ABSTRACT
Behavioural deficits, as we have termed them, are associated with poor functional outcomes and long-term disability, often with an associated poor quality of life. We propose that the term ‘behavioural deficits’ avoids the ambiguity present in the term ‘negative symptoms’ and highlights the frequent co-morbidity of cognitive problems. With a few notable exceptions (e.g. Kingdom and Turkington, 2005), psychological approaches such as cognitive-behavioural therapy (CBT) have not been well developed to adequately address these difficulties. There is some evidence that the newer atypical neuroleptics such as clozapine and resperidone are effective treatments for cognitive deficits, including those in relation to fluency, memory and working memory, and may have greater effects on negative symptoms (Harvey and Sharma, 2002). However, both CBT and medication are less effective in highly treatment-resistant populations where adherence to prescribed medication is poor and engagement in psychological approaches is limited. Our focus here is on the rehabilitation of activity limitations or behavioural deficits that form the barriers to social participation in line with the vast literature in the neurorehabilitation field.
