Differences in social perception in people with schizophrenia and bipolar disorder.

People with schizophrenia have difficulties recognizing other people's expressions, emotional states, and intentions; however, much less is known about their ability to perceive and understand social interactions. We used scenes depicting social situations to compare responses from 90 volunteers (healthy controls [HC], schizophrenia [SZ], and bipolar disorder [BD] outpatients from the Hospital del Salvador in Valparaíso, Chile) to the question: "What do you think is happening in the scene?" Independent blind raters assigned a score of 0 (absent), 1 (partial), or 2 (present) for each item based on whether the description identifies a) the context, b) the people, and c) the interaction depicted in the scenes. Regarding the context of the scenes, the SZ and BD groups scored significantly lower than the HC group, with no significant difference between the SZ and BD groups. Regarding the identification of the people and the interactions, the SZ group scored lower than the HC and BD groups, with no significant difference between the HC and BD groups. An ANCOVA was used to examine the relationship between diagnosis, cognitive performance, and the results of the social perception test. The diagnosis had an effect on context (p = .001) and people (p = .0001) but not on interactions (p = .08). Cognitive performance had a significant effect on interactions (p = .008) but not on context (p = .88) or people (p = .62). Our main result is that people with schizophrenia may have significant difficulties perceiving and understanding social encounters between other people.

Eficacia del entrenamiento metacognitivo en una muestra chilena de personas con esquizofrenia / Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia

RESUMEN Introducción: El entrenamiento metacognitivo (EMC) de Moritz et al., una nueva dirección en terapia, es un programa de entrenamiento grupal manualizado, dirigido a corregir los sesgos cognitivos implicados en la formación y el mantenimiento de los síntomas psicóticos, principalmente los delirios. El objetivo de este estudio es evaluar la eficacia del EMC en una muestra chilena de personas con esquizofrenia. Métodos: Se aleatorizó a 50 pacientes ambulatorios del Hospital Del Salvador de Valparaíso, Chile, al grupo de intervención que recibió el EMC o al grupo de control que solo recibió el tratamiento habitual. Se evaluó a los sujetos al inicio y al término del estudio mediante la escala de los síndromes positivo y negativo (PANSS), el cuestionario de sesgos cognitivos para psicosis (CBQ) y la escala de insight cognitivo de Beck (BCIS). Resultados: En el grupo de EMC se registraron mayores mejorías estadísticamente significa tivas, tanto en síntomas y sesgos cognitivos como en insight cognitivo, que en el grupo de control. Al comparar ambos grupos, solo se observaron resultados significativos a favor del EMC en los síntomas positivos. Conclusiones: Los resultados de este estudio indican que el EMC es superior al tratamiento habitual en el tratamiento de los síntomas positivos. No fue posible demostrar su superio ridad en la mejoría de los sesgos cognitivos y el insight cognitivo.

ABSTRACT Introduction: Moritz et al.'s metacognitive training (MCT), a new development of cognitive therapy, is a manualized group training program, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia. Methods: 50 outpatients from the Hospital Del Salvador at Valparaíso, Chile, were randomly assigned to the intervention group (MCT), or the control group, that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS). Results: In the MCT group, we found larger, statistically significant improvements, in symp toms, cognitive biases and cognitive insight, than in the control group. However, after a direct comparison of both groups, only the improvement in psychotic symptoms for the MCT group, remained significantly different. Conclusions: The results of this study suggest superiority of MCT over TAU in the amelioration of positive symptoms. We could not, however demonstrate its superiority in the improvement of the cognitive biases and cognitive insight.

Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia.

INTRODUCTION: Moritz et al.'s metacognitive training (MCT), a new development of cognitive therapy, is a manualised group training programme, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia. METHODS: 50 outpatients from the Hospital Del Salvador in Valparaíso, Chile, were randomly assigned to the intervention group that received MCT or the control group that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS). RESULTS: Greater statistically significant improvements were recorded in the MCT group, both in symptoms and cognitive biases and in cognitive insight, than in the control group. When comparing both groups, significant results in favor of MCT were only observed in positive symptoms. CONCLUSIONS: The results of this study suggest MCT is superior to TAU in treating positive symptoms. It was not possible to demonstrate its superiority in improving cognitive biases and cognitive insight.

