| Peer-Reviewed

The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study

Received: 20 November 2013     Published: 30 December 2013
Views:       Downloads:
Abstract

The aim of this pilot study was to examine the effect of an exercise and token economy system program on improving quality of life of patients with schizophrenia. Thirty (30) patients with schizophrenia separated in three groups (control group, an exercise observation with tokens group and an actual exercise with tokens group) of 10 individuals, took part in an eight weeks exercise program combining physical activity with token economy behavioral treatment. Data included the use of SF-36 Quality of Life Questionnaire (QLQ). Experiment group B participants as compared to those of the experiment group A and control group individuals found at the end of the exercise program as experiencing less problems with daily activities and felling more energetic and vigorous leading to an improved mental component score. Overall, findings are encouraging concerning the effect of a combined exercise and token economy program on improving quality of life of patients with schizophrenia.

Published in American Journal of Applied Psychology (Volume 2, Issue 6)
DOI 10.11648/j.ajap.20130206.13
Page(s) 80-88
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Exercise, Behavioral Therapy, Psychological Parameters, Schizophrenia

References
[1] Acil, S. Dogan, and O. Dogan, "The effects of physical exercises to mental state and quality of life in patients with schizophrenia", Journal of Psychiatric and Mental Health Nursing, 15(10), 2008, pp. 808–815.
[2] Sibitz, A. Unger, A. Woppmann, T. Zidek, and M. Amering, "Stigma resistance in patients with schizophrenia", Schizophrenia bulletin, 37(2), 2011, pp. 316-323.
[3] M.M. Kurtz, and A. Tolman, (2011). "Neurocognition, insight into illness and subjective quality-of-life in schizophrenia: What is their relationship?", Schizophrenia Research, 127 (1), 2011, pp. 157–162.
[4] D.R. Jones, C. Macias, P.J. Barreira, W.H. Fisher, W.A. Hargreaves, and C.M. Harding, "Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness", Psychiatric Services, 55 (11), 2004, pp. 1250–1257.
[5] C. Roick, A. Fritz-Wieacker, H. Matschinger, D. Heider, J. Schindler, S. Riedel- Heller, and M.C. Angermeyer, "Health habits of patients with schizophrenia", Social Psychiatry and Psychiatric Epidemiology, 42, 2007, pp. 268–276.
[6] D. Vancampfort, M. Probst, T. Scheewe, K. Maurissen, K. Sweers, J. Knapen, and M. De Hert, "Lack of physical activity during leisure time contributes to an impaired health related quality of life in patients with schizophrenia", Schizophrenia Research, 129(2-3), 2011, pp. 122-127.
[7] L.A. Lindamer, C. McKibbin, and G.J. Norman, "Assessment of physical activity in middle-aged and older adults with schizophrenia", Schizophrenia Research, 104, 2008, pp. 294–301.
[8] G.J. Jerome, D.R. Young, A. Dalcin, J. Charleston, C. Anthony, J. Hayes, and G. Daumit, "Physical activity levels of persons with mental illness attending psychiatric rehabilitation programs", Schizophrenia Research, 108 (1-3), 2009, pp. 252-257.
[9] P.E. Bebbington, M. Angermeyer, J.M. Azorin, S. Marwaha, F. Marteau, and M. Toumi, "Side-effects of antipsychotic medication and health-related quality of life in schizophrenia", Acta Psychiatrica Scandinavica, 119 (438), 2009, pp. 22–28.
[10] S. Doğan, O. Doğan, H. Tel, F. Coker, O. Polatöz, and F.B. Doğan, "Psychosocial approaches in outpatients with schizophrenia", Psychiatric Rehabilitation Journal, 27, 2004, pp. 279–282.
[11] D. Crone, L. Heaney, and C. Owens, "Physical activity and mental health", In L. Dugdill, D. Crone, & R. Murphy (Eds.), Physical activity and health promotion: Evidenced-based approaches to practice, 2009, pp.198 –212, London: Blackwell.
[12] N. Ellis, D. Crone, R. Davey, and S. Grogan, "Exercise interventions as an adjunct therapy for psychosis: A critical review", British Journal of Clinical Psychology, 2007, 46(1), pp. 95–111.
[13] L.H. Beebe, L. Tian, A. Goodwin, N. Morris, S. Swant- Allen, and J. Kuldau, "Effects of exercise on mental and physical health parameters of persons with schizophrenia", Issues in Mental Health Nursing, 26(6), 2005, pp. 661–676.
[14] M. Fogarty, and B. Happell, "Exploring the benefits of an exercise program for people with schizophrenia: A qualitative study", Issues in Mental Health Nursing, 26(3), 2005, pp. 341-351.
