda, & Fisb.ia 198?) is 

wid€ly sed wI *lohlishe

ho*ldy. pffiuuon, gmdiosity. supicbune$ ad hosriliq. 

Negativc $rlc ircluda itebs alout sial i$lali@, @tional *ithdr.wal, 

bluled afat, D@. Fpporl pasiv. e.tn.dc witMdw|L deE .d ffibicldon dd 

l&k of{onhncny in now ol6nv.g1i6 ed difficulty in ab.rd 0i.lj!9. TIE 

8m@l psr{hop.thololy $ale irclude quelioM $out ; etutic @cfl, di.g, gult 

felirS!, lesio4 '1edkn dd posMins deprBrion mtor Erordltion. 

@6palivdd, usul lhoug[t pMdq disian iio., poor aftdlion, l&k of 

judgmlr lrd isiShr, disnlbe@ of @litio4 poor ilqde €nlrcL etiE sid 

avoidee, alTotiv. hbi.lity etc. SoE ofth6. 3ympioN @ e$.d on lh. bais of 

Mlvioral obs*ltioD ddins inrfliw or d dk d fton lhe fmily. AdrninisEador of 

PANSS tal6 .10 ro 45 ninutes. &ob ilqn is dtcd by a .peinc d.6ni1ion a rcU s 

Etirg in @sid.dtjon thc baic .rir.ri! for dl w.n ndlg poilc mgirg 6on 2-?. 

Thce e6 Doinc cnal inc@irg lolt of prtrhoplrhology, In 

'sdng di!g& 

oonsidenns Nheth.i a ltrplom prelat, is jldg.d by it deffrinor. A $or ofone i3 

giv@ if dre stmploD is rbsl if it pEsar, wdily is .letmin€d by Ffdin8 !o $. 

panicuh mling Finrs. In gadal a ntirg of 2 d.fr6 qu6tionable rubrlc q 5u46Ld 

parholoeJ,, wn@ u, ! nting of? rcf6 ro md siou ldel ofpsy.hoFr}obg/ 

whsebythe MiGli.tio6 int6f@ msr or.U mjor lif. ftnctid. tu1ioc @ 

clasified 6 politivc 'subtyp€" iflh.y @rc tlu@ or ture noddale srin$ (@e of4). 

On $e .e9dv€ ed! p.tiots @ clain.d s ' n.galiv€ subtrT." ifth.y &oF .r l6t 

thr b.d.ml. Edrg h d! ncsative sL but fBGr thd |nE @ dc p s.l..Th. l6t 

d.sr eliabilny ol PANSS is 0.88 md cnuion v.lidity is 0,62 (K!, Firzblia& Opl6, 

t987). 

l4

PANSS hld ba G.d by ditf@nt ltseh@ in lhcn tndies, M&PbaM, 

Jcmn! tud Hut6 (1996) uscd PANSS ro Dr@uc iGight dd judgpm@r s pm or $. 

coE ritive factor, S.@fc6 dd Kuip.s (1996) in thcn sndy u!.d io q.lute th. Eg.live 

di!|@io6 of $c entopb@ic dilodq. Munby, K!lM, rd @lldgu (2005) u&d 

PANSS {or F! md post eslncnt to 0.6@ thc lynptom evcrity witn p.ddls of 

In llc pltsl stdy bs.d otr PANSS ! rlrulur.d qutiomiF w pnp.E4 

sonc question6 w@ obtained non the rlr€.dy Fmlal€d ed daPld sl€ in Ur.b 

l&sua8. {p@ilrion wa se.r.d fen tbe cotudGl autloiity, (e. Ar4.ndn-q dd 

me i.dic.to6 w.rc dteled ton t[. ridco irrcNi.w sh.

€Ife!3 o. f.nily 6l:,Ms, .ffdt on fsnily o!ti!., etr*B on fdily Lisu., cfrets o! 

fmily i flcrios, .If*r. or phrsi@l halrh sd efi@l! on ndlrl halth (Appddix D 

Rlting for *h gd.dl c.l4orys well$ @[ individu] it mvr ddc on 

rhr4 poid lcale, W!.c 0 l)lE4 m 6ud.o, I tDd6.& burdd ad 2 t w@ budea 

$ hiehq sB m.s hicbd int E,ty of ce sivitgbutd@ 

l,16 

in orda to w thl! salc ir 

lhc pr.@r nudy qBtio6 q4 tr@lalcd inlo Urdu l.d!raa. ir ordd ro lcp lh. 

@jfounily ofrhe inteiviq (Appebdn Fi). Poi dtd Krp@r (1981) dl.blthld . hign 

degE of rlialilrty 6d r€lidity of tht isirllIml, md n ht sinc. b@n u5.d bv Munhv 

.nd couqel16 (2005) ed Ali ed Bhrti (1988) ii Indir Y.[ow. (1992) .!$ ha u!.d 

lhis $ale in lrudy on NiSdid popul*ioo. Rdsshq soldl lhe pdnision frcn ihc 

dcen€d aothditi.r lo B thi! $.1. (Appadix Fii). 

To s. in lbe pr@l rtudy qGtios w. E!trsltt d inio Utdu lan8ltgc i! odd 

tokccp the difomiiyoflh€ i eNi4. 

3"4 Pry.bo.duerion ht n.lliotr 

nr. trDdel of thdlpy which hs her u!.d in tnb study t . Ptt ofptv.hosid 

fahily inlfl.nlion plckaeB dcvclop.d by KuiPe6, Lrq ed Ld ( 192), (aPPendixA) 

Thc b@tl.l ofF rlo.dE.li@ rs Felat d ed adopLd i o l@.1l&glgc urd! e 

it *ould @l b. rlilficult for thc pdticipels 10 conprcn nd it (App.!dn G t As 

objative of 1he bmlation ws io @tc awenc$ omng th. f.nli* of thc patid|! 

wnn Schjzptuai., b wbile Eslating sitpL lDgugc ws u.d i$iad ofrehnic.l 

lm8uaep. It wG tried io caphF tn com.Ptud dd s@ti. tudin8 ed locieulffal 

@Exr inlo ooNdlr.lion. Soft ELtcnans w@ omined in .h. hslation whicb vw 

@BideFd ircldet or o't sid. rbc l@al cuhnl @ er! Fe ini.!@, lh. @14q

.$trErirc, iath. Fsr liB with paElc, ir i! . aood ida for llm !o stori d! 6nul 

pftssof lovinghomcmdliyitrgin!h6r.l."Ortn 5|!Lnat"srctirc)outMl'l 

healt! led will .mrgc for thm lo spad I ti@ I &y @ cenlrc or tud a job for 

tnd." be.u& 3uch eNic6 e rc1 pFvid.d by balln rystd in Patisl$, Sone 

ml.rial w6 add.

patioi epons ruh s sing tlrinss or hwing voic6 ehicb 0ln6 do no1 @ or hs, 

e drc to illn6 c.ll.d S.hiapbrdia Th.y qd iold bow it .trcl3 th. pdent 

doudts, .dolio6, and b.havio. A derril.d eco&t oI srtrrproN we pbvid.d. 

Distieiion betwm posnivc ed n Ftiv. !}np!o6 w6 explaincd dd fieii difidenti.l 

cfet on b.h.vitr wa .lalonicd Disnlnee b rt,inLing pltF6 v@ dsnL4 !.m 

lims paiot eys tl ngs tht dm't o,l. dy ffic or @ vdy dillicdr ro ud.dt&d, 

Tlis happds becaue tn ir tlDlshts re jmbl.d md tneir abiliry ro thinl cl@ly gct! 

nnpcir.d- It b*o@ ditlicult for rbd to t*! thcn doughls in ord6, $ lll€y do tu1 

s.tc *ns. Sore tin6 th.y sudrlcdy slop rhinling b€.@ thcir hird s@ ur!*. 

Becaue oflh* uuul fcclings dd rhoughL! O.y d€velop beli.ft seh s !o@ on€ ig 

consptri.8 rgainsi rhm or w&r5 !o kil lhcn. Ar rim6 tley ltrd f4lin8 tn.r $cy e 

v.ry sp@irl. Th.y m'l b. @nvilc€d by logjc lh.l tnis ir mt tru., This illl6 .fiqgF 

ftn whol. mrld ed 0!.y lo!. loucn Mth whd is 'ally n.!p.!ing, 

Diltu$ec6 in Frc.piion wft .xpldnc4 hrUuciMtioB rcldcd to ditrdhr 

s.ery rbdaliri* and rhcir.fQr on parimls bchrior eft denb.d ia det it whict 

w4 oncn vqy Aight@ing rd dbtr6ing for lhc p6li6l. Th.y wft qptained rhlr 

S.hiephenia ce olso afI6r feling!, $e f@ling sd qpesioo of.mli@! on6 is not 

app@priate to the situ rio& thcy my cry whm w.ry on€ et . is l6ughjq md my laugn 

.l bad @s wna orh6 e uF.L Fdi' ws infomFd th.l $@ dy be el|Hbrull 

cbsg6 in etudoml 3al. .nd rhe pati{t tuy b. t.rnnn b som on &d tl$ar6 !o 

s@h dings, they e @t always ir coniiol ofhow ltey f.el, ed usully no1 aw@ oa 

rbc cors.quaG od rh. cff-t' &is @ n vc on orhd p€opl€. If you 8d i.iLlcd by thc 

&i.g' dEy do, lney lecl vdy uFer ad $qla.d. 

t48

Ir @dporc reld.d ro eriology fmily w iDpdlcd infdMtid ahour thc 

posiblc crslal facrors. As f.milie! e always very keen to know about ihc ew of 

illn6, otl whedd irhdiimcc pLts a olc, Tn. eb inhdit trcc plars id &vclophenl of 

S.hiz@ledit ts explain€d !o fmily lMlb6 blr n wa diflicdt t dplain lbd wny 

jlln€ls appeds in E pdliculd p.M. ftey wd. €d@aftd ihat ir h not a anlogiou 

{iis€e llln6 in on fdily h.hbs der't no th.r od6 wiU.le der€lop thi! 

illnN. So tnc cft-ted p@n ce ml bc srigmrized ed di$inimrcd in Dy w!y. 

Fmily wa inlomed 6bout lacros whi.h irI]uocs $. occeoce of 

S.hi?.plMir" imludinS a.nci€, nsr@Ldistrr, biologjcd fEioF, lifc lrB 

inr€AdsoDl {d sial flcioF ac, RMatlR hv€ tde

ihfom.d lnal subsknce abse oo lrigad lhc illnes, cs cxrcdb.t the sFplom 

ElapG. ed $nida So n m sf6s.d dal fdilt shoold tur igmE tnis cler md b. 

visilant lo rcIrain patidt fton subsllr@ rb@, This *6 lddirio@l inf@tior 

d€livei.d lo fmililr w|!i.h w6 nol inctuded in ongidl ts*l€t. 

Th. ilteNdtioD dphGized ihe ote fdily ce pl.y ib lclpjrs thc p.riar io sity 

well. A3 hish E.E .ftitud.! dd arlributioN @ coBiddcd ro be r.lal.d io iho coue of 

illB3 &d Elap$ e rb4 r* rl$ dis.lsdt ed I'6ily ws artvir.d to mjni.jr . lry 

E,E home @vieltlMi Ha€ the focB vu or prorulion of mr. lolemt bch.ior i.d 

loiql anitud€ low.rd dlc plri€nr. Th! fmny dviremdr ed how d.ny m[6 e 

d*l wnh, is of tcy itrlponece bc.Be of lh. irc@ed @ilivity of p.riai! for tn 

hrppain8s in $cn s@ulrdings. p.rdcipeE w@ allo cducared abour drc Dlc ofs@lg 

in exerbalile sFlplo6 lrd how dvi!!|)mrd 3i!6$E r.igga 6. o@r of jlbe 

Aimi!8 ro Ede. saw, prcviding d opalhetic and suppotuve qvmmoq rh€ 

Elativ6 w@ prcvided ! fEft wort wini! ebicl lncy @utd b.gii io unddred 

b€nlvior ofdD pdidt whicb defini!.ly r€sul8 in bencr out coe. Fmilis w@ strcd 

n inpovin8 rh.t co@ic.rion stilts. Folowi.g greurd rut6 w@ 6lrbti6hcd ro 

irpDv! comuhatior srjls gl@8 palior dd tmity nhre6, 

Rnle I I On€ peM s!.ak al . tift. 