The Type of Information People with Schizophrenia Use in Ambiguous Social Situations.

BACKGROUND AND OBJECTIVES: Rather than focusing on the extensively studied social perception and recognition impairments in people with schizophrenia, this study focuses on the type of social information considered relevant by people with schizophrenia, and how they use it to arrive at conclusions about social situations. METHODS: Participants included 50 outpatients with schizophrenia from the Hospital del Salvador at Valparaíso, Chile, and 50 healthy comparators matched by age and gender. Subjects completed the Social Information Preference Test (SIPT), which presents scenes depicting ambiguous social situations with faces, thoughts, and facts about the scene hidden from view. Participants were required to select a limited number of these items and then choose between possible interpretations of the scene (positive, neutral, or negative). Additionally, they are asked to provide a feeling of certainty in their answers, using a 7-point visual analogue scale. RESULTS: People with schizophrenia, as well as controls had a strong preference for knowing the thoughts of the characters. Both groups were least likely to choose emotional expressions. Patients were significantly less likely to choose object/information than controls. Both groups showed a high certainty in their responses and no tendency to choose negative interpretations. LIMITATIONS: compensated clinical status of the patients may have influenced the results. CONCLUSIONS: The results of this study suggest that, despite difficulties perceiving clues about the mental state of others, people with schizophrenia use this information to make sense of social situations, and apparently, they do not have problems in understanding social interactions.

The Type of Information People with Schizophrenia Use in Ambiguous Social Situations / ¿Qué tipo de información usan las personas con esquizofrenia en situaciones sociales ambiguas?

ABSTRACT Background and objectives: Rather than focusing on the extensively studied social perception and recognition impairments in people with schizophrenia, this study focuses on the type of social information considered relevant by people with schizophrenia, and how they use it to arrive at conclusions about social situations. Methods: Participants included 50 outpatients with schizophrenia from the Hospital del Salvador at Valparaíso, Chile, and 50 healthy comparators matched by age and gender. Subjects completed the Social Information Preference Test (SIPT), which presents scenes depicting ambiguous social situations with faces, thoughts, and facts about the scene hidden from view. Participants were required to select a limited number of these items and then choose between possible interpretations of the scene (positive, neutral, or negative). Additionally, they are asked to provide a feeling of certainty in their answers, using a 7-point visual analogue scale. Results: People with schizophrenia, as well as controls had a strong preference for knowing the thoughts of the characters. Both groups were least likely to choose emotional expressions. Patients were significantly less likely to choose object/information than controls. Both groups showed a high certainty in their responses and no tendency to choose negative interpretations. Limitations: compensated clinical status of the patients may have influenced the results. Conclusions: The results of this study suggest that, despite difficulties perceiving clues about the mental state of others, people with schizophrenia use this information to make sense of social situations, and apparently, they do not have problems in understanding social interactions.

RESUMEN Objetivos: En lugar de los impedimentos en la percepción social, ampliamente estudiada en personas con esquizofrenia, centramos nuestra investigación en el tipo de información social considerada relevante por las personas con esquizofrenia y cómo la usan para llegar a conclusiones sobre situaciones sociales. Métodos: Se incluyó a 50 pacientes ambulatorios con esquizofrenia del Hospital del Salvador en Valparaíso, Chile, y 50 comparadores sanos, emparejados por edad y sexo. Los sujetos completaron la Prueba de Preferencia de Información Social (SIPT), que presenta escenas con situaciones sociales ambiguas en las que rostros, pensamientos y hechos sobre la escena están ocultos a la vista. Los participantes deben seleccionar un pequeño número de estos elementos y luego elegir entre posibles interpretaciones (positiva, neutral o negativa). Además, se les pide que proporcionen una sensación de certeza en sus respuestas, utilizando una escala analógica visual de 7 puntos. Resultados: Tanto las personas con esquizofrenia como los comparadores mostraron una fuerte preferencia por conocer los pensamientos de los personajes. La opción menos preferida por ambos grupos fue las expresiones emocionales, mientras que los pacientes escogieron menos objeto/información que los controles. Ambos grupos mostraron una alta certeza en sus respuestas y no se observó una tendencia a elegir interpretaciones negativas. Limitaciones: el estado clínico compensado de los pacientes puede haber influido en los resultados. Conclusiones: Los resultados de este estudio indican que, a pesar de las dificultades para percibir pistas sobre el estado mental de los demás, las personas con esquizofrenia usan esta información para dar sentido a las situaciones sociales y, aparentemente, no presentan problemas para comprender las interacciones sociales.

