Intervention Programs Focusing on Social Cognition in Schizophrenia

Year 2024, , 554 - 568, 30.09.2024

Ceren Hıdıroğlu Ongun

https://doi.org/10.18863/pgy.1393279

Abstract

Social cognitive functions make it possible to correctly recognize and interpret the emotions and mental states of others in the social environment, to understand their intentions correctly and to react accordingly. Therefore, these functions arecritical for healthy social interactions and professional success in human life. Social cognitive functions are impaired in many psychiatric and neurological diseases and this impairment negatively affects almost all areas of patients' lives, albeit in different dimensions. According to research findings revealing the relationship between social cognition and social functioning, social cognition should be one of the treatment targets for many diseases. Recently, there has been increasing interest in interventions that target the improvement of these functions. In this article, these training programs, research findings and assessment tools used in these studies are discussed in the specific case of schizophrenia.

Keywords

schizophrenia, social cognition, social cognitive training, social functioning, functional outcome

Şizofrenide Sosyal Bilişe Odaklanan Müdahale Programları

Abstract

Sosyal çevredeki diğer kişilerin duygularını ve zihinsel durumlarını doğru tanımayı ve yorumlamayı, niyetlerini doğru anlayabilmeyi ve buna uygun tepki verebilmeyi olanaklı kılan sosyal bilişsel işlevler insan hayatında sağlıklı sosyal etkileşimler kurabilmek ya da mesleki başarı için kritik önem taşır. Sosyal bilişsel işlevler, psikiyatrik ve nörolojik birçok hastalıkta bozulmakta ve bu bozulma farklı boyutlarda olsa da hastaların yaşamlarının hemen hemen tüm alanlarını olumsuz etkilemektedir. Sosyal biliş ile sosyal işlevselliğin ilişkisini ortaya koyan araştırma bulgularına göre sosyal biliş birçok hastalık için tedavi hedeflerinden biri olmalıdır. Son zamanlarda bu işlevlerin iyileşmesini hedef olarak belirleyen müdahalelere yönelik ilgi de giderek artmaktadır. Bu yazıda şizofrenik bozukluk özelinde bu eğitim programlarına, araştırma bulguları ve bu araştırmalarda kullanılan değerlendirme araçlarına odaklanılmıştır.

Keywords

şizofreni, sosyal biliş, sosyal biliş eğitimi, sosyal işlevsellik, işlevsel sonuç