[15] N. Schmitz, J. Kruse, and J. Kugler, "The association between physical exercises and health-related of life in subjects with mental disorders: results from a cross-sectional survey", Preventive Medicine, 39(6), 2004, pp. 1200–1207.
[16] J.A.J. Smits, A.C. Berry, D. Rosenfield, M.B. Powers, E. Behar, and M.W. Otto, "Reducing anxiety sensitivity with exercise", Depression and Anxiety, 25(8), 2008, pp. 689–699.
[17] G. Faulkner, and S. Biddle, "Exercise as an adjunct treatment for schizophrenia: a review of the literature", Journal of Mental Health 8(5), 1999, pp. 441–457.
[18] G. Faulkner, and A. Sparkes, "Exercise as therapy for schizophrenia: An ethnographic study", Journal of Sport & Exercise Psychology, 21, 1999, pp.52–69.
[19] J. Holley, D. Crone, P. Philip Tyson, and G. Lovell, "The effects of physical activity on psychological well-being for those with schizophrenia: A systematic review", British Journal of Clinical Psychology, 50, 2011, pp. 84–105.
[20] G. Faulkner, T. Cohn, and G. Remington, "Validation of a physical activity assessment tool for individuals with schizophrenia", Schizophrenia Research, 82(2), 2006, pp. 225–231.
[21] Richardson, G. Faulkner, J.McDevitt, G. Skrinar, D. Hutchinson, and J. Piette, "Integrating physical activity into mental health services for individuals with serious mental illness", Psychiatric Services, 56(3), 2005, pp. 324–331.
[22] L.H. Beebe, and K. Smith, "Feasibility of the Walk, Address, Learn and Cue (WALC) Intervention for Schizophrenia Spectrum Disorders", Archives of Psychiatric Nursing, 24 (1), 2010, pp. 54–62.
[23] S. Archie, J.H. Wilson, S. Osborne, H. Hobbs, and J. McNiven, "Pilot study: access to fitness facility and exercise levels in olanzapine-treated patients", Canadian Journal of Psychiatry, 48, 2003, pp. 628-632.
[24] S. Fassino, F. Amianto, G. Abbate Daga, and P. Leombruni, "Personality and psychopathology correlates of dropout in an outpatient psychiatric service", Panminerva Med., 49(1), 2007, pp. 7-15.
[25] D.R. Brown, "Physical activity, aging, and psychological well-being: An overview of the research", Canadian Journal of Sport Sciences, 17(3), 1992, pp. 185–193.
[26] M. Menza, B.Vreeland, S.Minsky, M.Gara, D.R.Radler, and M. Sakowitz, "Managing atypical antipsychotic-associated weight gain: 12-month data on a multimodal weight control program", Journal of Clinical Psychiatry, 65(4), 2004, pp. 471-477.
[27] G. Faulkner, A. Soundy, and K. Lloyd, "Schizophrenia and weight management: a systematic review of interventions to control weight", Acta Psychiatrica Scandinavica, 108(5), 2003, pp. 324–332.
[28] F. Dickerson, W.N. Tenhula, and L.D. Green-Paden, "The token economy for schizophrenia: review of the literature and recommendations for future research", Schizophrenia Research, 75(2-3), 2005, pp. 405-416.
[29] J.P. LePage, K. DelBen, S. Pollard, M. McGhee, L. VanHorn, J. Murphy, P. Lewis, A. Aboraya, and N. Mogg, "Reducing assaults on an acute psychiatric unit using a token economy: a 2-year follow-up", Behavioral Interventions, 18(3), 2003, pp. 179–190.
[30] R.P. Liberman, "The token economy", American Journal of Psychiatry, 157(9), 2000, pp. 1398.
[31] Turkington, D. Kingdon, and P.J. Weiden, "Cognitive behavior therapy for schizophrenia", American Journal of Psychiatry, 163(3), 2006, pp. 365-373.
[32] L.B. Dixon, F. Dickerson, A.S.Bellack, M.Bennett, D.Dickinson, R.W.Goldberg, A. Lehman, N. Wendy, W.N. Tenhula, C. Calme, R.M. Pasillas, J. Peer, and J. Kreyenbuhl, " The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements", Schizophrenia Bulletin, 36 (1), 2010, pp. 48 –70.
[33] K. Zlomke, and L. Zlomke, "Token economy plus self-monitoring to reduce disruptive classroom behaviours", Behavior Analyst Today, 4(2), 2003, pp. 177-182.
[34] J.E. Comaty, M. Stasio, and C. Advokat, "Analysis of outcome variables of a token economy system in a state psychiatric hospital: a program evaluation", Research in Developmental Disabilities, 22(3), 2001, pp. 233-253.
[35] L. Mei-Feng, C. Jaw-Haw, C. Mei-Hsien, and H. Mei-Chi, "Significant experiences of token therapy from the perspective of psychotic patients", The Journal of Nursing Research, 14 (4), 2006, pp. 315-323.
[36] L.W. Davis, and P.H. Lysaker, "Neurocognitive correlates of therapeutic alliance in schizophrenia", Journal of Nervous and Mental Disease, 192(7), 2004, pp. 508– 510.