Fmily hcnlb.B on n 5p€L ovq sch orhd, e@ riB cdrying or pr tcl 

corv@lioro, e this nnc ws inlroduc€q tlEt oDly one p€Mn woutd speal al ! rift, 

rrd n hcbs ro fa.ilirrt @tut.tion bcrw6 rhm S@eftl inplffit|rion of rhis 

rule inso6 slf conEol of fdily lhbdq bolh ova lpeh ald .mdo6l pqsw 

behind $. 3p@h. h also t.ad. dm io show rce c!.cr ro @h o&d. 

t50

Rul. 2: To lrlk 10 thc pq&n diedy iDsr.ld of refdirg !o lhem. 

b lllc sesioN, il is qlne collmr in fmily mmbd lh.t *h@ bl}ing lhout 

ptlifltordyolhdlFnbq, d.yrca.rrltd !o6 AE'or..she u rnoud rhey*d mr 

pr.!enl. Tl)js is pdlicuidly poblmlic fo p.tierts with S.hizophf@ia who oftdr h.ve a 

fdsile sm. of@lf, MoHvo, n Day be panicutdly ecobforr.ble for trtials wno 

dFrioe $ird Fen hrilmiflti@, Th@pi.t @nscd rh.m ro 3pet diBrty ro 

each o{rer. The advellg€ of didl comiclrjon is ihat jt ion6 doM cxpBsion of 

D.8.tve dofoc {d fost r . low L.y hoe ovircmmt wnich lts@h !!g96r j. very 

n.lpirl in b.(q tNsnosis. 

Ralc 3r Aclive lisrening, fdily Mb.r, ne€d cn@@gd@l to lisl6 .ctivcly 

lo qcb otncr rh.r could help in irpoving Fl.rionship and rEdEc ,litulion in pators 

3nd rbe Im l, by chtugus Imty anjtu& bw.rd5 S.hizoph@r 

Rule 4: Dcllins with emotional $Fl 

Th. iapoaet 0ing which w €drnqi4d 0o rh. fmily duing r[. sbr ws 

ltu Do@Uly of @o oro, esleially ncgldy. oM. Negadv€ emro@ epoas m 

families include guill, lo$, in86 dd d.FessioD. Thdapisr h€l!.

syn|pbG e pan of illn*, ls&!d rhly vicw n s b.irg uldd rh. pati6ts' @D!!l .!d 

conequcntly bl@ pltienr for bebrving bodly. So pan oad. €ducalio pogm ain€d 

d chtuging Flariv6 diridl b€lEvior .nd giv. lt@ & urdeLnding ofnc8.riw 

Fanily ndben wq. .le .ocoueed ro .rEr€$ lh.n oM ne€.b and 6me 

rh.ir fotu pe$al ud sial i eGrr Olc of rhe inporra spers of .deado, E 

io mbili& fmily's 6c@ tud nirhlishl si8rifi@t rolc Imity plars in ,@voy dd 

rhabilir.tion oflh. paridrr wirh S.hjhphdia, 

Ar a fnt stcp hospibl ! hodrie vd. @nr&led &d uh!. oft. study w6 

cxpl.inrd ro dd ro seet lh.n pmi$ion fo. thc lmjlrMt of pari@Ls, A lener w.. 

wina by lh. suldisr io lll rle @nce&d had! of iI. F]Eni.Ey uiB of ditrffir 

t &hjns holpiids h LatDr. (Appqdix H, Hi, Hji). All dlty ncdicat ofice$ in oui 

parmr d.prm.oq weE irfonb€d .bo!r rh€ lrudy,nd rhcy E@ r.qu6rcd ro Gf6 rh. 

SchiarhEni! porid! !o Itc @ehe. Oi thc sod stA pelihi,ary sa@tir ws 

done !o ectuit plridls who mt &. study imlulion cnrdi@. And h.ving 1ie pa$qtg 

@ned for !D stud, rhey qd thcn fmily nffirbcE wGrc wrb.lly jnfonrd &rl 

explaioed aboul mlue ofrh. st(ldy B w€[ s iold lhll ii ws sn mo bs follow up sbdy_ 

Th. righc oflh. panicip&t v@ also qplain.d ro thed! d

dd th. palidr eflscd ro plnjcipae in th. sludy. 

Diagmlis w$ contrm.d by rh. lEs€Nhd uirg DSM IV-TR criterioA 

i€s@cher heB.lf onfimed lhe dirSrosis. Paliall wdc rddohty alle.ret io rwo 

souF, {on go'p who @ivcd psrlho c

fE m.dicie bylh. 't.4ldm. r mnt[ Itjs ws arugcd to al'ic dcn 

notivalion for lollow W3 .! w€[ s 10 keep thm on me lrle of psrhoEopic 

Blrbo ed@tid sios wd mg.d in 1hc hospihl enjng_ Atl sio.! w* 

cebd out individudly Mrh fmily 6d th€ parienr in s6pdlte oom! dd coDlorrsbL 

@vinnhor .r rhc d@artrMr of Psy.hi.rry M.to Hospnd rjioF, TwdE p.li@lj, 

who *dc eniLd lilD Mryo Hospibl p.trhird, out dd, wd &ob ih. n.rby 

pdiphdy ofcuj@wala For Oeir coMivmce, dparticltr

inforn'atjon .bout sid. clTets ed lilcly h.n frs of @l.Fi6 ir uL ard 

MiDte.mc€ ph.F s wcll in pcvotins relopsc w@ olr lioed. lnponot o16 of faDny 

in @very .ad ahabih.rior of rh. pali@r wE dnptaiad 

Fourlh .d@lional 66sion povided gddal advi@ d@uaging fdily meDbft 

!o .ddrs then Fmr.l Dd sial ne.d! ro i(pove lh.ir reI h.ing rd ro l!.ifu lh€ir 

fomll sociol iDrcr' Baic guidclin6 EeqdiDS noagcn@r oI sidud sympiorts dd 

lo th. P8tiatis qu.liry of lile w@ provid€d. 

'mpove 

Fmily meDbets oflhc goup wbo @ived psycho educdion att {d€d . rorat 

n'D. lh@p€uric ssioB, Iniriallt fou ssioN wn on wcHy bst tud qa! d€vor€d 

lo irp.n psjrcho dualional iliodtiotr, .d@ti@ ws d.liv.rcd by G€Nhcr [@lf 

ed tsching w$ individualized. Th. !6sioN w@ int@rjv. ud p.rticipalion ws 

mohged, which gavc n$ ro fuihd di$uions. Fdilid v@ @urg.d io Bt 

Followlp6 forrix m h. &dc@brd of @lrhly fo,,:t @nr,.E wirb th. 

patcnt md thc fmily in holpit l. In th* folow-up ssjons lhe olinical con titid brt 

siol nmnoning su.h s @irt @lmuiarion, pdi@ts jrr.Ecrion Ml[ fDit, 

nenbe6, hit no panicipation in nose not chords ed rboli pdsond hygien. tud 

clanlin* of pddor ws @rded s r.lDn€d by fojty .d parid hiE/L@la. 

Anotnq ain of th. inrNstion wq b itrrpbve comuicaton ed fmity 

lrmb6 list iir8 slrilb $ ddi.g thd. ssions ir wa .ddm€d .ad ot. ptard io 

€nhsce ed f&ilibte @muicotion h.rwd tdily ad pariqr. Livirg wnn 

s.hieptnqia giv6 ris. b ! widc vdery oI @tional E+o@. R.t.rives vho d€ 

p@rE otta r@l sunry &d blarc $d.lv6 for 6e pEbld rhe orphais dujDe $* 

155

BioE wa to nomali4 Ih6e moIio6 €Eeirlly rhc n g.tivc ou wh@ cvd n€d.d 

th€ o|nq fmily llmb.B e@ also c!U.d Md involv.d in rhe $sio8, 

Duing th. s*iou olqdy i.8.liv. la.ramt w@ piclcd W dd EA.nFdby 

rh. theBpist. Fdily as wcll 6 de pltienr w6 inyited to di&us ey !@bl@ whioh 

tn.y cMurercd duira rh.r Friod. tuy mdoMl ups€! @muication prcbto or &c 

elationship prcblen were a&Escd ed l'cy wd€ couet.d fcotdinety, Ar avqrge 

riD. for llc .d@tiolal si6 ws e bou .!d r balf, .rd iO ro a0 ninurd for |!€ 

Wlo rh. pltidl w6 in r J1.bh pb* x individu.l rsio! ps condur.d wilh 

hin\he in Nhicn he /shc ws .d@.Ld ahour Ddu€ &d pe* ofhit [a ntB ui,a 

sdo cdmatioml pahem the fmily ws eduat 4 bul rbc tuin @phsis ws on d. 

@mpliue ofdtlgs dd thc lik€ty b.oe6t ofiltirgdogs rhey w@ ds @riwr.d foi 

tgul{ follow uF ed lo rsm€ noml olrirc !s @n s posibl., 

Palidtt of rh. @n p6rdo cdqtid gFrp w@ ,lo .dted for sMrbty folow 

up3. The olinicrl condilion rnd wial iDctionins or rhese patienE wa! @ord.d. Sonc of 

lr'* fmiI6 ad parids re ror rcgut& s $ey r4 mt g.ftjlg &y dr. s,ppon 

All &c pdicip.lin8 fdily ndlb6 w@ Fovidcd tne c.lt ndbd of reehd 

sd rh€y wft dlow.d to @nrlcl es@[s iI rlcy hld s, Fohl@, Tne Fycho 

edea!@ boolcr s,lich ws Fdllatcd i!!o Udu ws disEibule

8rcuF w.re !s&d uine PANSS ed Fdily Budeo Schedul., Fou p|liqnt .nd thcir 

paniGip.tins fMily n nb@ *ho follow.d u, Eguldly Dd ilid nor nd l+ for fnil 

$seh.nt duc 10 sne pceml E.s! wft 6ssd at d.n hoDc6, S6liotu wft nol 

teninat.d a!rupdy bur paridls ed thcn fuili.r stltld in @t ct Mth rb. cearchd 

.vo ana 6nrl a5*@r, 

The pupoe ol thL sMy ws ro inv6.iglc effetivas ofpsycbo .du.alior in 

pBention ofrlrple with p3timr6 ofscni@phrtui! od to Gjwe burd@ on fdiliB of 

the par'dt.. TIE srDdy u!.d ! b.r*6 Aol9 &d wnhi! subjer Epane

R6!ltt 

D*riptivc and inf@lial slalislic.l dilr5.! w@ csi€d out 10 Ml'% d!1a To 

exmjne m€m difi@eB betw€ t*! grcups for homgd€ny oflh. lrnDl. 

chmcrdisliG. r vdB w@ obpured fd tnc @ntDDu 8ia!|6 ..d chi tq@ tnd 

Fisnd q.ct t6t (fo. ts lhd fv.) tual)a€ *@ u&d for cor€gprical v{iabl6 

For infcdii.l stairsic! wiou edys *@ u5.d s F d. mtuE of 

ht!o$e!6. Mdn objstive of th€ pcent snrdy ws l! ddirc dfe.t olptycho 

edualion on p.tienkynploG {d fmily bud.D. clinical lti@tom s@ da!.d 

Bing PANSS tlirS $al. ed scor* w@ dqiv.d @rdi.g ro lhe si.ndardjz.d 

plstib.d maU.d. a sE of orc i!dic.r6 $rr syrprom is .bsri wbcE dix poilt 

6iing $alc mgtng nom 2 - ? Mif6ri rh. in FMrd ldel of syo9ton 5.qity, Ih. 

scor€s ws. derivcd Efding to the p&liculs ratirg poir$. The cuul.tiv. eoE ofall 

sub eals were cdculaied, 

Multivai.i. Mltsis of covdimc. *a compuld ro q@ire eafer olg@dcr 

md Fllho .d@tion otr pos:r iniqvdti@ rFplotr's, (PANNS) by kc?ing pG 

interventio$ syrptm ad paridr !8. s @v&i.r6, S$6€qrddn ild€tod.dt mplc 

l-r€ mlF6 *@ u!.d to @Dpd€ lwo CDUF if tquind 

Olhd vei.bles 8€d s iadiclloa oflflic&y of pstlho €duoador *@ locitl 

fidctiooi4 .onponcnt .r selr grooeins, social comunicatioA ed peticip.tion io 

hoEe hold chos. Sd@ poid ating &alc followiog tn. patkm of PANSS @rirg ws 

used. lrd.pc.dot splc t 16l .nalt5E wa cmpul.d io @q@ tm ptnicip&l 

158

sroup6. Padots erk nlnD ws .ls quincd a m oul @re wiau. 3.d it w 

aleed s cal.Sodcal vdiabl. e cbi sqw. Dalttit w6 dploye

EtaLd ch.r..tdiltiq ed tsti6B' sFnpioB v.E dicrd a Fldicla ofbuttd in 

rdriplc Egrcsion r&nt5ir, s.94L Fl! of r.g*ion ed'lis aw qri.d olt {ith 

dilfc@r butd@ 3u!erl6 s ou.om vdi!b16. For PF incDtdnion ld.l, t!8t63i6 

rulytis ws si.d out fd lotd dlplc &d fot polt-intdrc io! ld.l.t?.rd.!.lt of 

Drlyli. wd 6ied out wi0t D6tlho cdqtion ed td p6ycho cdqtio gFuI.. 