People with schizophrenia use less information to interpret ambiguous social situations.

BACKGROUND AND OBJECTIVES: The tendency of people with schizophrenia to gather insufficient information before making decisions or jumping to conclusions has been repeatedly reported. However, criticism has also been expressed regarding the ecological validity of this finding. Here we present the results obtained by a group of people with schizophrenia and a control group in a non-probabilistic task that requires obtaining items of information before interpreting an ambiguous social situation. METHODS: Patients with schizophrenia (n = 48) and controls (n = 44) aged 18-50 years participated in the study. All subjects completed the Beads Task and the modified Social Information Preference Task. RESULTS: Patients with schizophrenia showed a statistically significant tendency to jump to conclusions, including in the proposed novel social task. Unlike other studies, we were unable to find a relationship between this bias and greater severity of psychotic symptoms. LIMITATIONS: We did not include patients with high levels of psychotic symptoms or a clinical control group. CONCLUSIONS: The tendency to jump to conclusions in schizophrenia could be present in everyday interpersonal situations.

Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia. / Eficacia del entrenamiento metacognitivo en una muestra chilena de personas con esquizofrenia.

INTRODUCTION: Moritz et al.'s metacognitive training (MCT), a new development of cognitive therapy, is a manualized group training program, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia. METHODS: 50 outpatients from the Hospital Del Salvador at Valparaíso, Chile, were randomly assigned to the intervention group (MCT), or the control group, that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS). RESULTS: In the MCT group, we found larger, statistically significant improvements, in symptoms, cognitive biases and cognitive insight, than in the control group. However, after a direct comparison of both groups, only the improvement in psychotic symptoms for the MCT group, remained significantly different. CONCLUSIONS: The results of this study suggest superiority of MCT over TAU in the amelioration of positive symptoms. We could not, however demonstrate its superiority in the improvement of the cognitive biases and cognitive insight.

The Type of Information People with Schizophrenia Use in Ambiguous Social Situations.

BACKGROUND AND OBJECTIVES: Rather than focusing on the extensively studied social perception and recognition impairments in people with schizophrenia, this study focuses on the type of social information considered relevant by people with schizophrenia, and how they use it to arrive at conclusions about social situations. METHODS: Participants included 50 outpatients with schizophrenia from the Hospital del Salvador at Valparaíso, Chile, and 50 healthy comparators matched by age and gender. Subjects completed the Social Information Preference Test (SIPT), which presents scenes depicting ambiguous social situations with faces, thoughts, and facts about the scene hidden from view. Participants were required to select a limited number of these items and then choose between possible interpretations of the scene (positive, neutral, or negative). Additionally, they are asked to provide a feeling of certainty in their answers, using a 7-point visual analogue scale. RESULTS: People with schizophrenia, as well as controls had a strong preference for knowing the thoughts of the characters. Both groups were least likely to choose emotional expressions. Patients were significantly less likely to choose object/information than controls. Both groups showed a high certainty in their responses and no tendency to choose negative interpretations. LIMITATIONS: compensated clinical status of the patients may have influenced the results. CONCLUSIONS: The results of this study suggest that, despite difficulties perceiving clues about the mental state of others, people with schizophrenia use this information to make sense of social situations, and apparently, they do not have problems in understanding social interactions.