An Alternative to Generating Alternative Interpretations in Social Cognitive Therapy for Psychosis

2012 ◽  
Vol 40 (4) ◽  
pp. 491-495 ◽  
Author(s):  
David L. Roberts ◽  
Petra Kleinlein ◽  
Bruce Stevens

Background: Generating alternative interpretations is a widely used technique in cognitively-oriented treatments for psychosis, including social cognitive treatments. However, research on judgment and decision-making suggests that this technique may backfire among individuals with cognitive deficits. Aims: Mary/Eddie/Bill (MEB) was developed as an alternative approach to help improve Theory of Mind, attributional bias and Jumping to Conclusions in psychosis. An initial pilot trial was conducted to evaluate the tolerability and potential efficacy of MEB. Method: Twenty-four outpatients with psychotic disorders participated in an uncontrolled trial. Social cognition, social functioning, and participant feedback were assessed. Results: Treatment completers exhibited statistically significant improvements in Theory of Mind, social cognitive overconfidence and self-reported social engagement, and reported positive experiences with MEB. No improvements were observed in attributional bias. Conclusions: Given that there are risks associated with the use of traditional generating-alternatives techniques, the current findings support ongoing development of MEB and similar approaches.

2016 ◽  
Vol 44 (6) ◽  
pp. 711-716 ◽  
Author(s):  
Greta Voutilainen ◽  
Tiina Kouhia ◽  
David L. Roberts ◽  
Jorma Oksanen

Background: Social Cognition and Interaction Training (SCIT) is a psychosocial treatment designed to improve social functioning in schizophrenia by improving social cognition. Positive results have been reported from several studies, mainly from the USA, but more studies are needed to determine the feasibility of SCIT in different cultural contexts. Aims: The objective of this study was to evaluate the feasibility and acceptability of the Finnish translation of SCIT in Finland. Method: This was an uncontrolled, within-group study. Thirty-three patients with psychotic disorders participated in SCIT groups and also received the standard services provided at their respective care facilities. We measured participant attendance, attrition and responses on feedback surveys. Participants also completed measures of emotion perception, Theory of Mind (ToM), attributional bias and metacognitive overconfidence both before and after SCIT. Results: The attendance rate was high, attrition was low, and the patients expressed satisfaction with SCIT. Preliminary efficacy analyses showed a statistically significant pre to posttest improvement in emotion perception and ToM, but not attributional bias or overconfidence. Conclusions: SCIT is feasible and well accepted and may remediate social cognitive dysfunction in people with psychotic disorders in Finland.


2009 ◽  
Vol 38 (1) ◽  
pp. 35-47 ◽  
Author(s):  
David L. Roberts ◽  
David L. Penn ◽  
Daniella Labate ◽  
Seth A. Margolis ◽  
Abram Sterne

Background: Social Cognition and Interaction Training (SCIT) is a manual-based group intervention designed to improve social cognition in schizophrenia. Initial studies conducted by the developers of SCIT suggest that the intervention has promise in ameliorating social cognitive dysfunction in both inpatients and outpatients. Aims: The current study is a preliminary evaluation of SCIT in community samples. Method: An uncontrolled, pre-post design was used in this initial feasibility study. A collaborative research-clinical approach was employed to enable research evaluation while also meeting the administrative goals of participating clinics, and working within the constraints of real-world clinical practice. Transportability, acceptability, and feasibility of SCIT were evaluated in terms of pre- and post-treatment evaluations, client attendance data (N = 50), and clinic administrators’ decisions about whether to integrate SCIT into regular programming. Social-cognitive outcome measures assessed emotion perception, Theory of Mind, and attributional bias. Results: These support the transportability, acceptability, and feasibility of SCIT in community settings. SCIT has been integrated into routine practice at several test sites. Tentative support was found for improvement in emotion perception and Theory of Mind, but not attributional bias. Conclusions: SCIT may be a promising intervention for community agencies serving individuals with psychotic disorders who seek to improve their social functioning.