T|e dig& El.t d .hetaiatio of rh. Bti6r. e dd.nb.d fi6t which e 

follN.d by rb. iDfmtij ilri.tie 

aJl l|hd R&t d Ci.n t .!ds 

Deripti@ sr.dsric! w u..d to &dla drt Fidning 

to ddlgnphic &d 

dilca GbLd chE!di!ti6. Bodr Fnmtiic .nd M.F miic !ld!66 w ulcd It 

od6lo qmi.c homgcny of $p1., itrd.pcrddr !.dpl. t-tar .$lyri. e.. u.d fd 

@dMu vti!b16, chi{quc .DrlFi! ws $.d fd el'Soricd vailblo !d FidE 

.ur rat wa u!.d wh@ @lb h.d 16 rhe 5 c.s, R6uir. e dilpl.y.d ia r.d. 4. |. 

With t!g.d ro $c @np@iti6 ofthc gF!F, th. Fycho .de|ti@ gorp ud m 

Flrho .dF.lio! rroup 3hoqld sinilr che|ainics, ft.t! w@ m rignifL:..t 

dilT.|!.ch.twer tb. two g0146 i! illrs t Lr.d.b.ratatuds, Mtu !9.!1 otr&t oa 

dil.g wa 2l t!$, (S.D,629), Mtdiryof ln. P3rj6u hd hi.lory ottso Fl.pc 

(mg.2-?),ehil.r v.iyfapatiat h.d htut ry ofsd Eh!6.n.nd odc lhird ofl[. 

pqrialr hrd hiiory of0!E rcl.rG. On. fourh ofrh. prrid. hrd fdily hidory of 

illfts in rtyd@ El.live ud off.prirSr t|(l only . v.ry m[ nubbd oftb. pli@t! 

h.dbi$oryof fnilyp.fh ri. ilh@. 

t60

I I B r ft lated c hMc I d tt ti s 

Pry.ho.de.doncEw N@P.y.ho.duatioloFup cdtvdu 

(' - 4e, (' - 50) (r/FLt dt) P 

v.i.bL. I 

c{ionic 8 

DiuguiEd 9 

P..dtd U 

Unnitr6d.r.d 2 

R.lidud 4 

,1, 

Asf { fr6r HoDillE1id (ln Fu) 

,'D 

6 

e7 I 

No ofPtwiu gotihlirdo 

2 

62 

Fmily Hili.ry oflrrrli.tric IIB 

t6 

|l 

2t.ta 1211 

22,.E 21,9 

I 

5 

2 

30 

ll 

3 

I 

t3 

t6l 

tfi .47 

4.71 .45 

149 ,ll 

5.09 .t3 

Morr of rb6 pari@B f.I i! o.rlepiy ofpleoid S.LjzopIMi!, lbout oD folli! 

in dissuiz.d qF !.d r @ll otdq i! or.lodc od Gridut 9pc rt two gne.

wcF coNider€d equivalot in t€m of dhogsphic ch@tqisti6, ln@foE, it h.ld io 

b. sltill&tory for nrnna 6npdi$n of !di!b16, 

a. l. 2 P3ycbc.duqlio!, R.l.pe Ri. rd Synpton Sd..iry 

'ftc firs btlotbBb wa Fuitri.g !o @rp{ri$r of pariaIs in re gD'q6 m 

abpe bL. 14 palidls h lle mr F rho .drc.tion 8rout trd FhF€ itr l[. Fiod of 

six mnlh. wnru in pstrno .du.tion !r.!p rc prricnt 3ho*rd Flape, Th* Gdt! 

lcnd suppon !o ou ht?olh*k. 

Multivaiate ealJ6is of@vdidcc (MANCOVA) ws u.d io q@i@ lrdt of 

palial Sader ed p6rrho eduation on polt inLddtions syrnpl@ (?ANNS) by 

cnt ring pF nl.Nolios ryaptom &d Fticnt lgc a @vuiar6 s$&quendy, 

indep.nd€nI erple l-l6i analts w@ uscd io @npec two lrorq6 wLsd EquiEd. 

Ralc e sivd il l!bl6 4.24.3- 

Amna @Eiar.s, pcilrerydtion n s.rivc atmpioc lDd og. of th. prriar 

show.d rigilicdl efet or posr-inrcrv€ntionr tynpt@. D€Aire h.ving pe 

intcdentior stmploG dd parial !g. $ covdi.r.!, pdycho{d@1id had sigrficel 

.ffecl on post-intddtion slDpro6. Pdienr gcnder hsd no elfet on pollinrav@lion 

t62

'f'fr'E42 

M"dwiat atutnit o!@i@@ 4p4d tnt4*do'fut itt bsh 

tvilc'r&bd. HlDorblti.(u Eddf I P 

"r'piot {!|' 96 3.00 89.00 .96 .41 

163 

.n tro 89.00 EJ9 .ql 

pE@.lbolog .93 3.00 89.@ 1.95 .12 

rati@tBo .8t 3.00 89.00 5.17 .OO 

cntp .:16 3.()o E9.m 33.64 .oo 

Podat G@dq 

Cdp by Cddq 

,yo J.(ll, 89.{10 ,96 ,al 

J.ou 89,00 l,4l .24

Mak ene.t o.d i".mcti'. .X..1 ofpatiql eetula oul pty.ho.l@t1on d p6t- 

Godd psjdlop.thology 

Cds.l pltrhopatolo$/ 

Ccndrl FFnopailDlo$/ 

st 

76,77 

50-68 

260_14 

l25l.6l 

6559.79 

27.1t 

9J.64 

271,49 

16,77 1,93 

506E 1.90 

2@,7E 2.93 

4006.64 100.71 

t25l.6t 46.9 

6559.19 13.17 

21.13 

93.64 

217,49 

t@ 

.16 

.t1 

.09 

.00 

.00 

.00 

.69 .40 

3.51 ,06 

3.12 ,0E 

Psycbo.du:lio! hld di6@r ctrcr oa Fcr-inrqvdrion Fcitive mg.rirc 

and 8.lml syqlo@ in pada$. cqd.r ofth. pltielts brd & liSlifoer.f@r oi Dy 

oI thc p.ticnr 6,mplo@, Mo@vd @ signiff.dr inl@crive efld ofgndei ed 8reup 

wu foud on padai synpronE { posri !|@tio! I6€L R6ulB e.Lo D@r.d jr

Efrel ofc.od6 ed goup d poiiiire s'qod, ncerdre 6}iptod .!d efrq.l 

D6r.bopd6lory GErarivdy) 

f 

5 

165

: 

I 

I 

I 

T 

ln orda ro tuine prrisc (lifiGlqg i! !.trho €d!..tid dd M Fy.ho 

.dwtion gDl4s, in post intav€Dtior strlpbm wcity, ildcpadar s!rylc r-r€l 

@lt5i! wa pdfom.d ir p!ti@t! of two gouF (t bL 43). 

Dlfet n.a ii two Wtictpa Ctupt on pott irteMtto, stdptont (P,4NSE 

PANSS Sub!..1e M SD 

Gffil Pry.bopdholos/ 

Psy(ho€dultion Non-tstrbo€ducoriotr 

9.t2 

11.47 

2,45 

5.27 

22.42 

18,48 

40.97 

759 

424 

14.56 

166 

-10.?2 0@ 

,5.24 0.@ 

-7.74 0.@ 

Thc esulls sbowed siiffc.nt diflrcn€r in rFpiom evaity in two gow' 

Th. p.ticnt6 in p6,rho €du.tior erclp mmifBr€d gi8nificsntly les sydeto4 sdity

s cdrp.Ed io p.ridl. whoe flDily Imbss did mt FaE p6)eho .dN.rim rle 

gFup who eeivcd pycho .dwtion snow.d @sidmble inpov.l@t and mjfdtcd 

lignilicur reduclid in l'tDios, R6ul$ sulpon I!fuh hr!orh!!i!. 

Ncxi !.i of aldylir dqll {i|} ltbploh sEity ar pF 6d po.1 intdarioD 

lcv.l, S@dtc *ts ofplnld elqL t r.d adtris rc dicd out for FFbo edqrid 

dd rcr ps'tno educ.tion g!W. R6ulll s. gjva i! Lhl€q 4.5 & 4.6 

Swpton wti, dt prc and pdt Msde,u k ps;tcho edrcaria g@p (n=49) 

dF-48 

2629 5.01 

t.3t 6.cl 

50.81 9.16 

SD ,tD 

9.t2 

I1.4? 

23,13 

2,45 

5,27 

m.91 

15.82 

t9.0? 

o@ 

0,00 

0.m 

Analtsis |roLd rhlt r[@ ws slh6Lrtid

Srnpton sNity at le atA pd dsssneit ln hd ptFro edrcatid g@p (h-50) 

dF.l9 

SD 

21.29 s_tr 

22.EE 6.91 

52,04 10.8 

l6-04 

18.48 

4,92 

,tD 

9.J4 

8.24 

14,56 

.6t 

4.51 

Re tr eveled lhal noh rstlho eduation grcup .l$ showed derc.le in 

0.m 

0.00 

synllon *vdity. Th6e 6ulc @ in rhe @c li!. 6 for rh. Frcho ed@rion eroup. 

Witn lh. aim of iddirying prsdiclos ofno of retaps. 6repwie ngEdo! 

dalrsis B cei4l orL Pari6r!, dcrDgEphic chdcleisrj*, dis. ,.hi.d 

vdirblB ud burdo $6 w.rc cnrd€d s pcdicioB ofFta+s, IE Egeid 

Ml}lis indicared thal only family incom @dged 6 signifioDi Fedicior ofcldple 

41J P3ycho €dustlon rd So.t.t Furc{ontng 

OIhd si.l iDcrioaing nE6 ued B indic.roB of inpact of F6rtlo 

.ducation wd! s.lf SMnilg *iat colmui.ari@, dd panicipation in l@@ hotd 

cnor.r, A sepmlc &l oft 161 @lysis wa cei.d oul !o conF@ rwo gbuP3 dd a 

*ri6 of paircd smllc I,16l wq us.d for Fc &d pod llsdsiml @tr9rid. rsdl! 

d. 8iven iI tabl.! 4,? & 4.8. 

0.00 

163

Co"tpariw oltw parti.iptnt g/ept on wiallncti@kawianles (pe-iit t8tka) 

Variablecaregory Psrrho.ducorion NonFrbo€ducario 

elup (, = 49, GoW(Ft0) 

OurlM€ vdtutlc M SD M SD T p 

Selfcooming 4.37 1,36 4,48 1.40 -0.40 0.65 

cotfuiqrior 4.85 t.08 4.80 1.43 0.22 0_82 

hold ohoB 5.35 .90 5,38 l.l4 4.16 0.87 

No sigDjfic.nt dififficB in two p&riciprnt AmuF wce foud al Fc 

inteoadon locl in ey oI @i.l fucrioling vdiabte. 

