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This mixed-methods study explored the quality of life and lived experiences of adult individualswith diagnoses of schizophrenia spectrum disorders residing and receiving treatment on theSocial Learning Program (SLP) at Fulton State Hospital, a high-security state forensic facility.Eleven participants completed the WHOQOL-BREF quantitative quality-of-life measure. Tenparticipants completed in-depth, semi-structured, qualitative interviews. Interviews weretranscribed then analysed using Interpretive Phenomenological Analysis. The major themes thatemerged included “Working the Program,” “Relationship Dynamics with Self and Others,”“Meaning,” “I’ve Been Having Breakthroughs,” and “Areas for Improvement in the Program.”Combined, the findings of the present investigation demonstrate the utility of the SLP andhighlight the importance of studying the lived experience and quality of life of individuals withdiagnoses of schizophrenia spectrum disorders residing in forensic facilities.

Insula is postulated to be a critical cortical region with extensive cortico-limbic connections and is hypothesized to play a role in pain/auditory/facial affect processing and interoception. Morphological abnormalities in this region may contribute to schizophrenia (SZ), schizoaffective disorder (SAD), and psychotic Bipolar disorder (BDP) symptomatology. Previous studies of insula have led to somewhat inconsistent results. Few studies have separately examined the left and right insula's anterior and posterior components, which have distinct functional roles. This study will examine the morphological and cognitive changes which occur in psychosis within the left and right insula, bilateral insula, and anterior and posterior insula. Although the exact localization of these deficits is inconsistent, we postulate that control groups will have greater volume, thickness, and local Gyrification Index (LGI) across all measures compared to psychosis groups, with greater reductions confined to the anterior insula since it is hypothesized to play a role in higher-order processing. Due to the hypothesized decrease in LGI in psychosis groups, we postulate to see the most significant correlations in LGI, supporting the view that decreases in gyrification correlate to decreases in cognitive abilities (Gautam et al., 2015; Park et al., 2021). T1-MPRAGE scans were obtained using 3T MRI scans. Insula measurements were extracted using FreeSurfer (FS) 7.1 in healthy controls (NC=935) and psychosis probands (SZ=481, SAD=383, BDP=381). FS measures were correlated with cognition (verbal memory (VM), verbal fluency (VF), digit sequencing (DS), and symbol coding (SC)), and symptomatology in SZ/SAD/BPD. P values < 0.05 adjusted for False Discovery Rate (FDR) were reported. Our observations suggest structural alterations in the insula, predominantly in volume, thickness, and LGI, across affective and non-affective psychotic disorders. Though we observed relations between the insula and cognitive measures, we did not see correlations with symptomatology. Future studies will examine further the relation between insular structure and socio-emotional and self-processing believed to be related to the anterior insula.

Research indicates that people with schizophrenia or schizoaffective disorder have a high rate of unemployment. This qualitative phenomenological study was designed to explore the perceptions of eight individuals with either disorder who have secured employment after diagnosis. The rationale for this study arises from the researcher‘s desire to find the process which was used by individuals with either disorder to become employed. It was the researcher‘s assumption that uncovering such a process could lead to implementation of employment as a therapeutic goal of treatment with such individuals.The purposefully selected sample consisted of eight individuals from a Midwestern state who have been diagnosed with either disorder. The primary method of data collection was three in-depth interviews. The data were organized according to the research and field-developed questions asked of participants. Analysis and interpretation of findings were completed using the van Kaam method of qualitative data processing. The research revealed that participants in the study interpreted recovery as living in asmuch of a perceived degree of normalcy as possible. Recovery was found to be a developmental concept among participants. The six following categories were developed from the data: self-help; employment; assistance with employment; benefits of employment; functioning at a perceived normal level while living as full a life as possible with the illness; and recovery to employment. Five themes were found: self-care; supports; issues of employment; rewards of employment; and recovery process. Fourteen sub-themes emerged from the analysis of data. They were as follows: medication compliance; stress reduction; approaching employment gradually and carefully; stigma; disclosure of condition; formal accommodations; change of employers due to problems of disability; lack of failure; family and friends; governmental support; private supports; intrinsic rewards of employment; extrinsic rewards of employment; developmental process; and normalcy.Recommendations are offered for mental health and rehabilitation professionals who work with this population and for further research possibilities. Given that multiple factors are present in an individual‘s recovery to the point of employment with either disorder, the recommendations suggested should be considered on an individual basis.