2018 ◽  
Author(s):  
Nicholas James Rowark

Depression has been associated with poor social cognitive functioning, including impaired performance on measures of theory of mind. However, the association between depression and theory of mind performance has been removed when controlling for differences in executive functioning, which is also impacted by depression. Among these executive functions, inhibition of prepotent response has been demonstrated as enabling success on theory of mind tests. In the context of these findings, the current investigation tested whether a relationship could be found between depressive traits and theory of mind in a non-clinical sample, and whether this relationship was mediated by differences in executive control of inhibition. Theory of mind was assessed in 31 healthy individuals using an audio-presented false-belief reasoning task, which also tested baseline performance in non-mental-state reasoning. Inhibition of prepotent response was assessed with interference measures on a Stroop colour-word task, and depressive traits were self-reported through the second version of the Beck Depression Inventory. Mediation analysis revealed that executive control of inhibition did not significantly mediate an indirect effect of depressive traits on theory of mind. It was interpreted that relationships previously found between major depression, executive and social-cognitive functions do not generalise beyond clinical boundaries. However, these findings are discussed in terms of the small sample size, limiting statistical power, and several methodological limitations. Future research should assess the relationship between depressive traits and theory of mind using alternative measures of mental representation, or include a neurocognitive battery assessing executive functions other than inhibition.


2021 ◽  
pp. 002076402110230
Author(s):  
Antonio Vázquez-Reyes ◽  
María Ángeles Pérez-San-Gregorio ◽  
Agustín Martín-Rodríguez ◽  
Antonio J Vázquez-Morejón

Background: In recent years, several variables in the course of schizophrenia and related psychotic disorders have been studied. However, an instrumental analysis of the evolution of social functioning and behaviour problems has scarcely been explored. Aim: To analyse the evolution of social functioning and behaviour problems and find any diagnosis or gender differences. Method: The Social Functioning Scale (SFS) and the Behaviour Problems Inventory (BPI) were administered in Stages I (2003–2007) and II (2014–2017) to 100 close relatives of patients under treatment at a Community Mental Health Unit. A related samples t-test, analysis of variance and multivariate analysis of variance were performed to study the evolution and differences in social functioning and behaviour problems. Then a stepwise multiple linear regression analysis was done to predict the evolution of social functioning. Results: No deterioration in the evolution of social functioning or behaviour problems was observed, and schizophrenia patient scores were lower. Women scored higher in withdrawal/social engagement, interpersonal behaviour, independence-performance, independence-competence and total social functioning, with no significant differences in behaviour problems. Previous social functioning, underactivity/social withdrawal and education are predictive factors in the evolution of social functioning. Conclusion: The results show the need for implementing psychosocial intervention programs that promote functional recovery and keep problems from becoming chronic.


2022 ◽  
Author(s):  
Emilio López-Navarro

Impaired Theory of Mind (ToM) ability is a core feature of psychotic disorders that challenges psychosis treatment. We aimed to explore the effect of a Mindfulness-Based Intervention (MBI) on ToM ability in a randomized clinical trial (RCT). A sample of 36 participants diagnosed with psychotic disorder were recruited from a community center and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT+MBI. ToM skills were assessed through the Hinting Test and the Reading the Mind in the Eyes Test (RMET). IRT+MBI scored higher in RMET than IRT at posttreatment. MBI is a promising tool for improving ToM ability in psychosis.Keywords: psychotic disorders, theory of mind, mindfulness-based-interventions.


