An ecological momentary intervention incorporating personalised feedback to improve symptoms and social functioning in schizophrenia spectrum disorders

Rapid and accurate trustworthiness judgments are important during successful day-to-day social interactions because they can influence the decision whether to approach someone and initiate social interaction. The aim of the present study was to analyze associations between these judgments and self-reported and clinician-rated social functioning. The sample consisted of 48 patients with schizophrenia spectrum disorders and 35 healthy controls matched for age, gender, and educational level. A trustworthiness task, subjective, and clinician-rated scales for social functioning were administered to both samples. Trustworthiness judgments did not differ between patients and healthy controls. Both groups were able to discriminate between trustworthy and untrustworthy faces. Trustworthiness ratings were associated with self-reported and clinician-rated measures of interpersonal functioning in patients with schizophrenia. Despite the absence of differences between groups, in patients with schizophrenia, a tendency to mistrust based on facial appearance was related to worse functional outcome, predominantly in the domain of disturbed interpersonal functioning. This study highlights the importance of future research into social–cognitive biases in schizophrenia.

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Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis

Journal of Experimental Psychopathology ◽

10.1177/2043808719830821 ◽

2019 ◽

Vol 10 (1) ◽

pp. 204380871983082 ◽

Cited By ~ 4

Author(s):

Emily C. Gagen ◽

Aieyat B. Zalzala ◽

Jesse Hochheiser ◽

Ashley Schnakenberg Martin ◽

Paul H. Lysaker

Keyword(s):

Latent Class Analysis ◽

Social Functioning ◽

Latent Class ◽

Class Analysis ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Class 1 ◽

Spectrum Disorders ◽

Meaningful Connections ◽

Relationship Of

Functional deficits are a hallmark of schizophrenia spectrum disorders, but much debate still exists over why and how they originate. One model suggests that disturbances in social functioning are a result of metacognitive deficits or a failure to integrate information to form more complex ideas of themselves and others. It is unclear if this social dysfunction is present across different symptom presentations. We examined the relationship of metacognition, symptoms, and social functioning among a sample of adults with schizophrenia spectrum disorders ( N = 334). A latent class analysis produced a four-class model. Groups were classified as follows: diffuse symptoms/moderately impaired social functioning (Class 1), positive and hostility symptoms/mildly impaired social functioning (Class 2), minimal symptoms/good social functioning (Class 3), and negative and cognitive symptoms/severely impaired social functioning (Class 4). Class 3 demonstrated better overall metacognitive capacity than both Classes 1 and 4 but did not differ significantly from Class 2. Classes 2 and 3 both demonstrated better interpersonal functioning than Classes 1 and 4. Together, these findings provide support for models of poor functioning that stem from fragmentation of an individual’s experience, leading to diminished abilities to form meaningful connections with others. Additional interpretations, limitations, and research implications are discussed.

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Aspects of Theory of Mind that attenuate the relationship between persecutory delusions and social functioning in schizophrenia spectrum disorders

Journal of Behavior Therapy and Experimental Psychiatry ◽

10.1016/j.jbtep.2016.07.008 ◽

2017 ◽

Vol 56 ◽

pp. 65-70 ◽

Cited By ~ 6

Author(s):

Peter L. Phalen ◽

Giancarlo Dimaggio ◽

Raffaele Popolo ◽

Paul H. Lysaker

Keyword(s):

Theory Of Mind ◽

Social Functioning ◽

Schizophrenia Spectrum Disorders ◽

Persecutory Delusions ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

The Relationship

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Can we use Ecological Momentary Assessment for real-world patients with schizophrenia? A study of acceptability of the passive smartphone-based app Evidence-Based Behavior (eB2). (Preprint)

10.2196/preprints.26548 ◽

2020 ◽

Author(s):

Javier-David Lopez-Morinigo ◽

María Luisa Barrigón ◽

Alejandro Porras-Segovia ◽

Verónica González Ruiz-Ruano ◽

Adela Sánchez Escribano Martínez ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Controlled Trial ◽

Evidence Based ◽

Schizophrenia Spectrum Disorders ◽

Premorbid Adjustment ◽

Cognitive Insight ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Ecological Momentary ◽

Momentary Assessment

BACKGROUND Ecological momentary assessment (EMA) tools collect real-time data on patients’ behaviour and functioning and may be useful interventions. However, concerns have been voiced regarding acceptability of EMA among patients with schizophrenia and what may underlie this remains poorly understood. OBJECTIVE To investigate acceptability of a passive smartphone-based EMA app, the Evidence-Based Behavior (eB2), among patients with schizophrenia spectrum disorders and putative variables underlying this. METHODS Participants came from an ongoing randomised controlled trial (RCT) of metacognitive training - outpatients with schizophrenia spectrum disorders (SSD) (F20-29-ICD10 codes), age 18-64 - none of whom received any financial compensation. Those who consented to installation of the eB2 app (users) were compared with those who did not (non-users) in sociodemographic, clinical, premorbid adjustment (Premorbid Adjustment Scale -PAS-), neurocognitive, psychopathological, insight and metacognitive variables. A multivariable binary logistic regression tested the influence of the above (independent) variables on ‘being user vs. non-user’ (acceptability), which was the main outcome measure. RESULTS Out of N=77 RCT participants, n=24 subjects (31%) consented to eB2, which remained installed at the end of the study (median follow-up=14.50 weeks) in n=14 subjects (70%). Users were younger and had a high education level, better premorbid adjustment, better executive function (according to the Trail Making Test) and higher cognitive insight levels (measured with the Beck Cognitive Insight Scale) than non-users (univariate analyses), although only age (OR 0.93, 95% CI 0.86-0.99; P=.048) and early adolescence PAS (OR 0.75, 95% CI 0.61-0.93; P=.010) survived the multivariable regression model, thus predicting eB2 acceptability. CONCLUSIONS Acceptability of a passive smartphone-based EMA app among SSD participants in this RCT where no participant received financial compensation was, as expected, relatively low, and linked with being young and good premorbid adjustment. Further research should examine how to increase EMA acceptability to SSD patients, particularly older participants and those with poor premorbid adjustment. CLINICALTRIAL This stusy is part of a randmised controlled trial which has been registered at ClinicalTrials.gov (NCT04104347) since the 26/09/2019. URL of registry https://clinicaltrials.gov/ct2/show/NCT04104347

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