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The Institute for the Study of Human Resilience has negotiated with publishers and authors to offer several full-text educational downloads of resilience, recovery and schizophrenia writings. The resources are in chronological order starting from most recently published.
Harding, C. M. (2003). Changes in schizophrenia across time: Paradox, patterns, and predictors. In: Carl Cohen (Ed). Schizophrenia into later life: Treatment, research, and policy. Washington, DC: American Psychiatric Publishing, Inc., 19-42.
Intro: There exist two polar, yet accurate, views about the outcome of schizophrenia. Huber et al. (1979), after studying the outcome of schizophrenia in 502 patients for more than two decades, wrote: “Schizophrenia does not seem to be a disease of slow progressive deterioration. Even in the second and third decades of illness, there is still a potential for full or partial recovery” (p. 595). Nine other such studies agree. Yet today, we have dayrooms, shelters, and public mental health caseloads consistently overcrowded with persons chronically languishing with the diagnosis of schizophrenia.
Download fulll-text: harding2003.pdf
McGuire, P. A. (2000). New hope for people with schizophrenia. Monitor on Psychology, 31(2).
Intro: Early last year, when Ronald F. Levant, EdD, sought out colleagues to support an APA miniconvention on serious mental illness, he told a group of fellow psychologists how recovery from a major disorder such as schizophrenia was not only possible, it was happening regularly.
Read full-text online: http://www.apa.org/monitor/feb00/schizophrenia.html
Deegan, P. E. (1996). Recovery and the Conspiracy of Hope. Presented at: The Sixth Annual Mental Health Services Conference of Australia and New Zealand. Brisbane, Australia.
Brief Excerpt: ” . . . recovery is a process. It is a way of life. It is an attitude and a way of approaching the day’s challenges. It is not a perfectly linear process. Like the sea rose, recovery has its seasons, its time of downward growth into the darkness to secure new roots and then the times of breaking out into the sunlight. But most of all recovery is a slow, deliberate process that occurs by poking through one little grain of sand at a time.”
Download full-text: deegan-recovery-hope.pdf
Text-only alternative: deegan-recovery-hope.txt
DeSisto, M. J., Harding, C. M., McCormick, R. V., Ashikaga, T., & Brooks, G. W. (1995a). The Maine and Vermont three-decade studies of serious mental illness: I. Matched comparisons of cross-sectional outcome. British Journal of Psychiatry, 167(3), 331-338.
Abstract: Background: This study compared long-term outcome of serious mental illness in two states using a matched design to assess psychiatric rehabilitation programs; Vermont subjects participated in a model psychiatric rehabilitation program, while the Maine group received more traditional care. Method: Maine and Vermont subjects (n=269) were matched by age. sex. diagnosis, and chronicity. Demographic, illness, and life history information were abstracted from hospital records by clinicians blind to outcome. DSM-111 criteria were applied retrospectively. Outcome was assessed by clinicians blind to history. Results: Vermont subjects alive at follow-up (n= 180) were more productive (P< 0.0009), had fewer symptoms (P< 0.002), better community adjustment (P<0.001) and global functioning (P<0.0001) than Maine subjects (n=119). Conclusions: Outcome differences may be due to Vermont’s model program and a policy of allowing an earlier opportunity for community life.
Download full-text: desisto-etal1995a.pdf
DeSisto, M. J., Harding, C. M., McCormick, R. V., Ashikaga, T., & Brooks, G. W. (1995b). The Maine and Vermont three-decade studies of serious mental illness: II. Longitudinal course comparisons. British Journal of Psychiatry, 167(3), 338-341.
Abstract: Background: This paper supplements the cross-sectional outcome comparisons of the companion paper by providing a brief account of the longitudinal courses of the Maine and Vermont samples across several outcome domains. Method: A Life Chart method was used to document changes in individual lives over the domains of residence, work, income source, and use of community resources over a 20-year period. Reliability studies between states were conducted. Results: Throughout much of the period, more Vermont subjects lived independently, were working, and were less likely to use community resources compared to Maine subjects. Conclusions: Differences in both policies and programmes contributed to course differences between the groups. System characteristics that may lead to better outcomes are discussed.
Download full-text: desisto-etal1995b.pdf
Harding, C. M. (1994). An examination of the complexities in the measurement of recovery in severe psychiatric disorders. In R. Ancil (ed). Exploring the Spectrum of Psychosis. Hoboken, NJ: John Wiley & Sons Ltd.
Intro: Results from five recent investigations studying the very long-term “outcome” of schizophrenia (in Switzerland, Germany, and the United States) indicate that no matter how chronic the cohorts were, approximately 25% of the subjects achieved recovery at follow-up, with an additional 25 – 40% improved, with achievement of wide heterogeneity as the rule rather than the exception (Bleuler, 1972; Ciompi and Moller, 1976; Harding et al., 1987b, Huber et al., 1979; Tsuang et al., 1979). In fact, these studies and other shorter ones (Bland and Orn, 1980; Gardos et al., 1982; Hawk et al., 1975, Strauss and Carpenter, 1974; Strauss et al., 1978; WHO, 1979) have shown that the course of severe psychiatric disorder is a complex, dynamic, and heterogeneous process, which is non-linear in its patterns moving toward significant improvement over time and helped along by an active, developing person in interaction with his or her environment (Harding and Strauss, 1985).
Download full-text: harding1994.pdf