References

• Addington J, Saeedi H, Addington D (2006) Facial affect recognition: a mediator between cognitive and social functioning in psychosis? Schizophr Res, 85:142–150.
• Adolphs R (2001) The neurobiology of social cognition. Curr Opin Neurobiol, 11:231–239.
• Adolphs R, Tranel D (2003) Amygdala damage impairs emotion recognition from scenes only when they contain facial expressions. Neuropsychologia, 41:1281–1289.
• APA (2013) Diagnostic and Statistical Manual of Mental
• Disorders, 5th Edition: DSM-5. Washington DC, American Psychiatric Association.
• Bandura A (1999) Social cognitive theory: an agentic perspective. Annu Rev Psychol, 2:21-41.
• Baron-Cohen S, Golan O, Wheelwright S, Hill JJ (2004) Mind Reading: The Interactive Guide to Emotions. London, Jessica Kingsley.
• Baron-Cohen S, O’Riordan M, Jones R, Stone VE, Plaisted K (1999) A new test of social sensitivity: detection of faux pas in normal children and children with asperger syndrome. J Autism Dev Disord, 29:407-418.
• Baron-Cohen S, Wheelwright S (2004) The empathy quotient: an investigation of adults with asperger syndrome or high functioning autism, and normal sex differences. J Autism Dev Disord, 34:163–175.
• Baron-Cohen S, Wheelwright S, Hill J, Raste Y, Plumb I (2001) The “reading the mind in the eyes” test revised version: a study with normal adults, and adults with asperger syndrome or high-functioning autism. J Child Psychol Psychiatry, 42:241–251.
• Bechi M, Spangaro M, Bosia M, Zanoletti A, Fresi F, Buonocore M et al. (2013) Theory of mind intervention for outpatients with schizophrenia. Neuropsychol Rehabil, 23:383–400.
• Beer JS, Ochsner KN (2006) Social cognition: a multi level analysis. Brain Res, 1079:98–105.
• Bell M, Bryson G, Greig T (2001) Neurocognitive enhancement therapy with work therapy. Arch Gen Psychiatry, 58:763–768.
• Bora E, Baysan L (2009) Empati ölçeği Türkçe formunun üniversite öğrencilerinde psikometrik özellikleri. Klinik Psikofarmakol Bulteni, 19:39-47.
• Bowers D, Blonder LX, Feinberg T, Heilman KM (1991) Differential impact of right and left hemisphere lesions on facial emotion and object imagery. Brain, 114:2593-2609.
• Brown EC, Tas C, Can H, Esen-Danaci A, Brüne M (2014) A closer look at the relationship between the subdomains of social functioning, social cognition and symptomatology in clinically stable patients with schizophrenia. Compr Psychiatry, 55:25–32.
• Brekke J, Kay DD, Lee KS, Green MF (2005) Biosocial pathways to functional outcome in schizophrenia. Schizophr Res, 80:213–225.
• Brenner HD, Hodel B, Genner R, Roder V, Corrigan PW (1992) Biological and cognitive vulnerability factors in schizophrenia: implications for treatment. Br J Psychiatry Suppl, 18:154–163.
• Brockmeyer T, Pellegrino J, Münch H, Herzog W, Dziobek I, Friederich HC (2016)
• Social cognition in anorexia nervosa: specific difficulties in decoding emotional but not
• nonemotional mental states. Int J Eat Disord, 49:883–890.
• Brüne M (2005) “Theory of mind” in schizophrenia: a review of the literature. Schizophr Bull, 31:21–42.
• Combs DR, Adams SD, Penn DL, Roberts D, Tiegreen J, Stem P (2007) Social cognition and interaction training (SCIT) for inpatients with schizophrenia spectrum disorders: preliminary findings. Schizophr Res, 91:112–116.
• Combs DR, Elerson K, Penn DL, Tiegreen JA, Nelson A, Ledet SN et al. (2009) Stability and generalization of social cognition and interaction training (SCIT) for schizophrenia: six-month follow-up results. Schizophr Res, 112:196–197.
• Combs DR, Penn DL, Wicher M, Waldheter E (2007a) The ambiguous intentions hostility questionnaire (AIHQ): a new measure for evaluating hostile social-cognitive biases in paranoia. Cogn Neuropsychiatry, 12:128–143.
• Corcoran R, Mercer G, Frith CD (1995) Schizophrenia, symptomatology and social inference: investigating theory of mind in people with schizophrenia. Schizophr Res, 17:5-13.
• Couture SM, Penn DL, Roberts DL (2006) The functional significance of social cognition in schizophrenia: a review. Schizophr Bull, 32:S44–S63.
• Drusch K, Stroth S, Kamp D, Frommann N, Wölwer W (2014) Effects of training of affect recognition on the recognition and visual exploration of emotional faces in schizophrenia. Schizophr Res, 159:485–490.
• Ekman P, Friesen WV (1976) Pictures of Facial Affect. Palo Alto, CA, Consulting Psychologists Press.
• Erol A, Keleş Ünal E, Gülpek D, Mete L (2009) Yüzde dışavuran duyguların tanınması ve ayırt edilmesi testlerinin Türk toplumunda güvenilirlik ve geçerlilik çalışması. Anadolu Psikiyatri Derg, 10:116-123.
• Fett AK, Viechtbauer W, Dominguez MD, Penn DL, van Os J, Krabbendam L (2011) The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci Biobehav Rev, 35:573–588.
• Fiske ST, Taylor SE (2013) Social Cognition, From Brains to Culture, 2nd ed. London, Sage.
