Social Cognition Intervention
| Status: | Completed |
|---|---|
| Conditions: | Schizophrenia, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 60 |
| Updated: | 4/22/2016 |
| Start Date: | February 2011 |
| End Date: | December 2015 |
Augmenting Social Cognitive Intervention for Veterans With Schizophrenia
Veterans with schizophrenia and schizoaffective disorder experience high levels of
disability and poor community outcome, and these poor functional outcomes constitute a major
public health concern. The treatment of schizophrenia spectrum disorders has shifted
fundamentally from a focus on symptom reduction to a focus on recovery and improving aspects
of functioning. Needed improvements in community outcome for patients with these disorders
will not occur simply through better control of clinical symptoms. Instead, it is necessary
to find new treatments that address the key determinants of poor functional outcome,
including social cognition. Both basic (non-social) cognition and social cognition are
considered key determinants of functional outcome for schizophrenia and schizoaffective
disorder. Basic cognition includes the domains of: learning and memory, vigilance /
attention, speed of processing, reasoning and problem solving, and working memory. Social
cognition generally refers to mental operations that underlie social interactions, including
perceiving, interpreting, managing, and generating responses to socially relevant stimuli,
including the intentions and behaviors of others. As part of the investigators' previous
Merit grant, they have developed a training program for social cognition and are in the
process of validating it. Initial results suggest that the program improves performance on
measures of social cognition and functional capacity.
In this study, the investigators will evaluate whether adding an in vivo component (training
activities that occur in the community) to the current social cognition intervention
facilitates generalization of training effects to community outcome and subjective
satisfaction. Outcome measures of social cognition and functional capacity will be examined
during the 12 week training program, and durability of benefits will be assessed at a
3-month follow up. Generalization to community functioning and subjective satisfaction will
be assessed at the end of training and at the 3-month follow up. The investigators will
enroll 105 patients across the 5 years of the study with random assignment to training group
(social cognition intervention with in vivo exercises, social cognition intervention without
in vivo exercises and control). Subjects will receive assessments at baseline, 6 weeks
(mid-point), completion of training (12 weeks), and the 3-month follow up.
disability and poor community outcome, and these poor functional outcomes constitute a major
public health concern. The treatment of schizophrenia spectrum disorders has shifted
fundamentally from a focus on symptom reduction to a focus on recovery and improving aspects
of functioning. Needed improvements in community outcome for patients with these disorders
will not occur simply through better control of clinical symptoms. Instead, it is necessary
to find new treatments that address the key determinants of poor functional outcome,
including social cognition. Both basic (non-social) cognition and social cognition are
considered key determinants of functional outcome for schizophrenia and schizoaffective
disorder. Basic cognition includes the domains of: learning and memory, vigilance /
attention, speed of processing, reasoning and problem solving, and working memory. Social
cognition generally refers to mental operations that underlie social interactions, including
perceiving, interpreting, managing, and generating responses to socially relevant stimuli,
including the intentions and behaviors of others. As part of the investigators' previous
Merit grant, they have developed a training program for social cognition and are in the
process of validating it. Initial results suggest that the program improves performance on
measures of social cognition and functional capacity.
In this study, the investigators will evaluate whether adding an in vivo component (training
activities that occur in the community) to the current social cognition intervention
facilitates generalization of training effects to community outcome and subjective
satisfaction. Outcome measures of social cognition and functional capacity will be examined
during the 12 week training program, and durability of benefits will be assessed at a
3-month follow up. Generalization to community functioning and subjective satisfaction will
be assessed at the end of training and at the 3-month follow up. The investigators will
enroll 105 patients across the 5 years of the study with random assignment to training group
(social cognition intervention with in vivo exercises, social cognition intervention without
in vivo exercises and control). Subjects will receive assessments at baseline, 6 weeks
(mid-point), completion of training (12 weeks), and the 3-month follow up.
Inclusion Criteria:
All patients must be diagnosed with Schizophrenia, Schizoaffective Disorder, or Psychosis
NOS according to DSM-IV criteria. In addition, the subjects will meet the following
criteria:
- Between 18 and 60 years of age
- Estimated premorbid IQ > 70 (based on reading ability)
- Understand spoken English sufficiently to comprehend testing procedures
- Clinically stable (e.g., no inpatient hospitalization in the 8 weeks prior to
enrollment, no significant changes in medication in the 4 weeks prior to enrollment,
and none anticipated for the 3 months of participation)
- In sufficient health to be able to walk outdoors unaided for at least 15 minutes.
Exclusion Criteria:
- No clinically significant neurological disease as determined by medical history
- No history of serious head injury (e.g., loss of consciousness longer than 1 hour)
- No physical, cognitive, or language impairment of such severity as to adversely
affect the validity of data
- No evidence of drug or alcohol dependence in the past six months, and not intoxicated
at time of testing based on urine toxicology screen and saliva alcohol test strip.
Subjects who test positive will not be disqualified but instead will be asked to
return for testing on a different day. However, subjects who test positive on 3
consecutive occasions will be disqualified from the study.
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