2021 ◽  
pp. 1-11
Author(s):  
Emre Bora

Abstract Background It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it is important to distinguish neuro-social cognitive impairment from the abnormal meta-social-cognitive style of patients. Methods The current systematic review aimed to conduct separate meta-analyses of ‘mentalization’ [reflective functioning (RF] and different aspects of ToM in BPD. A literature search was conducted to locate relevant articles published between January 1990 to July 2021. Random-effect meta-analyses were conducted in 34 studies involving 1448 individuals with BPD and 2006 healthy controls. Results A very large impairment in RF was evident in BPD [d = 1.68, confidence interval (CI) = 1.17–2.19]. In contrast, ToM impairment was modest (d = 0.36, CI = 0.24–0.48). BPD patients underperformed healthy controls in ToM-reasoning (d = 0.44, CI = 0.32–0.56) but not ToM-decoding. Increased HyperToM (d = 0.60, CI = 0.41–0.79) and faux pas recognition (d = 0.62, CI = 0.35–0.90) errors in BPD compared to healthy controls were most robust ToM findings in this meta-analysis. Conclusions BPD is characterized by very severe deficits in RF and modest and selective abnormalities in ToM. Interpersonal problems and difficulties in processing social information in BPD can be best explained by patients' maldaptive meta-social cognitive style and top-down effects of these abnormalities rather than having a primary neuro-social cognitive deficit.


2009 ◽  
pp. 123-141
Author(s):  
Dennis R. Combs ◽  
Dustin J: Chapman ◽  
Casey Reneau

- There has been an increased interest in research on paranoia and persecutory delusions. This is partly based on the idea that paranoia exists on a continuum ranging from sub-clinical to clinical levels. One area of interest is in social cognition as it may provide methods to understand how persons with paranoia perceive, interpret, and understand their social world. Previous research has showed that social cognition directly influences or mediates social functioning. Paranoia can be ideally approached from a social cognitive perspective, which makes understanding these processes even more important. For this review, we will focus on the current state of knowledge for paranoia as it pertains to the three primary domains of social cognition: 1) emotion/social perception, 2) theory of mind, and 3) attributional style. Deficits in emotion/social perception appear to be found across the paranoia continuum. In contrast, deficits in theory of mind and attributional style are typically found in persons with clinical levels of paranoia. Future studies should focus on understanding the processes that might underlie the deficits.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24035-e24035
Author(s):  
Marcy Haynam ◽  
Ciaran Fairman ◽  
Jessica Bowman ◽  
Victoria DeScenza ◽  
Zachary Chaplow ◽  
...  

e24035 Background: Post-treatment weight gain places breast cancer (BCa) survivors at heightened risk for cardiovascular disease, metabolic syndrome, and functional decline. Lifestyle weight management (LWM) interventions combining exercise and dietary weight loss represents an effective approach to mitigating the adverse cardiometabolic and functional effects frequently observed in BCa survivors. Unfortunately, community access to cost-effective, sustainable, LWM interventions among BCa survivors remains limited. The purpose of this study is to determine the preliminary efficacy of a community-based LWM intervention in BCa survivors on select body composition (BC), physical function, and social cognitive outcomes of the first wave of participants in the Healthy New Albany Breast Cancer (HNABC) pilot trial. Methods: The 24-week, community-based pilot trial promotes lifestyle behavior changes through a group-mediated cognitive behavioral (GMCB) approach driven by Social Cognitive Theory. The measures analyzed were BC done via Dual-energy X-ray Absorptiometry, physical function via the 400m walk test, and social cognitive outcomes via satisfaction with function and appearance and perceived competence with exercise and diet at 6-months via effect size calculations using Cohen’s d. Results: Meaningful changes were observed in fat mass ( d= -0.46), percent lean mass ( d= 0.33), lean mass ( d= -0.45), and physical function ( d= -0.59), some of which reached clinical relevance. Select self-reported outcomes also saw meaningful improvements from this LWM intervention. Conclusions: Findings from this study demonstrate the preliminary efficacy of implementing a GMCB-based LWM intervention among overweight or obese BCa survivors. Given the meaningful impact that successful weight management has on reducing risk for chronic diseases, these results highlight the utility of implementing a LWM intervention in the community for BCa survivors in an effort to extend the access, reach, and scalability of supportive care approaches during BCa survivorship.


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