[37] C.M. Donnell, D.C. Lustig, and D.R. Strauser, "The working alliance: rehabilitation outcomes for persons with severe mental illness", Journal of Rehabilitation, 70(2), 2004, pp. 12-18.
[38] P.E. Smerud, and L.S. Rosenfarb, "The therapeutic alliance and family psychoeducation in the treatment of schizophrenia: an exploratory prospective change process study", Journal of Consulting and Clinical Psychology, 76 (3), 2008, pp. 505–510.
[39] E.S. Bordin, "The generalizability of the psychoanalytic concept of the working alliance", Psychotherapy: Theory, Research and Practice, 16(3), 1979, pp. 252 – 260.
[40] A.O. Horvath, and L.S. Greenberg, "The development of the working alliance inventory". In L. Greenberg & W. Pinsof (Eds.), Psychotherapeutic process: A research handbook, 1986, (pp.529-556), New York: Guilford Press.
[41] T.G. Plante, "Aerobic exercise in prevention and treatment of psychopathology," in Exercise psychology, P. Seraganian, Ed., 1993, pp.358-379, Wiley-Interscience, London.
[42] T. Pelham, and P. Campagna, "Benefits of exercise in psychiatric rehabilitation of persons with schizophrenia," Canadian Journal of Rehabilitation, 4, 1991, pp. 159-168.
[43] Starkey, H. Deleone, and R.B. Flannery, "Stress management for psychiatric patients in a state hospital setting, American Journal of Orthopsychiatry, 65(3), 1995, pp. 446–450.
[44] S. Viertiö, P. Sainio, S. Koskinen, J. Perälä, S.I. Saarni, J. Lönnqvist, and J. Suvisaari, " Mobility limitations in persons with psychotic disorder: findings from a population-based survey", Social Psychiatry and Psychiatric Epidemiology, 44, 2009, pp. 325–332.
[45] E.V. Sullivan, M.J. Rosenbloom, and A. Pfefferbaum, "Balance and Gait Deficits in Schizophrenia Compounded by the Comorbidity of Alcoholism", American Journal of Psychiatry, 161(4), 2004, pp. 751-755.
[46] A.I. Green, K. Patel, R.M. Goisman, D.B. Allison, and G. Blackburn, "Weight gain from novel antipsychotic drugs: Need for action", General Hospital Psychiatry, 22(4), 2000, pp.224-235.
[47] A.E. Kazdin, "Research design in clinical psychology"(2nd ed.), Needham Heights, MA: Allyn & Bacon, 1992.
[48] J.E. Ware, and C.D. Sherbourne, "The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection", Medical Care, 30(6), 1992, pp. 473-483.
[49] S.L. Tunis, T.W. Croghan, D.K. Heilman, B.M. Johnstone, and R.L. Obenchain, "Reliability, validity, and application of the medical outcomes study 36- item short-form health survey (SF-36) in schizophrenic patients treated with olanzapine versus haloperidol", Medical Care, 37(7), 1999, pp.678–691.
[50] R.G. O'Brien, and M.K. Kaiser, "The MANOVA approach for analyzing repeated measures designs: An extensive primer", Psychological Bulletin, 97, 1985, pp. 316–333.
[51] T. Grant, "Physical activity and mental health – national consensus statements and guidelines for practitioners", London: Health Education Authority, 2000.
[52] Crone, "Walking back to health: A qualitative investigation into service users experiences of a walking project", Issues in Mental Health Nursing, 28(2), 2007, pp. 167-184.
[53] J. Dattilo, "Inclusive leisure services: Responding to the rights of people with disabilities" (2nd ed.). State College, PA: Venture, 2002.
[54] E.L. Deci, R. Koestner, and R.M. Ryan, "A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation", Psychology Bulletin, 125, 1999, pp. 627–668.
[55] S.M. Silverstein, "Bridging the Gap between Extrinsic and Intrinsic Motivation in the Cognitive Remediation of Schizophrenia", Schizophrenia Bulletin, 36 (5), 2010, pp. 949-956.
[56] S.M. Silverstein, W.D. Spaulding, A.A. Menditto, A. Saritz, R.P. Liberman, S. Berten, and H. Starobin, "Attention shaping: a reward-based learning method to enhance skills training outcomes in schizophrenia", Schizophrenia Bulletin, 35(1), 2009, pp. 222–232.
[57] S. Glynn, and K.T. Mueser, "Social learning for chronic mental inpatients". Schizophrenia Bulletin, 12, 1986, pp. 648–668.
[58] S. Park, C. Gibson, and T. McMichael, "Socioaffective factors modulate working memory in schizophrenia patients", Neuroscience, 139(3), 2006, pp. 373–384.
[59] P.W. Corrigan, "Use of a token economy with seriously mentally ill patients: Criticisms and misconceptions", Psychiatric Services, 46, 1995, pp. 1258-1263.
Cite This Article
  • APA Style