Conpaitun o/ nao poticipaat steps on t@i.Uunaiohihg wiabtes (post-trte@ntid) 

vdiablecotcgo.y Psldo.duqrid t,tonpslenocdution 

ere'p{' - 49) soup(' = r0) 

Our cone Veisbl. M SD M SD ----i 

s.lfcenins r.16 0.51 aj4 aj--8.6? o.d 

coJmuiclrion 1.,r0 0.73 3.52 1.50 -8.86 o.oo 

hold cho6 l-,lo 0.76 4_08 l.6t t0.49 O,OO 

At lollow up 6sssl@r, thft Ms significd diff@ncc betwm two panjcipdl 

sDups ondelffuctiding. Prtlhocduarion gmp showcd sjgoi6@r inptlvc|Mt ir 

s@iol tumrioli4 codpondrs al pcr inlePdrion t€vel @rP.rcd !o iG no,_plyclo 

169

Peliat work rralu bo$ ar pFintery€nrioo dd polr.intervniion l*l w6 

@npar.d b rs go,ps uins cni-lqw D.l}!is (I!bl6 4.q 4.l0)- 

ConpMd oJM pottictpa"t grcups or wt ohs (pe i,twrtid) 

GFtp wo&ng Non wdkirg r' P 

544 

NorF rhoedearior 7 43 

dFl 

otj 0,19 

TM gmpr did rct ditra in ert sl,l! .r ple iardvanion t4t ard mjofty of 

fie palicnti fell in thc caregory of non turking drn6. 

Conporit@ ottue paticipaht e.oups 04 w* sat6 (p6t int Mior) 

workbg Non Dortjrg tI 

Psrrbo Ed@too 26 n 

Non p6yrho- Edrrtion 12 t8 

rltsl 

! 

8.13 .00 

Sig'ifmr diftu in *o* !i.tu ofrh. parinrs slid deljv€ry ofprycho 

dlqtion wB lo@d. Tte rMbd ofpdiet! who h.d rciosr.r.d lh€irjob 6r.lu ir 

pcFto cdmarion goup siglifiotly itu@.d s @trpsld to rtioe in M psrho 

ednc.uon 8roup. ln ps'tno educa$on grup, n@bd oflhos who h.rt cL,red b wdt 

itr@s.d rLMt dE ric (non 5 b 26) {dc s i! M?.y.tD e

a.r, lrtcho .dEr!o! |.d L!& l!!tn 

A,&.bJ.dFof 6nddyr-bs.&cof !.ld.d!.d..otut 

h!d.d qpalolrd by lh.m u ! clu.quac. ofFtilor lhds Mrhv..i.b |!.lr,& of 

@[iG wcrri.d or t drb tu.abc ofr.ldo.d!.jo odrddre 

oo porr-iucraio frdly bndco. &d!r!.v..dos tuIy brd- l|brcrlo $et. ,rd 

lddryr3dld|t@Eid.. Sd..q!.dybd.!.!itldrd.rrdlF. 

$.!coqrld6.coqrieroftmtud.ildiNp.oonoivhltt L R-{.e! 

ftE i!.r!La,ll-4.13. 

r

M"hi|4ttc..Nltth o! @wiM dro$ i .N.ti.a t6t, tut 

Wilt!'kbh. Hyporhqildf Ertudf ! p 

t7t 

,87 6,00 83.@ 1,98 .07 

,90 6,00 83,@ t-47 1.9 

.92 6.(x) 83,@ r_07 .38 

,85 6,00 83.@ 2J7 .03 

,82 6,00 83.00 2,86 ,Ol 

(Pairrcrr'rio!) 94 6@ $m r!6 52 

Agcofpat@i .8? 6.00 s1,00 1.99 .0? 

.74 6_@ 83.00 4.84 ,00 

.95 6.00 $.m 49 65 

.86 6.00 83,00 2.12 .05

T$L a.l2 

Main.iut otut i,t tuctiw ei.ct ofpsycto4uqtt@ azd pott nt cekt t orlafint 

M.tr(F t i,ttMrlon) 

t9.52 

u,55 

t1,,5 

s4.a 

15,72 

t9.13 

2.50 

l.!3 

,023 

,ll 

.(B 

6,01 

188 

t,t2 

l,6l 

{ 

I 

I 

I 

I 

t9.52 

4,55 

92.35 

19.t8 

2,50 

.023 

.ll 

-00 

6,01 

2ta 

t,92 

t,5l 

6.,48 

rl.t6 

12,16 

2t,42 

Nt9 

6.06 

l,,a 

t.65 

.08 

.o! 

.59 

!.87 

32 

.00 

.q, 

.a 

.m 

,33 

.35 

t13

A|@a @v{i.L.r pFiirdtttio hur|.d srb el- (flDily bu{h *.lc) od 

.ec of lLe palidt 3how.d no siglif@t €f*t on po inrddtid fatnily bu!d!n, Pltrho 

c

t.' 

I 

! 

qlnr!'.,:r.l!!.if,j+ijib?.iHi*FjiF#itiilfj;';gf#F.1#.,:{,fi+1,F"r.'!rrir:.rs- 

I t 

E, 

T 

t75

t 

* 

t 

,! 

E.r||rbd kl!|n.l r..r. dr.ord .@r othbEct on.fi.r 

DfrFnc@p 

-r'iili'.ftt* !p;:i*,..!..flr!-"ir,I; 

I 

t 

! 

a 

E.h.t d [.ral..l L.n. ot.c.t d .cor ot phyic.t h{ih .tb. 

Pdbrp.nt gElp 

%:#*-!#f*..i.ftiT:1g:1fi*3?si#..r1ii,s-+xr..!"iiE:*- 

t16

177 

Errhrbd l.rrhl| ra..n3 ot .4Ld .c.o or Fycnobsrc.l horah .n r 

Pd&|tsdercu' 

*jiili?fi"1*3P-: :'..!...-",1t--.tT.j..irt'n-J:.jrf'*'-€;;::i;i.::,a.f;.","n-"-.:!g- 

Tlblc4.ll 

codpai'on olpa ictpdntt i" tuo ctuup' $!.niu buda (w kr.Nntion) 

lstrho.drcarion 

vei!bl.C.&go.y Ooudr=49) crew (r - 50) 

dH1 

4.10 

4.43 

4.12 

3,18 

2,45 

2.31 

.'D 

2.12 

1.58 

2.45 

2.O7 

2.70 

t.86 

3,54 

3.67 

4.08 

1,52 

2.16 

2.08 

50 

2.t0 

't,87 

2.46 

2.19 

2.38 

r 

1.32 

2.32 

0,08 

4.14 

0.56 

0,68 

PE iltavotid ard)lis Evaled no dift@@ in burd6 eo6 of pswho 

dlution gol9 dd M Fy.ho cduari@ eoup acer for mri@, Fdily Dd6a! in 

P3 rho durtior ercup &pon d ln.n oudN b.in8 ri@ifi@{y tuc deEds 

0,18 

0,02 

0.93 

o43 

0.51 

0.49

@dP@ to nor P6y.bo ed@tion go4. 

Conpqitono/participa s i, tu Ctuups d lohily b"nler (posr lrtwntid) 

V$irbL C.tcmry - 

PtFbo .

Con?arita, oJlonilt btden d pte a.d pNt intery"tid ldel (pt .ho e.fu.atiu srcup, 

dH8 

4.10 

4,t2 

3.13 

2_45 

2.31 

SD 

2,t2 

1.58 

2.45 

2.4 

2,70 

1.87 

2,.12 

Ll6 

t,49 

l-06 

r.06 

0.90 

SD 

1.28 

1.09 

1,78 

l,3l 

1.42 

6.49 0.00 

10,84 0.00 

6.11 0.00 

6.89 0_00 

3.?3 0.00 

5.39 0.00 

fteF 16 signilicdt inProvmtut in p.trhodu..rion gntp o! dt Nb scatcs of 

fmjly blrdeD. Burd.n ldel us lignific&dy Educed ii .U djmioB of f&bny 

Conpntur oJfanil, haden at pr. atd p6t i.tetwtiM INt (M p,r.ho edlutid 

3.62 

4.08 

3,52 

2.16 

kychological nal|h 2.03 

.tD 

2.10 

1.87 

2.46 

2.t9 

2.38 

2.29 

2.90 

2,t4 

3.J6 

2.76 

1.56 

1.72 

SD 

t.79 

2.25 

2.09 

2.M 

2.68 0,01 

5.?l 0.00 

l.8l o07 

2,19 0.03 

t.?4 0.08 

1.02 0.31 

h noD pstrhoduatio g!up, dc@l for "muli@ no sisdicdi r6dEri@ ws 

t79

A nurnber of nultipl. linear r.g6sion ualys.s w@ cdicd o!i, to cxmine 

p'ldicioB of amily budo. Arulysis B csi.d out for toLl sdpl. o plr i.ra€rion 

lev.l, Foi p6t intflqdon ls€1, two 6epdot. s.|s ofe.lylj! w@ cmied out for 

FJcho drcltion .nd no! psy.no cdEatio! goup. R6ulrs @ r*'En d in |hc s@ 

ResE ion .naltsh parainirg ro pE inrderrion l@l iluE r.d r!.1 feily 

incom ed nMba of p.ticnls' holpiialtatior w@ liidcer p.djc1o6 of ftucial 

burt n. (Appddn K). No rignilicdr prediclor M d.r8.d tor Imily ourir 

(ApFndix K-U. wla $. suh6c.lc ofletw qs edad s ourom vEiabk. prIi@i!. 

gqcrd pstrhoparholog mdrsed 4 a significst pildicror. Fmily nanbq, lchE 

aiiliIi6 w@ afc&d if pttior ws lmif6dng mE Seaal p6,chop.lhologtr 

(Appcntlir K-ii). Fmily incone eft.ged 6 a 3iSnificmr F.dicror of blrda on fmily 

m*tiol l-owd Gnily iM hrd dv* .ftet m did inc,!.tion of S. fabily 

Gec App6d,x K-iii), No significet Fldiclor 4erge

on fanily 6 irc dd l€is@ &trvni.s. Nmbs oftoQirarizdonc nqsed 6 lhc 

signiicnt prldi.tor ofteisue !!be.le. No signilicel E€diobr .n68ed lor fmily 

irt.@tiol! phJ6icil h€nltl ed Fy![ologicrl hqllh Ctall6 b Ar4cldrx Li to v)- 

Analtli6 pcrlaining lo rc! psttno .drclnon 8ror4 dctlcd oDly 6mily in.dc 

rs sigojfiont pFdictor of lnily budq Ge APPddii L-i io v). 

4.1.5 SumMry oftn€ Fililtrg' 

The eli6t lindirS! oIth. sMy rc E folos: 

1 Fmily pclcno edrcotion bad o irp&r on lynpton Fvqity, lhc potim|! in lb. 

psjaholdqtid grol4 Ehow.d signiticddy l* syr@lom edty !t tollow !9. 

ThG ws siidcui rldstion in rFploh seity d thc p6i irt ry4iion Lvcl 

in pstehoedualion Sroup .s corpard lo rcn psychosdeltion eroup. 

2. Bolh eolta sho*rd d@|!& in 3'rnpioB eEity !t follo* W bur |hi3 

irpovme vs mE toeboed ir pati!!$ nob psFho cd@adon sdp, 

3. No flrple occued in pati@ls i! tlte plycho edu€adon grcup a1 3ix lMthg 

follo{ Wi whft a in mn p6y.ho ed@ti@ grcu! rEbps. @utd in 14 

4, Thec w.6 @ted imprcv@at ir locirl a@tioning of ptticni! in p6,tho 

edrcnion goup a 6np&d 10 no p.ycho .du.$ion eoup. 

181 

thougb th. pqli@t 

in non pitrho cdrcltioD SFrp als had inpovddl b thir inrpov@dt ws 

@rc ruked in palidt in p6ydo edMlion erolp. 

5. Psrtho.duciliod had r posiliv. ellc.r on p.lrots' mrk slnos, At po6r 

interydtl@ ld€l mjority ofpalidlr in pctrho €dultion gelp rcpon d 

Eiosratin8 th€n wor* sl.tu5 or b.d retm.d !o lhen Nrk whi& mjorily of

paliai. i! .o! D6'rho .dE lon gD|4 w@ still ftt vqiing 

6. FuilyFlrho.du.ti@ hld dSdfiMt inp*t o! ftnily butda, Fmilid ir 

p6y.ho du.li@ grout Eroi.d li8rifody l* burda a @!p.!d t! do!. in 

@ F),!ho .dMtid 8oW. Burdd tld t@ E&x.d i! ![ f.ct! of f@ily 

buda et dd., i.. fileclr], ou&. Liidr, iltdalioE, orl!.|ltD I poct 

7. h M Fy.ho dutid Irorp,ll@ ws @ cletp ir bud.n ra F! &d pod 

inEvalid ldcl d.?t fd f@id &d @de cd.gp.y. 

