The Effects of Metacognition-Oriented Social Skills Training on Psychosocial Outcome in Schizophrenia-Spectrum Disorders: A Randomized Controlled Trial.

A pilot study of the effects of metacognition-oriented social skills training (MOSST) on social functioning in patients with schizophrenia spectrum disorders (SSDs) reported promising results. The main purpose of the current trial was to compare the effectiveness and potential benefits of MOSST vs conventional social skills training (SST). Single-blind randomized controlled trial with 2 groups of patients aged 18-65 with SSDs on partial hospitalization. Participants were randomly assigned (1:1) to receive 16 group sessions with MOSST or conventional SST, both in addition to standard care, over 4 months, with a 6-month follow-up. Psychosocial functioning, metacognition, and symptom outcomes were measured by blind assessors. Statistical analyses used mixed models to estimate treatment effects in each postrandomization time point. Thirty-six patients were randomly assigned to the MOSST group and 33 patients to the conventional SST group. Between-group differences were significant in favor of MOSST on Social and Occupational Functioning Assessment Scale (SOFAS) and Personal and Social Performance Scale (PSP) total scores at post-treatment and follow-up. Concerning PSP subscales, there were significant between-group differences in favor of MOSST at follow-up on socially useful activities, personal and social relationships, and disturbing and aggressive behaviors. Metacognition only improved following MOSST group. For people with SDDs, MOSST appears to have short- and long-term beneficial effects on social functioning and symptoms. Further studies are required to replicate the current results in other samples.

A pilot study on feasibility, acceptance and effectiveness of metacognitive-oriented social skills training in schizophrenia.

BACKGROUND: In preparation for a randomized controlled trial, a pilot study was conducted to investigate the feasibility, acceptability and effectiveness of a psychotherapy group based on metacognitive-oriented social skills training (MOSST). METHODS: Twelve outpatients with schizophrenia were offered 16 group-sessions of MOSST. Effect sizes were calculated for changes from baseline to treatment end for both psychosocial functioning and metacognitive abilities measured by the Personal and Social Performance Scale (PSP) and the Metacognition Assessment Scale-Abbreviated (MAS-A) respectively. RESULTS AND DISCUSSION: Ten patients finished the full treatment protocol and nonsignificant moderate effect sizes were obtained on PSP and MAS-A scores. To date, this is the first study in Spain to suggest that outpatients with schizophrenia will accept metacognitive therapy for social skills training and evidence improvements in psychosocial functioning and metacognition. CONCLUSION: Despite limitations inherent in a pilot study, including a small sample size and the absence of a control group, sufficient evidence of effectiveness was found to warrant further investigation. TRIAL REGISTRATION: ISRCTN10917911 . Retrospectively registered 30 November 2016.

Habilidades metacognitivas en adultos con abuso de sustancias bajo tratamiento en comunidad terapéutica / Metacognitive abilities in adults with substance abuse treated in therapeutic community

Antecedentes: El término de metacognición hace referencia al conjunto de procesos psicológicos que permiten a los individuos desarrollar e integrar representaciones sobre los estados mentales propios y de los demás. El objetivo principal de este estudio fue examinar si los pacientes bajo tratamiento por consumo de sustancias, en régimen de comunidad terapéutica, presentan un perfil específico de déficits metacognitivos en las áreas de Autorreflexividad, Diferenciación, Descentramiento y Dominio, comparando sus puntuaciones con las obtenidas por dos muestras clínicas de pacientes con trastornos del espectro esquizofrénico y trastornos de ansiedad. Método: Se diseñó un estudio con metodología mixta (cualitativa-cuantitativa). Se seleccionaron un total de 216 participantes con diagnósticos principales por consumo de sustancias (n = 52), espectro esquizofrénico (n = 49) y trastornos de ansiedad (n = 115). Los datos cualitativos se obtuvieron con la Entrevista de Evaluación de la Metacognición (MAI) y, posteriormente, estos fueron cuantificados con la Escala Abreviada de Evaluación de la Metacognición (MAS-A). Resultados: Las puntuaciones totales en la MAS–A del grupo con trastornos de ansiedad fueron estadísticamente superiores a las del grupo con trastornos por consumo de sustancias (TCS), y éstas, a su vez, fueron significativamente superiores a las del grupo con trastornos del espectro esquizofrénico. Por subescalas de la MAS-A, sólo hubo diferencias estadísticamente significativas entre las puntuaciones de Dominio del grupo con ansiedad y TCS, obteniendo el grupo con TCS puntuaciones estadísticamente equivalentes a las del grupo con trastornos del espectro esquizofrénico. Conclusiones: De acuerdo con estos resultados, los programas actuales de intervención en drogadicción deberían orientarse más específicamente a mejorar las habilidades metacognitivas de Dominio