    Dimitrios Kokaridas, Georgia Maggouritsa, Periklis Stoforos, Asterios Patsiaouras, Yiannis Theodorakis, et al. (2013). The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study. American Journal of Applied Psychology, 2(6), 80-88. https://doi.org/10.11648/j.ajap.20130206.13

    Copy | Download

    ACS Style

    Dimitrios Kokaridas; Georgia Maggouritsa; Periklis Stoforos; Asterios Patsiaouras; Yiannis Theodorakis, et al. The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study. Am. J. Appl. Psychol. 2013, 2(6), 80-88. doi: 10.11648/j.ajap.20130206.13

    Copy | Download

    AMA Style

    Dimitrios Kokaridas, Georgia Maggouritsa, Periklis Stoforos, Asterios Patsiaouras, Yiannis Theodorakis, et al. The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study. Am J Appl Psychol. 2013;2(6):80-88. doi: 10.11648/j.ajap.20130206.13

    Copy | Download

  • @article{10.11648/j.ajap.20130206.13,
      author = {Dimitrios Kokaridas and Georgia Maggouritsa and Periklis Stoforos and Asterios Patsiaouras and Yiannis Theodorakis and Nikolaos Diggelidis},
      title = {The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study},
      journal = {American Journal of Applied Psychology},
      volume = {2},
      number = {6},
      pages = {80-88},
      doi = {10.11648/j.ajap.20130206.13},
      url = {https://doi.org/10.11648/j.ajap.20130206.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajap.20130206.13},
      abstract = {The aim of this pilot study was to examine the effect of an exercise and token economy system program on improving quality of life of patients with schizophrenia. Thirty (30) patients with schizophrenia separated in three groups (control group, an exercise observation with tokens group and an actual exercise with tokens group) of 10 individuals, took part in an eight weeks exercise program combining physical activity with token economy behavioral treatment. Data included the use of SF-36 Quality of Life Questionnaire (QLQ). Experiment group B participants as compared to those of the experiment group A and control group individuals found at the end of the exercise program as experiencing less problems with daily activities and felling more energetic and vigorous leading to an improved mental component score. Overall, findings are encouraging concerning the effect of a combined exercise and token economy program on improving quality of life of patients with schizophrenia.},
     year = {2013}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - The Effect of a Token Economy System Program and Physical Activity on Improving Quality of Life of Patients with Schizophrenia: A Pilot Study
    AU  - Dimitrios Kokaridas
    AU  - Georgia Maggouritsa
    AU  - Periklis Stoforos
    AU  - Asterios Patsiaouras
    AU  - Yiannis Theodorakis
    AU  - Nikolaos Diggelidis
    Y1  - 2013/12/30
    PY  - 2013
    N1  - https://doi.org/10.11648/j.ajap.20130206.13
    DO  - 10.11648/j.ajap.20130206.13
    T2  - American Journal of Applied Psychology
    JF  - American Journal of Applied Psychology
    JO  - American Journal of Applied Psychology
    SP  - 80
    EP  - 88
    PB  - Science Publishing Group
    SN  - 2328-5672
    UR  - https://doi.org/10.11648/j.ajap.20130206.13
    AB  - The aim of this pilot study was to examine the effect of an exercise and token economy system program on improving quality of life of patients with schizophrenia. Thirty (30) patients with schizophrenia separated in three groups (control group, an exercise observation with tokens group and an actual exercise with tokens group) of 10 individuals, took part in an eight weeks exercise program combining physical activity with token economy behavioral treatment. Data included the use of SF-36 Quality of Life Questionnaire (QLQ). Experiment group B participants as compared to those of the experiment group A and control group individuals found at the end of the exercise program as experiencing less problems with daily activities and felling more energetic and vigorous leading to an improved mental component score. Overall, findings are encouraging concerning the effect of a combined exercise and token economy program on improving quality of life of patients with schizophrenia.
    VL  - 2
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece

  • University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece

  • Psychiatrist, Director of Psychiatry Unit, Trikala, Greece

  • University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece

  • University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece

  • University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece

  • Sections