8. Ar F. id4Erio! .!6tEt f.bily imdE, Do.itivc lyqroD| ed sd.r|l 

p6'rlto?!|!olo6' ofoE p.rid aE8cd s rtus Fldictod ofbt!d.. o! tulily 

ftnh

Discr$lo! 

The pE6dl study aincd !o qeird $e efllcacy ofpsrho eduationol 

iltefranioro witn fdili6 ofp.tiob wi$ S.hi6pb@ia in t.m ofEl.p& pFvdtior 

s w€U a Lmily buda. Ar lh. .Fetiv@e of thc Fqar 

dudy c@m, n bs 

provid€d evidenoe supponing lhll fmily pcrlho cduation dos h.vc & inpacl on 

5.r Prychoduc.dor ud R.I.PF Rrr. 

The mio ain of this shrdy wa to prevdt El.ps ed to rldw slnpron @€.ity 

h pati€lrs with S.hizophMia rhough psttho Gducalion of th€ feili.sr e th.t oplinul 

help is pmvidd !o fmni.! !o itrprcv. out @m ol Schi4phMia. Fuilid 9@ 

rodonly assiF.d lo two sroups one grcup @.iv.d F rho .duo.lion ad lh. otha 

go\p di{,o'l. n. fi61 hypothBis of llis sllldy wa thar Frdo cdNltion euld r.d@ 

Ehpp Ete in patidts wilh S.hizophqia i! th! grcup *do @.iv.d pGtrho ldwtion, 

Tn ffdin$ of lh. study suppon tne I!s@h hypotbeis a $. r.laFe Et wa v.ry 

low ed Bulrs & in eord.G with thc arlldi6 by Vauehn.rd t lti! ( 1989).!d 

wirh Agugli., F.brici, Benosi, {d Bei (200?), Fmily intervotioE hav€ @Bistatly 

bee. shoM lo rcduce Elapse alc id snrdier ofboth €mcdy {Tdid, et al., 1994i Walz, 

ct al., 2001) Dd .f-tivo6 (Bftwclord, .r !1., 199; sna& 266g, cn !. tln 

In dre pF@l snrdy P5tlbo .duation wa povid€d in rddilion io 

pbr@logi.d tiatnai. Bot! !10'116 14 gcrilA tn. e iv.ldt d.t$a. of 

n.ubleprics. TIE clinical siSnificece ofrli! srudy ce be opptri.tcd in rlation to olha 

simnd studi€. It@ nad bm r.iah of ldily inclMtid in coDjMtion win 

t83

noinrenanc. ofntuleflics for schibphMia (Coldltcin, et !1., 1978; Lloon .i .1,, 

1984I985r Hogrny, el al., 1986; Tuid, ctd.,1988),Ihe o coreoffmily 

inr.dalid in si{ sludi* M Imdtlbly cotuisldl whh rclap& mle of 12% or ls 

ov.r ! F{ or s onp€Ed *ilh .bout 5e,6 for @!d pltiots. 

Thc eli of pl.qr snldy agadjrA ddanion of rLpe a& d@ io {E 

rhdputic cfidtirds offanily !6ttho .dertion.l iltd€Dtiod al$ g€l srppon 

ftom . sh|dy by Lefi, KuiFis, dd Bslowilz, d d. ( 1982) vhft the Ebpe nr. ir 

conlrol 8rclp sd 5(r/q 6 conrpded wilh only y,6 in pstrhosocial inlndtiob goup, In 

ou study no rclop* nod ffied in the goup who eeiv€d psrho dualio. in six 

@nih! lollow up pedod while dE olhd goup who w$ only on nedication hrd 14% 

el.p$ nic in lhc sid pqiod. 

R6!lc of rhis srudy @ in agtE4nl sirh Coldsi.in (195) sudy wh.rc rha 

pdl'.nlr g.tling nDdoate rlo$ oftrmlcprica i! .ddirior io fdny duc*iotr dowcd C,6 

clape @nDo,!d lo 14% in @d@re doe lo no fmily €d@.ri@ goup. lloywd, 

Tdiq .nd collelgud (1988) study with a gloup or 'clativ$ vho @iv.d edulrior did 

not show dedsse in sFpton *venty. 

Findirss hig isht lhe inportalc ofp€yohoduqtion ed inchdillg fdily 

fthh.6 in lhe comuny ce of pati@c qirh S.hjephmia parti€uldy i! $c 

P*is|.ni dlell. FDdiags of rbis study Einfo@ $c Bults of orha twn 

&mcElling lhlt w ofpctlno€du.rio. podl@ th€ b€t ctinic.l Bulls in rh. 

lret ncnr of schizophreni. (BaM,l, cr .1., 2006; Dixon, .r .1., 2003j Pilli.e, et d., 

2@2), 

184

s.t Pqsnoedrstiotr .d SyEprod S*enry 

Amrha ibportat findin8 of lh. p!!gl srudy pa ilai Fmily p8y.hoedEaiion 

hod { i[!rct or sytr'pton sdity a in lhc F lho ed@lior eroup th@ wa a rErk.d 

inprcvdal in lbc clinjsl sbtur oflh. plti.rb in r.mr of s,rnpton *venty. Th@ 

ws . sisnifiMt r€dulion in IMilslalion of psyoholio rlmptc'n eerity tt lollow up, 

Plevoline or delayine Frhoti. symptom .x&erbation app.as !o nsve e i!'poltad 

po9osric val@, s ddumdted in a ftvis of th. tr.ibneri 6eeh lit@rw (wyat! 

191; P@ & waldheda, 2005). 

Subsratrtial ders. in wdily of lyhplom in th€ greup who wiv€d F rb. 

edEatio! v6 obsdc4 Ou findings @ in @c@q wilh Munhy od Kum' (2005) 

cdrs Ehich snowed @ted d6t!e ir sytrqom evdity. 'It. 3iificdt ditr.|!!B 

wft rctic€.l fq all $b sl6 of PANSS .rc.pl for d.lEive iyrnpioc, whe lhc 

sE iIM€d atthc follow lp !5fficnr 

Ole posible cxpl@tion for ifttle in d.p6ivc aynlploG @dd be side efrcl 

of lhe l@g tm E of nml.ptic dFdiqrio (O.!dd, Mltoq & Cowca 2001). 

S6ondl, it could hc due io inprcv.d iBighi of p.tic.t wno g.c .w.m.s .boui the 

debilitlting €fiots of $e illns wbich i! ! threl !o th.ir nc.d!, gsls ed 1016, $d @y 

l€ld to depBiotr (Jekson & BiEhwod., 1996r G.ldd, er ol., 2001). Mormver, 

cehtion of p6rrhotic slbprom, $our . qlsns of pati€.t! .xhibn p4istot ed 

sigdffctul d.?Esion (Geldr, €t .1., 2001) and incr6.d !ui.id!l ideadon rt posl 

inreoqlio. osssnmr tirc (Owd, Caoll, F.n.n, & Cyl&, €t !1., 2001). 

Signrn..nr r€durion in PANSS $06 ovd rioc, .ug€l.r3 thc ol€ or!6,rho 

.ducalion i! lhe ir4rev.tMt olclinic.l @ndirion of tn! pariat . Anolha in&6riog 

185

firdiq oI rhe plgt study wa th.t both grcups shdrd I d@Ee i! s)dptoD sdty, 

this could b€ atEibuttd to de efted of phm*othcnpy, bea6c bolh groups w@ 

€eiving d alJMt equl dos of nc@lc!ti6. Howd.r, mr€ prcnouc.d impmvdot 

vas obweJ ir pslrhoeduation eroup qhicb could be du. to @n6olidaled synergy 

berwd drug t@lftot ed f@ily psy.hoed@rtiooal inreoqtior. 

Redudion in posilive, neSalivc lylproru ud gddal pstrhopalholo&/ on 

PANSS evi&nc6 how psychoeducador c& r.sull h r Sendlizcd iDpoydql ovd all 

tintls of syr9bft. Findirgs @ @nsilt nt wilh Aguglir, F.bnci, & Bedosi (2m7) 

sludy wh@ pdidl! ofpsphoedeador greup Fporud a ltltic.lly siiicdl &dwlio! 

in all cl@car pa4meie6 of syngron edily. Redt @ lle in lsl@ndr wi[ Dyct, 

Sho4 and E€nlryr (2000) who Epon d | trr*ld d.c@ in m8{iv. sytrptoft i! 

bulri fdily gro'D EqEMt !1 orc Fr follos up The cults e paniculdly rldor 

beaw ncg.tive strproB e si.t.d wirh clape, 

Thft e .ub€r of sodi6 which e ii @'sfuc *ith thc fndings of prMt 

study (Fallmq 1982j Tdie, l99l i Tei€r & B.mwclouSh, 1994; Tmid, €1 al., I 998l 

Walz, €t al., 2001; Teier, d al., 2002 ; J.tsd, .r al., 2005 ; Munlt KUM, 

Cnidar\ et al., 2005i Agugli4 ct d., 2O0t) AU ths. rludi.s EFrr . siiidt 

&dwtion in sy$pton s€vdily folloMn8 fmily Fychocdeational inreFotioN, 

Moreover, pstrhosocid luclioning ol th6e padqt! Mkedly ihpev€d !t six 

ft@rhs followup, Not onlythepatienls clinic.l slaru! show€d ! tr€nd ioward 

inprcvenent, their lbilily !o pcrfoft r ongc of doGtic cho@ independendy &d sll 

h€lp shlls itrrpFved sisnificurly. Tn !c tindio!6 d. in .gmcnt wil|l rhoe of Cnog' 

(2005) dd Fe@dcz, Gieldea sha ed @llc.gu6 ( 199). T1'* rodjls! als set 

136

dppon Aon sodid dolc i! Chi!. (Xion8" 1994; a&8 & Aflihd, 2005) tp.cifcdly it 

rlrB ofr.rM io wdL larclvdrEt ofpariat i! ddly proSrm my a$1. rd.tiv6 

io Ei!5t!c ild.p@dat erivitie Ed @i.l ftFtiodi& 

P.li6ll ofm FFb6.de.don SMp do ![orcd irpDvqncnl &d Fdstio 

ir .ytrrplon cvdity, Fmili6 .lo i?o@d ld ldcl of butlctr .l follN l{ |t.6.!Mt 

Tti! @uld b. .ttrbuGd 10 eSul! l@lbly follw l+ &d .db.@ io diqlio a 

lhe p.ridr! ud lhcir f.Dily !Mt6 w@ @i.g for Egul{ follow upr @ttly !d 

w@ bd.s pdidcd tE D.dicic 

b th. FEat sudn f&iu6 sw dD...d !o @t|!@&ra|od rr t lrlid!8; Dn 

.ir!.d .l .@lio..ti!s tlc p.6olosi..l inlaedood rDl6 which t qa tqd@r 

plDsr4 fdili6 rtlodd r 8.in i! @mubicrdd *ilb dd thn ciD8. odd b. 

.itibutd !o pcitivc clldt ofca'-.do"'l liDgre lqrotrDclt obr.,!.d ttreW! ttir 

lahal !Dd.l (Fttrto.detio &d rFdiqtio) ir .ix ddh! folbw lp Fiod .Ud 

io fo6la l!. ny of bo!. thtr l[* cllc& fly bc di!r.i.d oE dm. 

Fildi.8' of rhi! mdy o88..r lb.l Fovi.iN 

187 

of ido@li@ .rd ,{?on b tuity 

ffiih6 i! d inTofrrl r4..r of tatrhr fd bnili. of Ftids *i6 &tiz.Dhrai. 