• Frommann N, Streit M, Wölwer W (2003) Remediation of facial affect recognition impairments in patients with schizophrenia: a new training program. Psychiatry Res, 117:281–284.
• García S, Fuentes I, Ruíz JC, Gallach E, Roder V (2003) Application of the IPT in a Spanish sample: evaluation of the “social perception subprogramme”. Int J Psychol Psychol Ther, 3:299–310.
• Green MF, Penn DL, Bentall R, Carpenter WT, Gaebel W, Gur RC et al. (2008) Social cognition in schizophrenia: an NIMH workshop on definitions, assessment, and research opportunities. Schizophr Bull, 34:1211–1220.
• Gur RC, Sara R, Hagendoorn M, Marom O, Hughett P, Macy L et al. (2002) A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies. J Neurosci Methods, 115:137–143.
• Healey KM, Combs DR, Gibson CM, Keefe RS, Roberts DL, Penn DL (2015) Observable social cognition-a rating scale: an interview-based assessment for schizophrenia. Cogn Neuropsychiatry, 20:198–221.
• Henry JD, von Hippel W, Molenberghs P, Lee T, Sachdev PS (2016) Clinical assessment of social cognitive function in neurological disorders. Nat Rev Neurol, 12:28–39.
• Hogarty GE, Flesher S (1999) Practice principles of cognitive enhancement therapy for schizophrenia. Schizophr Bull, 25:693–708.
• Hogarty GE, Flesher S, Ulrich R, Carter M, Greenwald D, Pogue-Geile M et al. (2004) Cognitive enhancement therapy for schizophrenia. Arch Gen Psychiatry, 61:866–876.
• Horan WP, Kern RS, Shokat-Fadai K, Sergi MJ, Wynn JK, Green MF (2009) Social cognitive skills training in schizophrenia: an initial efficacy study of stabilized outpatients. Schizophr Res, 107:47–54.
• Javed A, Charles A (2018) The importance of social cognition in improving functional outcomes in schizophrenia. Front Psychiatry, 9:157.
• Kee KS, Green MF, Mintz J, Brekke JS (2003) Is emotion processing a predictor of functional outcome in schizophrenia? Schizophr Bull, 29:487–497.
• Kennedy DP, Adolphs R (2012) The social brain in psychiatric and neurological disorders. Trends Cogn Sci, 16:559–572.
• Kerr SL, Neale JM (1993) Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance? J Abnorm Psychol, 102:312-318.
• Kinderman P, Bentall RP (1995) A new measure of causal locus: the internal, personal and situational attributions questionnaire. Pers Individ Dif, 20:261–264.
• Kurtz MM, Richardson CL (2012) Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophr Bull, 3:1092–1104.
• Ladegaard N, Larsen ER, Videbech P, Lysaker PH (2014) Higher-order social cognition in first-episode major depression. Psychiatry Res, 216:37–43.
• Lahera G, Benito A, Montes JM, Fernández-Liria A, Olbert CM, Penn DL (2013) Social cognition and interaction training (SCIT) for outpatients with bipolar disorder. J Affect Disord, 146:132–136.
• Langdon R, Michie PT, Ward PB, McConaghy N, Catts SV, Coltheart M (1997) Defective self and/or other mentalising in schizophrenia: a cognitive neuropsychological approach. Cogn Neuropsychiatry, 2:167–193.
• Lincoln TM, Mehl S, Kesting ML, Rief W (2011) Negative symptoms and social cognition: identifying targets for psychological interventions. Schizophr Bull, 37:23–32.
• Loughland CM, Williams LM, Gordon E (2002) Schizophrenia and affective disorder show different visual scanning behavior for faces: a trait versus state-based distinction? Biol Psychiatry, 52:338–348.
• Lysaker PH, Lancaster RS, Nees MA, Davis LW (2004) Attributional style and symptoms as predictors of social function in schizophrenia. J Rehabil Res Dev, 41:225–232.
• McDonald S, Cassel A (2017) Rehabilitation of social cognition disorders. In Neuropsychological Rehabilitation, The International Handbook (Eds B Wilson, J Winegardner, C van Heugten, T Ownsworth): 266-281. London, Routledge.
• McDonald S, Flanagan S, Rollins J, Kinch J (2003) TASIT: A new clinical tool for
• assessing social perception after traumatic brain injury. J Head Trauma Rehabil, 18:219–238.
• McKay R, Langdon R, Coltheart (2006) Need for closure, jumping to conclusions, and decisiveness in delusion-prone individuals. J Nerv Ment Dis, 194:422–426.
• Mehta UM, Thirthalli J, Subbakrishna DK, Gangadhar BN, Eack SM, Keshavan MS (2013) Social and neuro-cognition as distinct cognitive factors in schizophrenia: a systematic review. Schizophr Res, 148:3–11.
• Montag C, Ehrlich A, Neuhaus K, Dziobek I, Heekeren HR, Heinz A et al. (2010) Theory of mind impairments in euthymic bipolar patients. J Affect Disord, 123:264–269.
• Moritz S, Menon M, Balzan R, Woodward TS (2023) Metacognitive training for psychosis (MCT): past, present, and future. Eur Arch Psychiatry Clin Neurosci, 273:811–817.
• Moritz S, Veckenstedt R, Hottenrott B, Woodward T, Randjbar S, Lincoln T (2010). Different sides of the same coin? Intercorrelations of cognitive biases in schizophrenia. Cogn Neuropsychiatry, 15:406–421.
• Moritz S, Woodward TS (2007) Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Curr Opin Psychiatry, 20:619–625.
