Token Reinforcement Therapeutic Approach is More Effective than Exercise for Controlling Negative Symptoms of Schizophrenic Patients: A Randomized Controlled Trial

Abstract

Introduction: This study aimed to evaluate the effectiveness of exercise and token‑behavior therapy on the negative symptoms of schizophrenic patients.

Objective: Comparison of the effectiveness of exercise and token‑behavior therapy on the negative symptoms of schizophrenic patients.

Methods: This research was a randomized controlled clinical trial that was done on 45 schizophrenic patients, hospitalized in Rasht, Iran. Through systematic random allocation, the samples were placed in one control and two intervention groups, 15 patients in each. To assess the negative symptoms, the scale for the assessment of negative symptoms (SANS) was used. The effect of the interventions used (exercise and token‑behavior therapy) was studied by completing the relevant checklists before and after using the interventions, and then, by comparing it with that of the studied control group. In order to analyze the collected data, one way ANOVA and Bonferroni’s test and SPSS software were used.

Results: Analyses showed that the token reinforcement approach was highly and significantly more effective than exercise for reducing the negative symptoms in schizophrenic patients (−36 ± 7 vs. −21 ± 8, respectively; P<0.001). Exercise was also shown to have a highly significant advantage over no therapy, in controls, to improve the negative symptoms in schizophrenic patients (−25 ± 8 vs. 0.2 ± 1.08, respectively; P<0.001).

Conclusion: Both exercise and token‑behavior therapies, along with drug treatment, are very effective in reducing the negative symptoms of schizophrenia; but the impact of token therapy issignificantly higher.