N..& of6. fmilio dould b..dtd.4 wit[ i!da..d i qluli@ od.qton 

.niodial .l$96 o.cu i! f&ily &d lbi. fly b. .3sird wirh f.G cl.p6 nd 

bcnd nmdonin8 ofth. a.Dily nd Fti6t ov6 tim 

53 Froily E$dd $d ttyclo.rllsdo! 

Th. c@ for t!. pdian wnh S.hjz.phdir .r hotu 6!litu1. r cooidq$|. 

burddo!th.fuily, I!P.ri .nwhichi.Iddclolilg@atryudwh6!O.dr.ndd 

fM y a8l mF .tpponirc fdily lrndph.d @ qFcrd !o dl.vi{. l[! fdilyt

urdcA ii is d6 thr fmili6 still f*l d app@irbl€ b'rdo md fe.l dilfic'rlt io @F 

*ith lbe dislressing sthplom. IlEy oft.n l&k larwleds€ abour 0!c nrte ofpdidas 

illnes rnd €eiv. liilc help 6on pDfssionals for t|@gmdl of diflicult b.hrvid, 

.xcepl ir ri@ ofdilh. Copins with the patioti' preblm frrqGtly Bult' in !dv@ 

.d@t! on their on phyliol ed lsrhologic.l hqlln, s ELtiv6 lhould b. preeid.d 

mor6 infotmlion rsSddin8 fie illn6s dd b€ giva morc suppon b au.vi.le lhe djst&ls 

thcy f4l. R@or studi.! (Dixo'r Adam, & L$kllc4 200D deibins inrflarios 

vith fmi[6 n!v. shoM th.t sEh b€lp @ b. cffariw .rd wonb whib IrE 

int Fention sludiB lhar dGady h!re bd .ui.d our (Roictq ct al., 2006; Ho6n a cr 

el., 2005i Sklcly, ci dl., 2006) &d rhis study lls ts reldr.d in r.duccd td.t ofburdo 

aner fmily psycno.ducafior md thii night als b. ! Hliliic ain for oltta 

In rhis 51udy th. Epon d 6l@id burdm we high i! borh 90146 .r rim of pE 

rssesDenl. Ihis bunld could b€ dre lo low fmily inoom ed @inly due b 

disntinulio! o. lo$ ofjob .nd rdded qpddiiws or Latbd! m.dicin., r,aspon 

ad rilG dnc ro hcpi1lliatio. mly noh hotu. As l!. d@enptics Fvar€d r 

ldg. ejo.ity ofpad..6 ws ool worting so fmily ws minry GpoBiblc for m€rilg 

nrancial nc.ft ofrlc p6li.nt. In Paldskn, lt't mly prcvjd€s ey bcndir or sskla&e 

to dEs cm Civ@ ed El.liv.6, e lle f@dal burdd ofc4 i! pEciic.lly bany. Thi! 

su886c rhar reh.bilndirc inrtutioN such s p.tidrt vmtio!.1 slitb E hi.g my 

nrv. . positjy€ itrpet on fd y burda. 

'Ir'e findinss p.rr.inins to ffmjll buden e. in aeIt@ wnh tn.t of Rougnl 

aDd Aubrg (20{6). h hir ltudy rhe mir bu.dd rport d w filmiat, BhlgFt'Mi, 

188

R vol (2003) rtrd D. Silva ed S. Silv. (2001) d5o fo6d nbddt lo w@ r@id 

b!rd6 in 86% ofrh. .ffetcd fuili6. I! pE@|'ndy fmily Duti!. ws dlo .rr..L4 

di!ruprjon of dtinc rtivitie 3c4 midy bc.u. of th. Md of oG o!. l@ti!8 

.nd rh. prti.nt'! *dviti6.Thi. fbdilg ir alF ir lirc wi$ thc Bh.gFlFi ed Rad 

(2003) who rcpond . ri8niflot dsrplioa in oudtu &lividd i6 ElaliG ofp.li@tt 

An inpdt !t firding of th. Flgt nudy i! $|r lh@ i. ! 3i8njli@l tdalion in 

buldd d.u $. dit)@ioB of fmjly burdla followhg i dvdtio!.t dE follow W 

aciffit in Fylho.du.lid grorp. SigDifidl .hx86 .ncgd in G8!.d b eaiF 

of fmily nmb6.'Da wa de. mat d inDrovffit in did El.doe soid 

int tudon eih fmily nH$6 awlla h @rujty iftF5.d, 

A sigrifcet i!.tq$ wa do fouDd in l.im divitic., cliolr ud AD y 

l|mb.r prnicip.tiq ir mE !.liviti6 ru.h $ dLrding hnily fonctioM d tuilg. 

ffii6 or to go for 3hopping, Tbc Gulll @ in .glaMr will SL.l.y.!d 

Shwd!.! (2006) rh.y rlo '!fori.d . .igoifi@r icdFrion i! th. butL' r.lt by r.DiU6 

.rd e inp[or.fur in qlrlity of lia. of fDily nEnhas in thcn $dy .t po.t 

i .FdridtimIL*culr@6dhq$p!on dby.ihilfrtudi6(RoicL,.rd., 

2006; Muy, ct.j,,2005i HofiiEt! ci rl,, 2005), Ire fldin$ N.Lo !ut6t!.ridd 

by Mrsli@ i'd Mirr€ (2005) wlb !!rqt d I rFrid detlE ir budd !.@ !ft.r 

Fovisiotr 

of pdycho.d@tionrl inrflotio.. Thir &@EFrra .fi*ri6d of nmily 

p3 rho€deridd iatdcnrion in p€ridtr wirh schiaphmi.. 

Howdd, rh4 ftrdirg. e rcr i. .grem@t with rh. Eiull! of Bmftl6u8L 

T6i6. t pis, Dd @dcg8 (1999) 6rpu.d .flicey of fdily slppon alo. d i! 

189

conbination {ith psrho sial inlEvorio6 ed foud tro chdgc i! rwo gn46 in 

l.m! oa fmilyhudch, No chdge had occM.d fionbse lin 10 six mrth! folow up 

in buds sm in th.n dudy. h @n plrho aducation goup, Ehriv6' d@irl 

itrlhctior ud lcise .ctiviti6 w@ siifi@d, mF rfier.d .!d me Guicrio d 

sial ictivity w6 qpdi4cd by relaiivd corp&d ro F do.duqtion AoW rni. it 

consisleht witn 6ndin$ of Mrglido ed @ll.a8us (2m2) Kouik!, Msdisld md 

.ollogues (2006) md .aliq siudi€s by WiDS dd ollagus (l9A) aql Waiq ad 

Nonhovq (1965). Tr'e nndingl @.bo i! lgttdat witb thG€ of Sonjlh 

Schiaphmi! Rs.eh T@ (198, wh@ rchtivd r!?ort d rut d dieqrior ir 

wial ud leirw &tiviti.!. 

Ite diNptio! of ebnv6' leil@ wd significdty Ehtcd 10 pariofs positive 

stmprotu rnd gndl F rhop.drolos (M.glino, .r rt., 2002; wolrl!$, & DircmlD, 

2002i Kouitr, & Mldie$A 2005; Roiclq .r .1., 2006) M .Lo fould rhll sdfty of 

raychopalholo$/ od ryrnprom lfet d llte !6tlboloSicll n .]{1 ofthc rhtiva. 

'Ihe fndiry of fmily ircom, nmbs of hospitltizjrio! &d g.n@l 

p6trhop.tlolo$r wcE lh. @in plq,icioB offnitt budd. Tns fDdin$ e i! tirc 

wnh th€ firdirgs of o$d studid (Roick, H€ida, Tomi & AlgmF 2006; Maglie, 

Mdasco, Fionlio, ct .1,, 2002) wnde in@sed budm wa 6s@iarcd wilh hieh{ lev€ls 

or p6tcbopalholosy i... wi$ positive ed lceariv. t nptom. 

Ite f!di,8 thrr p6iriv., n.gat vc sFpioN .rd C@qit p6trhop nobg' e 

pndicroE ofFor FlcholoSjcd nalrh oflh. &tatis is @Bisrdr Mrh fldingr oflh. 

(DrrL Snon, & Vilrliso, 1999t Kouti4 MsdjoMn,20o5i wolrhm, Ding@, & 

S.heDc 2002). Tt tndings oltn.F snldi6 esd.rcd f@ily burdeD wjlh Fsidve ed 

190

n eltiv. sFptom ol th. paridr, which c.s ihe dinr* rnd sxidy in rclatvd, 

Fq 6ndies hlve focu&d o! th€ distr.ss Bsmilted MIh de ilh6s {d hiv. 

qojrcd .II*ti of p6Jcno.dNdion @ dicty .rd disltBe in td ie BiEhwo.4 

Snjd', dd C@nM€ (192) fosd signilicdt r.dwtio6 in str€ss dd diety lev.l 

tponerl by elltiv6 an r $on duation ofF thodutioD Similr fsding! wc 

Epon d by Ab''mwir.!n Coury(1989) who had sir.duc.ri@t sim wilh 

fmily rcnb!6 of Mtilly ill pesB. Itey r.poded siglificlnr Fdrcli@s in felt 

disf€s ed exi€ty ii Eldlivd rnd e ituIt4 in c.ping b€n.vior, Ihe pEtrt'tudy did 

nol t@B on diety.!d disdes bui @incd bunt . on fimiti6, D€rasdbud.! iD 

all dindsionr followirg fmily F 

€hoed@rtionrl inlmdtior hightigbrs lhe 

inporlrec ofircorpoEtirg pstrho€ducaiiotul inrervdtioB ijio rclrin€ tresrncnt ptd 

tindinS! or&i! sludy did el show oy itrlp.ct on phrEic.t {d p6rboloaicll 

nml1n ofGhrivs. ftouSh sd. Elariv.s fell difijculi to cope. a subsimiid pbponion 

M8.d ro copc wirh t[. illR beh.vio. of rhc pdidr wilbout ,ulfqing tob 6y 

ph'sicd ad FFholosical ill cfers. Ilee findinF & in coMDae wirh !h. finding 

of Oldridgc hd Hueh6 srudy (1992) whjcn sh@€d lower prd.lo.e ofpsrnobgicat 

halth poblm ed h.nd copirg witd the ldidfr pmbte@ How.va, rhe tudilgs 

re nor ir s .Ee€mr wirh tudiq. of sconi,h E@h gFup (t98?) shde @& |h! 

75% ofdc c.rc givds rc?oncd hnving p6ylhjanic pebl@ rheruelvB. 

A coaid@ble rdrction ir faDily bud6 m be &|ticved |nough pbvisio by 

8ov@.or of fEe or n@h Nb3ided psFhi.Fic rGallnot thc qt|bliBhml of 

l9l

pltthilEic dits at dillicr dd Teh*il ldel hoqir.h. Elr.hlistmnr of c@ity 

psychi.hic .liniq * min uil l@atid! co'!d rlso r.dke &c 6@cid burd6, tmus! 

Eduing dp€'s @ trtr5pofi.tion for folow up visib. 

the @jodty ofPlnicipllitrg Ehtiv6 i! Oi. rndy .!d olla Dhr.d rndi6 e 

wons, so .p€i.l .ndion should b. plid lo thcit rc.ds in ordei lo h.lp thd .ad sha€ 

rclpo6ibili1i6 th.t lhce .aB hav€ trkeh on, w.t! of disFibutins th! duty of cd€ 

.|Me rclariv6 or drd

Clioql incflcotiotu for fdilid e on.n dclivered who paiidt tu in &!te 

phe dd e disrrirlcd who be geE 4.lle. Cliniql ob6flatio. rugg.3t $c n €d 

for@otinul i dcntioG with fdily Imb6.v6 rnd synpro8 hrvc deds€d. 

Multiple Imily gmlp€ cm ptuv. coct .f-tivc. Thce sdic6 sno d b. oftocd $ p.n 

of rcudne wiccs in psycniaEic our prtiert!, b.oau. involvddl of th€ fdily 

mehbers in lrc.lnaot pld h6 ba preyd ed Glociot d vith betrd out co@ j! lone 

lm (Pdlict, Ros..helq & r@zrsLi, 2006). 

b p€rtho .dKlion wdl i3 d@€ on cogniti* lwel witb rclativg snd p.tia i of 

SchizopbEni! tnn h.lp! $d 10 ud6Lrd ill@s dd tne diE n cd for trqrnft. Tnis 

My suSgst lncn 10 accept lh€i illn6! ard inc@le adh@ce to treidndt s lte 6uli 

ofircEa$d !w@re dd fdilidity with rqtrncnt kchdques- PsrclD.dqtjon @y 

help 10 r.dwe rli&m!, @Gt nythr dd to mclio c prjrdiG bw.rd Md illlB 

ty pbvi.ling infomtid in . @r€xr of cultu l Eldee, p.Fto$i6t inr.ddrions 

rcbym @M sub itut s forpb@tha.py in @jor plrhianic illnc!$! IiLe 

S.ntopnmi4 bui tlrcsc my augndl in porctiDg palidts nom stnpion dcldiontion 

4 well a cnhecc @dlplime wiih mi cMe l,!r!n@r (S.lt@lo. Kcir\ S.qq ei 

al., 1994. 