• Nijman SA, Veling W, Greaves-Lord K, Vos M, Zandee CER, Aan Het Rot M et al. (2020) Dynamic interactive social cognition training in virtual reality (DiSCoVR) for people with a psychotic disorder: single-group feasibility and acceptability study. JMIR Ment Health, 7:e17808.
• Olgun Kaval N (2021) Sosyal anksiyete belirtilerini azaltmaya yönelik internet temelli bir sosyal biliş eğitim programının uyarlanması ve etkililiğinin incelenmesi (Doktora tezi). İzmir, Ege Üniversitesi.
• Özaslan Z (2019) Şizofreni hastalarında sosyal bilişi değerlendirme görüşmesinin Türkçe geçerlilik ve güvenilirlik çalışması (Doktora tezi). Kocaeli, Kocaeli Üniversitesi.
• Papatya I (1987) Depresif kişilerin kendilerine ve önem verdikleri bir kişiye ilişkin yüklemeleri (Yüksek lisans tezi). Ankara, Hacettepe Üniversitesi.
• Penn D, Roberts DL, Munt ED, Silverstein E, Jones N, Sheitman B (2005) A pilot study of social cognition and interaction training (SCIT) for schizophrenia. Schizophr Res, 80:357–359.
• Penn DL, Combs D (2000) Modification of affect perception deficits in schizophrenia. Schizophr Res, 46:217–229.
• Penn DL, Roberts DL, Combs D, Sterne A (2007) Best practices: the development of the social cognition and interaction training program for schizophrenia spectrum disorders. Psychiatr Serv, 58:449–451.
• Peterson C, Semmel A, von Baeyer C, Abramson LY, Metalsky GI, Seligman MEP (1982) The attributional style questionnaire. Cogn Ther Res, 6:287–300.
• Pinkham AE (2014) Social cognition in schizophrenia. J Clin Psychiatry, 75:14–19.
• Pinkham AE, Penn DL, Green MF, Buck B, Healey K, Harvey PD (2013) The social cognition psychometric evaluation study: results of the expert survey and RAND panel. Schizophr Bull, 40:813–823.
• Roberts DL, Penn DL (2009) Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study. Psychiatry Res, 166:141–147.
• Rocha NB, Queirós C (2013) Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study. Schizophr Res, 150:64–68.
• Roder V, Müller DR (2015) INT-Integrated Neurocognitive Therapy for Schizophrenia Patients. Springer International.
• Sachs G, Winklbaur B, Jagsch R, Lasser I, Kryspin-Exner I, Frommann N et al. (2012) Training of affect recognition (TAR) in schizophrenia--impact on functional outcome. Schizophr Res, 138:262–267.
• Shamay-Tsoory SG (2010) The neural bases for empathy. Neuroscientist, 17:18–24.
• Shen ZH, Liu MH, Wu Y, Lin QQ, Wang YG (2022) Virtual-reality-based social cognition and interaction training for patients with schizophrenia: a preliminary efficacy study. Front Psychiatry, 13:1022278.
• Şandor S, İşcen P (2021) Faux-pas recognition test: a Turkish adaptation study and a proposal of a standardized short version. Appl Neuropsychol Adult, 30:34–42.
• Taş C (2011) Şizofreni hastalarında aile etkileşimli sosyal biliş geliştirme programının etkinliği (Uzmanlık tezi). Manisa, Celal Bayar Üniversitesi.
• Tombul K, Samancı B, Tüfekçioğlu Z, Bilgiç B, Tatlıdede AD, Kalem ŞA et al. (2023) Validity and reliability of the pictures of facial affect (POFA) in healthy people and patients with essential tremor in the Turkish population. Noro Psikiyatr Ars, 60:194–201.
• Tottenham N, Borscheid A, Ellertsen K, Marcus DJ, Nelson CA (2002) Categorization of facial expressions in children and adults: establishing a larger stimulus set. J Cogn Neurosci, 14:S74.
• van der Gaag M, Kern RS, van den Bosch RJ, Liberman RP (2002) A controlled trial of cognitive remediation in schizophrenia. Schizophr Bull, 28:167–176.
• van Neerven T, Bos DJ, van Haren NE (2021) Deficiencies in theory of mind in patients with schizophrenia, bipolar disorder, and major depressive disorder: a systematic review of secondary literature. Neurosci Biobehav Rev, 120:249–261.
• Vauth R, Rusch N, Wirtz M, Corrigan PW (2004) Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? Psychiatry Res, 128:155–165.
• Wölwer W, Frommann N, Halfmann S, Piaszek A, Streit M, Gaebel W (2005) Remediation of impairments in facial affect recognition in schizophrenia: efficacy and specificity of a new training program. Schizophr Res, 80:295–303.
• Yamada Y, Inagawa T, Sueyoshi K, Sugawara N, Ueda N, Omachi Y et al. (2019) Social cognition deficits as a target of early intervention for psychoses: a systematic review. Front Psychiatry, 10:333.
• Yıldırım EA, Kaşar M, Güdük M, Ateş E, Küçükparlak İ, Özalmete EO (2011) Gözlerden zihin okuma testi’nin Türkçe güvenirlik çalışması. Turk Psikiyatri Derg, 22:177-186.
• Yolland COB, Carruthers SP, Toh WL, Neill E, Sumner PJ, Thomas EHX et al. (2021) The relationship between negative symptoms and both emotion management and non-social cognition in schizophrenia spectrum disorders. J Int Neuropsychol Soc, 27:916–928.
• Young A, Perrett D, Calder A, Sprengelmeyer R, Ekman P (2002) Facial Expressions of Emotion: Stimuli and Tests (FEEST). Edmunds, UK, Thames Valley Test Company.