Psychophysiological contributions to clinical assessment and treatment

Abstract

Psychophysiological measures have been extensively used by clinical researchers to investigate phenomena associated with the psychiatric construct of’ schizophrenia’. In contrast, practising clinicians have rarely resorted to such measures either during assessment or the course of treating these disorders. The major purpose of this chapter, therefore, is to attempt to construct a bridge between clinical research and clinical practice. This will necessitate examining, first of all, the historical application of psychophysiological research to schizophrenia. The various rationales for the use of psychophysiological measures adopted by clinical researchers will be identified and critically appraised. It will be argued that in order to provide an explanatory framework with which to view the plethora of research findings in this area, theoretical models will need to be developed which explain both the production of schizophrenic symptoms and also the role of psychophysiology in their study. Particular emphasis will be given to vulnerability models such as those proposed by Zubin and Spring (1977) and Nuechterlein and Dawson (1984). The use of psychophysiological measures to explore such models will be reviewed. Finally, the disparity between the use of psychophysiological measures in clinical research and practice will be addressed. On one hand, the limitations and obstacles relating to the application of psychophysiological measures to clinical practice will be discussed, on the other hand the potential advantages of adopting such measures for assessment and treatment evaluation will be outlined from the perspective of vulnerability models.