Burden on th. lmily !l@b6 rL{r.e! ilpltior i! Ntiv.rcd to rd. inc$ire 

ue of trealmol opportuiliG. Pstrniltrist and clinicll psrhologisls .hould rnonSly &d 

enpdhetically encom8e deir patidts 10 Bc !.ryics leh 6 shelr'ld wort ud orh6 

e* eld€d &tivilic.r o. @i6 for sEuciultd *rivitie As *lt s sid orn d5 and 

mr sir+ly suss€t rhm m.djcira Fmilid rholld bc in@tved i! rhis ptG rh.y cd 

nrn}ta mnv.€ thc pllimt. Psrrho.deation h.lps 1id !o ud6t nd abou, veious 

193

wiq ud olportDitie of !6trbirrric 4 rryica Ihe fdc mw shoutd be @ thc 

ilclBion of fdil,6 i! rh. ft|lmr pld dd Ehlbilihrive p@6. 

One ch@latlic ofrhb dtudy ws &at th. patioB ed th.n d.dv6 wq. 

6run.d fton od pltianr clinic6 ulite 'My orha srldi6 {Mc Credie. PbniD6, Hd.y, 

d .1., l9l; Snirb, | 992) ebich harc nigh Gt!.| .nd dmp our .d., rhir lidy t& m 

Etu .l md a very low dtop olt nle- Itris could bc pcible; pdt4! drc to fr€ 3upply of 

tudi.in* al lca51 for a mnlh aier e&h follow !p, this poed a g@d agagd@l 

sfdL&/ tu prdat 6d rclaiiB, Il is mrru. th.r dep ou1 w@ fd f.Diti6 *tr v@ 

Iiviry .t f.r ollpl&6 rw.y tlD rjhoF !.d h3. io ryad ! lo1 eF mrcy on 

trbrFtulion dd io Adc . lo1 of tine io drdd rhk sniccs. 

Oustudyna evcral rEagrhs; n'sthc ti6tsludyofits kindin P isr.nqh@ 

fdi[6 nrve be! ilvolv.d o pr.r of drc m4@@r ptin. S€dd ir *s cddErcd in 

M.'e hc5pit l bboE ehich ir 3inded i! U. colDt ciry sd pandr tlD rt. wnob 

Pujab ac efd€d io rhis iutiture bdue ir i! on. of $€ old€lr md biga6r Toching 

Ho+it ls in Asi! $ lhc..!lplc l.mit d t EpsanliiE of rh. FpuLtio4 s oD ry 

thrt finding e C6cFli.bl., 

5.5 Cllnl..l Inpllcrf onr 

This sndy emind cfficrcy of pltrho .dlcdior h lh. qt clinicd peaticc, 

wt@ p.li6t heo@ o .ri!c p.niciFqd in d.n 6.EFnic p(o6, sFi@ilg 

inpdcm.nt rcl only iid . clidcd vid poinr, bn d$ e ow .lt iftM!.d 

Frrhologi.al @llnesr, Eduing significetly th. bad f*litrgs cru.d by the di$ds. 

Inp&'ed our @ft for prridrc enr.d witl ilmlrmnt of fmily mb.6 

i! rlc lsElal my b. rcl.rcd ro Edrdion ir bud.o, giva $d tosd tdd of hrdm 

t94

hav€ beetr shoM !o prodict b.na our oom in pati6n6, 

'I1re pEEnt !tudy ta prcved it! .fnc&y in t iucing r€lapse rlt and in 

dc.Eitrs sytDbn &vdity i! patiots wnn SchizophMia 6 wcll s r.drciog th. l*l 

oaburda h fmily hmba of lh* patiml!, lr pevid.s widtu. lhlt fdily F lho 

.dualion had d adddd .ffe1 wha @nbh.d with 6ulin€ treotiMt Srch gF of 

neatrnql Fd@ed lhe risk of Elap6e $ itt wonh while clinically lo w .oDbine

uiry lsgq sql6 dd {ith long tcm follow ups elld b. clinically wonn wbn. b 

Fovid. tun[q rid@@ abour ft em*yoalh* i crdtioB in ou@mtry- 

Nmb6 of Fycno cdution l Bim s only r.n ed ir k $Cgerdltal Oi3 

preCm @'td b. nfind iq@v.d i! tcm of rwba 016{06, it Ds of disNion 

md rcle ofthc fdily md lhe patisls in lh. phc.sr in odd ro bettcr minrdn lle 

posnive our co@, &d for lhe loneer sulriMbiliry of $e &nis.d soal. 

Ihis study did .ot sploE wial llppod f.mily nob6 Cpl 6on d@ @ial nct 

vork or rhe nu$d of hom lhey reivcd llpDon o. ey olhq p@d@l suppon t[.y g.t 

, lcycl of dotioMl suppon also mr @dcd n'k @uld b. the ilre€t of tutue Fs@h 

Furhd mdomizld hials wnh noE inprevcMl5 in Nthodolo$, sbodd be bied wirh 

Irslr snpl6. Scal6 6ed in th. p|wnt !!3eh D..d 6fiId v.li&lid. 

Pators ed t!. famjli6 wbo dlircd F)eho .duetion w@ sierlifiddy 

idlpmv.d. Th€ psycho eduadon gdp had @ El.ps rt rh. sn mdh. lolow W dre. 

Th. seventy ofFFhonc symploru wa .l@ educ.d in patrho educarion go(9. Psrho 

.

R.f.r.trc.! 

Ab!!@viq 4,, CoNey, D, R (1989). [4&l of e .duotio$l .uFort gDup o! 

fmllt pdicip.nc who r.tc ce of tn.n $bjzoplmic Ebtiv6. Ja!,E/,/ 

Contuli"C hd CllnLal Pr.holop, 57P),232-236. 

Aglglia, E.. Flbdci, E- P., Bdlo$i, !-, & Bsi, M, (200?) Pljtrho.duqrioml 

irt Rdd@ dd p@6tion of Ebos mog $hiaptoic died6 ir th. 

ft.lie comny plycl .tic ne1 worL Clinical Prcti@ anA Epiddiologr in 

Mertdl sealth 3(7),)0. 

^ri, M' & Ahrd, E. s. 0 98E). Seirl sllporirysld &d flnily budo d!. Il, chFnic 

Schiaphmi! in tuif dd urbe bekglotud l"dian JMI of psychiahy, 30, 

349-353. 

AIoy, L. 8-, A@Ia J-, & Bst ;i\r-L (1996). /b,od't p'r.hobst.v,ql 

peBpctiw,

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lndy ofEf.riE ofschizop[rbi. priq|!. &cizl Pr]zhtotry aad ktthttttc 

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BmA M., Go.r\ R, S,, Oru.., t. M. R- ( 192), Positive ed Depliv. lyrnptoB: 

Rel.tion b lmilial trdsissid of S.nibpltqi4 Errish JNnot oJ psltNtatry. 

i61,6lG6t4, 

Bamdou8b. C., H.ddocl! G., Tni6, N., t!si4 S. w, & Robi@ll .,. M. (2OOt ). 

Rddomiz.d conlrollcd rial of @rivarion.l inrervi*, i rorion forplrie|l 

wirh SchiephMia ed snbsrre€ nisw. thencm Jounat ef ptttltta,/r, 1 58 

(tq,1106-t713. 

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dpBsd mtim in Elaric of p.dcnr $fdins nw Scniaphmi' It 

Rritish Jortul of Pstahiatr. ! 71,26-tO. 

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B@wdoud, C., Johsro4 M., Tmid, N., ( 1994). AtFibutiotrn ElpBed mlioc 

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200 

Bd@4 G., ,&t$o, D., sd.y, J-, & we&u4 J. H. (E G} (1981 ). TMdt a th.o,r of 

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^ 

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Jdndinvh,.l.r2, 173,179, 

BelldL A. S,, Har{ C. L., &1@lo, N. R & FIo.y, ,. D. {2OOO), Ef@rs ofb.hryiod 

tdily mlg.lMt or flDilycfuuiotion Dd p.riar ourtuB in 

Scniadtraia, Bntilth JMal of Ptychiatry, 172, 434439. 

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PF6!€|! for r @girivc dqcloptDdtrl .@ut of F dolic .xpsitu6. ,rriri 

Jounal ofclinial Pt .tologt,16, 155-r7t. 

B.N4 P, (2UJ3), AbMl ad.lki.al pq.hologl: ,1n ianodt lo.y ted b@toA,l4+ 

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Bmron, M. K, & &brc€da, H. (1990). sdill lkillr tlinine wit! $hiapbrqics: A 

Mela snalr$is evllurion. J,,nal oJ Coitrltlng drd ClirLdl tu .hologt, 98, 

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rncltsis of @mbiqtion ddiecc in ihc f.nilie! ol Schizopbdh patiots. 

Ptttttot r, 58, 6-19 

vatur., J., Nuahdlir\ K II., & Luctotr D., .t .1. 0989). 

A ptD+etiv. .l!dy of 

srBsfin lif. *mts in SchibphMit tul?pe, Jutul oJ.4b"otul Ps!.iolog), 

96,tO74ll_ 

vdtu!, .,,, Nu€l&n.iq K. H., llsdesty, J. P., Cidtr M. ( 1992)- Life ehts ed 

*hjaphmic El.p6e and eiur drwl ot 6tdi.î@. Btuilth Joml 4 

PstthioD, I61 , 615-420. 

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evqtg in S.hizophrqie Jo,/,4, o! Int.n4tionol Nd/opt tholog & S@iolag 

8 (6). 86t-866. 

waddiclon, J. L, ( l9l), M@huitru ol.ctiot oft Tiol 

md . itlicd etipsltholic 

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$atp.a;n poq@t . Clinici^, I I A, 45-52. 

walz, c. P., ksn i s., BsdDl, J,, Ki$ling w, & Eng.l, R (2001) Th. cfl-t of 

fdjly inh.ntiotr or ftltPs in SchiephMia: A m.l| e.lr.is, Scrtolr.ae 

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u3 

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cl:'ll.Jruity. Dritith Jutul of k .htatrr,, lll,245-267 

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oultuslly i.fomed fmjly focu!.d rqbncnt lor S.hieplmia FztltFd.$. 

15(2),17t-t86,

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746

Appendixes 

241

APPENDIX. A 

DIAGNOSTIC CRITERIA FOR SCHIZOPHRENIA 

Two (or mo.e) of the.ot,owing are presenr for significart port,o_ oft.me 

ouflng a r month perjod (or less if successfu y Eeated). 

Delusions 

Disorganized speech (e.g. frequent deEitment or incoherence) 

G.ossly djsorganized or catatonic b€havior 

N€gatlve symptoms i.e. effelc{ve Ratterjng alogia, avotitjon 

DIAGNOSTIC CRITERIA FOR 295.30 

Pa.anoid type: 

The foltowing crit€ria a.e met: 

n 

! 

B. 

;1ffi;TiiT,H:T#" ". mo,e derusions or rrequenr 

None ofthe folowing is promjnent: 

a). Dtsorganized speecfi - 

",?ff;?#lif"L::i:"nic behavior or'ator 

3$[]"1,]f";1'*'^'"*,".'o 

I 

! 

E 

! 

n 

D 

A. . Allofthe following are prominent 

l Disorganized speech 

2. Oisofgani2edbehavior 

3. Flat or inappfopriate effect 

B, The c.iteria are not nret for catatonjc type 

243

DIAGI{OSTIC CRITERII FOR 295.20 

Catatonic Type 

A type 0f schDophrenia in which the cllnlcal pjcture is domjnated in 

two of f|e followlng afe present. 

l-l r l4otoric immobility as evjdence by aatalepsy (lnduorng waxy 

flexibllity 

nz 

of stupor. 

Excessive motor actjvjty (that is apparenly purpos€less and 

not inlluence by external sEmuti) 

tr-'l . 

Exfeme negativism ( an apparentt mouveless resstance to 

n.q 

all instiucton or haintenance of a dgjd posture aganst 

attempb to be moved or mutjsm. 

Pecullarilies of voluntary movernenb as evjdence Oy posturing 

voluntary assumption of inapproprtate or biza.re posrures), 

stereovped movemenb, prominent mannerisms or promhent 

9rimactng. 

Echolalia or echopraxia 

DIAGI{OSTIC CRTTERIA FOR 295.90 

UndiffeEndated TypG 

A type of schizophrenla 

are presan! but the criteda are 

catatontc type, 

symptoms that 

for h€ paranoid 

meet citerion A 

disorganized or 

249

DTAG]IOSIS CRIIERIA FOR 295.5t' 

R.aldual Typar 

Th€ ltllowlng qlt€ria are met: 

! I Ab6ae of prcntnert ddu{d|s, ha&Er|.loot dtsorgdhed 

Ie. 

slaecl) and grossly dlsorganlz€d or catltontc behauor. 

TheF is coatinulng eaidence of tha dtstrrbance, as lndicaEd 

by the FGanoe of negdtv! syr|lpbtrE 

250

APPENDIX- B 

IDENTIFYING DATA 

n NAme: 

Ser I lvtale 

!! Female 

Age or Oate of Birth: 

Occupadon :Eefore 

Current: 

Education: paftofs income 

llariblStatusi 

Birth order 

Family monthty Income _ Ulban I D RuEll 

No. of Chlldren: 

. Un-maried 

. Oivorced 

Lives with: 

. Spouse 

. parcnts 

. own 

. Other 

PsvchlaEtc Historv 

DIVS-IV Dlagnosls 

Type 

. catatonic 

. Disorgaoized 

. paranoid 

. Undifferentiated 

. Residual 

! 

n 

! 

! 

n 

nr 

! 

D 

! 

Tr 

if Yes, Dtvorced before j ness 

Or afur illness 

! 

n

l 

I I 

I 

t 

t 

1 

I 

Age at the onset of disorder : fE years old 

Age at the time of |lri psychiahic hosphallzauon 

Is the padeit hogitaflzed at Fegent yes 

N0. ot p€vlorJs p6l$iabk hosdbt atons 

No. of eplsod€s or Elapsed 

X.lff t n* t *-ut of neurulogicaror pslchrabic rness ln be 

If yes, spedry reJadon 

m 

NaUIE of lllnqrsi 

252

I 

I 

I 

I 

APPENDIX- C 

R€: Request 

From inowadat hu$atn lana 

(mhrana786@grca .com) 

senti t,tonday, Apnt 07, 2008 

12t39146 AM 

io. tlnveer nasr 

(tanveernasrLAholmait.com ) 

Dear Mr Nasr, 

Thank you for asking the permission to use the Urdu verston of PANNS 

trangated and standardtsed by us, 

flease conslder_this e_mail as 6 vatid perhlsston docrJment, we at the 

ytr?:trxi:lTJ,.ili,g#rr.ue nappy to assrst yout; ;;; ;;;;:i 

w_e ll s:nd y-ou the copy ofthe Urdu verston ol PANNS ln a coupte of 

oays at the prof RLkhsana Kausar,s tntve6lv aooress. 

YYrm oest wtshes 

lvlowadat HY Ran! 

Prof of kychta?y 

Head Dept of psych 

llilttary Hosptt l Rawatpindt 

On Sun. Apr 6, 2008 at 4:23 pM, tanveer na

AIIENDTX- E 

r-_-r...|..- 

GERTIFTCATE 

JANSSEN-CllAG,rrrt'rs 

4as surrr!;slu//y tonphl a lraining s.gsion on 

*ffi 

Dr. 

'Eualuadon of PAIISS- 

(Positive and Negative Slndrofie Scale) 

200L

Dear Mr Nasr 

APPBNDX.FN 

uP/ 2OnnK,493O4 

Dave Ja9o (djagoOr:cpsych.ac.uk) 

:You may not know this sende.,Mark 

rs safel[4ark as !nsalQ 

Monday, July 07, 2008 

4:07:26 pM 

ta nveernasr@hotma il. com 

Thank you tor yo!r elrdit. Copy.ight in artictes pubtished in thc 

British Journatof psychiatry is assigned to the Royat Co ege of 

Psychlat.ists, so I am abte to hetp you with this without recourse 

(o the authors. you are very wetcome to use this scare rn your 

research or ct'nic.t.work- C(Jpyright permission wouro onty be 

Aquir€d if you wished tr) reD.oduce this scate in print o. ontine, 

in which cas€ you wouid |eed ro let me have funn€r detaits, 

Head of Publications 

The Roynt Co[egc or pryr ]i,rlrists 

ll$P-Zwww.a-eBsych. n. I I k 

262

@,-** iiLffiHi#^,'.affififfik- 

Pol Dr Riaz thafli 

Head of Acad€mic Depaftnent of psychiab.y 

And BeheMo.at Scjences Mayo Hospjtal 

O6ar St, 

Hope hat you are keeping ws[. tam Mting tih to cedt that lvs. Tanveer Nasr ls a rcguJaf 

slrrdsflt of Ph.D. prcg€m ot the Oepanment o, psychotogy & Applied psychotogy. Her 

Ph.D, R6earch is on psychGEducalton ol the patents wjltl Schizophrenja Io prevent 

:]::::'-.n: "y. . .*, dara ron varous ho6p a,s. I uri much apFeciare ., you 

enory auow ier to cdlect data of your parienl to ,aciltAe ier .esearch u/orfi. 

I tvould like to exiend ny thanks for you tdnd cooperaton. 

YouE Slnc€rely 

Dr. Rukhsana 

ChalFerson 

fr.rbt ... t.riril| b 

tL. !|''. Ld.l l-n|'. 

tdt l Lb 

Ptbne tr_0, sz+.earzr#;;iD;Ei6i 

Ent inro@aplEy,lu.€du.Dt 

4p

* our*or*tifil'^l*Eo rsroo,.oui *,' -,fffi 

ufrvERsIIY 0F IHE pul,utB, 0t Afi}{rzfi clrfirs, t A,toRE 

H.ad, 

Dcpdhldt of ?srclirrr , 

Str Ganga kD Eorpitd, 

Dar Slr, 

Hopilg tha! yo! e !*pin8 yeu ! 3r si!!g &i! 11..t!:4,td I4r_ le€ Ne i3 ! Esuld 

slldld ofP!,D. hog@ ofthe D.psrrldr dfpsycholog/ & Appli.d rryhotoey, Ha ph,D, 

dsrh is d PsycbeRledion of t!. Padds Schia@oir io pcvdr al|pe, Sh. !..dr to 

co!@t datr 6@ wios L@pitak. I wju dwh spFciatc ifyou ki!.Uy altow bd 10 @lled dlrl 

of you paticds ro flcilirlc ha ac@h rclk. 

I sodd li!.; dldd EJ, r!e!j for rou tird @pdlrid 

{hot Di Rrllsn. (iurll 

Pho!. No: ,2-4t923124s Fr: 9-at9!1801 

En.tl: infoA$b*.or.dn.pk 

^)\t" 

t

DEPART EITOFPSYCIIOI.OGYTAFPLIDPSYCTIOLOGY ]82 

UNI/ERSIW OF THE PI/IIIAB, OUAI}FAZATI CIMPIJS, LAflORE 

To the M.di.d Supaiot nlcnt 

Plnjab hsridc of Menlll H*lth 

HoF rha yo! @ tepin8 *ll r m Miring this to cdtify thd Mr. T&verNe is aEsulr 

lfudcnt of Ph,D, Prcctm of rhe Dcpano.nt olPsycholory & Applicd lsycholoSy, Es !h D, 

R.sdrd is on Psycho,Educarjo. of rhc l,a.ients {nh SchizopbEnio to pEvcnr Elaps. She 

n6ds ro coll€t drr. toD v.rioE hospirals. I will neh lpFEjsl. it you tjndl/ dtoe ftd b 

@lletdrtaofyoupirie b faciljrate hc! rcqrch ftit, 

I muld lik to lxtad oy lheb for you ldrd aop.drion. 

,.(.u{ 

-\{t\dl 

onlrusnlr rhgpmu 

ciiet contllh.r Psv.hlrtisl 

PuiFb lnsdtule ol lhnr.l H.allh 

Phono No: 9.42.9a1a5 Fdr 92.a2.923t8o1 

Eruilr inl@aoo5v,o!.odu.pk

TJMVERSITY OF TIIE PT]NJAB 

CONSENT FORM FOR THE PATIENT 

$,-( a - n J e A f- I t 

283 . 

DEPAFTIIENI OF PSYCHOLOGY ANO 

APPIJED PSYCHOIOOY 

O!al4+A2m CmpaB, 

r!h.c.flakj.ian 

idt U-42.9231235 

L, I t, 

+r 4 a 7 - u't 6 )'4 / t/'4 J t2 u( 

-+v(Jt7t 

- - - - - - - - - - - - - - - - /'r 1 u 

___-____-____-_ /-rF,

APPINDIX.J 

UNIVERSITY OF TIIE 

CO SET{T FORM FOR RELATIVE 

PUNJAB 

: 2a4 

"*ffiESJ"ffi'*, 

oi[id.{un catfu 

L!i@ - patdsb. 

t t: 9a42-923i23s 

4 /,t ) u8 L/L tt',, I d.r,p-g ug ;, L, t, E L,-,i 

t!/{t*,'9w,.r.,t'fol7a,;r_*pV6lirrf 

:f -LU.yt,rt 2^-Lc),t;L_ia,,,t *tin_{rt*.C,,i,41:* 

)/:V,y'i 

rblJ (tt 

.'bitE?:

A?PIIJDIX-X 

'r&LK Dcwgqhtc ard cltnt al wta .t atydctott 4161, M.n @i 

dsilwdt totd wplt) 

o .Mo wttblt - FINBtal Bttrtu" (lt' 3,90, p

PPENDIX.XI 

T&t K-i Dr@sdphic a,.t ctini.at rdi.U.s 6 panaut oflnity M, (pt - 

6EM.t, total Mnpl.) 

ard@ wiabl. = Routire a*.hn (F - 1,57,p

APPET{I'IX.KII 

T.bbK-ii D.tusaphic a'd cliri@l wtobLt 6 p,.dtctds ottdil, bud.d An' 

deB4cn4 total sadPl.) 

LRz =0.t2 

Ott@tuwit hL =r't@. Bv&n (F = 248, p

APPENDIX-IOI 

T&Kin ,tfrogtqdn arddnettwtdlaatFddon{hltr M, b- 

a...'er',old @) ' ' 

Ad.fir,drdL - t,taertu (r - r.8i, p

AppENDIX-Kiv 

Tdbl K-iy D.nosaphic dd clini.al eariabtet ds pt dtclots ofjdniu brrden (pe- 

Oden. v a e :Phrsicat h.utrh (t - 06A p

AppENDIX-Kv 

Tabt K- v Denographic ad ctintcat wtabt.s at pQdictott otJantb boden (pe 

6s.sth.nt, btal t6Pl.) 

Otttu wiable - Pstct@toaiat bdrlh (F - r.16p

'r^bt t, t m)Nr.t,hit dtkt .ti'ti, tt tut nt)lA st pr..lt4o( of]'ntil! b*.lor (tD!- 

wettunt, NtfhoeAration ontl ko" psy.h@drcotior gotp s.pnrel) 

Ortcoue eniabl. - Fiaahciat buden (F = 1.88. p

APPENDIX.LI 

TobleLn At@ whbl. : RoutiQ (F : L$, p

APPDNDIX.LIi 

Tabb L ii O|tcow wiabte = L. tuut (F = 2. J 9, p

APPENDIX-LiiI 

'fable L-ni Aucow wdabl e = tnte ructioh (F - t. 4 2, p

AppENDIX-Liv 

TabL l,-iy Our.oN wriable - Ph$kot healh (F - 1.27, p

AptENDIX-Lv 

Tab]cLy Adcotuwttbt - pttchotoCicc! hattt 1p - fia, p

Tov€er Nasr

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