Background: The term metacognition reflects a spectrum of psychological activities that allows people to form and integrate representations about their own mental states and those of others. The main goal of this study was to examine whether people with substance abuse disorders (SUDs), and treated in therapeutic community regime, displayed specific patterns of metacognitive deficits on Selfreflectivity, Understanding others’ mind, Decentration, and Mastery, comparing their scores with two clinical groups of patients with schizophrenia spectrum disorders (SSDs) and anxiety disorders. Method: A mixed-methods (qualitative-quantitative) study was designed. Two hundred and sixteen adults aged 18-65 with principal diagnoses of SUDs (n = 52), SSDs (n = 49), and anxiety disorders (n = 115) were recruited. Qualitative data were obtained with the Metacognition Assessment Interview, which was then rated using a quantitative scale, the Metacognition Assessment Scale-Abbreviated (MAS-A). Results: The anxiety disorders group had significantly higher MAS-A total scores than the SUDs group, and the SUDs group obtained significantly higher MAS-A total scores than the SSDs group. Concerning the MAS-A subscale scores, the SUDs group displayed significantly lower scores only on the Mastery subscale compared to the anxiety disorders group, with the SUDs and SSDs groups obtaining equivalent Mastery scores. Conclusions: According to these findings, current interventions for addiction should focus more specifically on improving metacognitive Mastery

Metacognitive abilities in adults with substance abuse treated in therapeutic community. / Habilidades metacognitivas en adultos con abuso de sustancias bajo tratamiento en comunidad terapéutica.

BACKGROUND: The term metacognition reflects a spectrum of psychological activities that allows people to form and integrate representations about their own mental states and those of others. The main goal of this study was to examine whether people with substance abuse disorders (SUDs), and treated in therapeutic community regime, displayed specific patterns of metacognitive deficits on Self-reflectivity, Understanding others’ mind, Decentration, and Mastery, comparing their scores with two clinical groups of patients with schizophrenia spectrum disorders (SSDs) and anxiety disorders. METHOD: A mixed-methods (qualitative-quantitative) study was designed. Two hundred and sixteen adults aged 18-65 with principal diagnoses of SUDs (n = 52), SSDs (n = 49), and anxiety disorders (n = 115) were recruited. Qualitative data were obtained with the Metacognition Assessment Interview, which was then rated using a quantitative scale, the Metacognition Assessment Scale-Abbreviated (MAS-A). RESULTS: The anxiety disorders group had significantly higher MAS-A total scores than the SUDs group, and the SUDs group obtained significantly higher MAS-A total scores than the SSDs group. Concerning the MAS-A subscale scores, the SUDs group displayed significantly lower scores only on the Mastery subscale compared to the anxiety disorders group, with the SUDs and SSDs groups obtaining equivalent Mastery scores. CONCLUSIONS: According to these findings, current interventions for addiction should focus more specifically on improving metacognitive Mastery.

Antecedentes: El término de metacognición hace referencia al conjunto de procesos psicológicos que permiten a los individuos desarrollar e integrar representaciones sobre los estados mentales propios y de los demás. El objetivo principal de este estudio fue examinar si los pacientes bajo tratamiento por consumo de sustancias, en régimen de comunidad terapéutica, presentan un perfil específico de déficits metacognitivos en las áreas de Autorreflexividad, Diferenciación, Descentramiento y Dominio, comparando sus puntuaciones con las obtenidas por dos muestras clínicas de pacientes con trastornos del espectro esquizofrénico y trastornos de ansiedad. Método: Se diseñó un estudio con metodología mixta (cualitativa-cuantitativa). Se seleccionaron un total de 216 participantes con diagnósticos principales por consumo de sustancias (n = 52), espectro esquizofrénico (n = 49) y trastornos de ansiedad (n = 115). Los datos cualitativos se obtuvieron con la Entrevista de Evaluación de la Metacognición (MAI) y, posteriormente, estos fueron cuantificados con la Escala Abreviada de Evaluación de la Metacognición (MAS-A). Resultados: Las puntuaciones totales en la MAS­A del grupo con trastornos de ansiedad fueron estadísticamente superiores a las del grupo con trastornos por consumo de sustancias (TCS), y éstas, a su vez, fueron significativamente superiores a las del grupo con trastornos del espectro esquizofrénico. Por subescalas de la MAS-A, sólo hubo diferencias estadísticamente significativas entre las puntuaciones de Dominio del grupo con ansiedad y TCS, obteniendo el grupo con TCS puntuaciones estadísticamente equivalentes a las del grupo con trastornos del espectro esquizofrénico. Conclusiones: De acuerdo con estos resultados, los programas actuales de intervención en drogadicción deberían orientarse más específicamente a mejorar las habilidades metacognitivas de Dominio.

Análisis psicodinámico breve en un caso de dependencia del alcohol / Brief Psychodynamic analysis in a case of alcohol dependence

Se presenta el caso de un paciente masculino de 41 años de edad diagnosticado con dependencia del alcohol, con el objetivo de elaborar un juicio diagnóstico y pronóstico desde el punto de vista psicodinámico, y descubrir, en la medida de lo posible, “quién” es el paciente, qué desarrollo vital le ha llevado a ser lo que actualmente es y derivando de esta concepción, qué sentido tiene su “enfermar” (AU)

We report a case of a client diagnosed of alcohol dependence with the aim of developing a psychodynamic approach to study his diagnosis and prognosis. In addition, we pretend to address “who” is the patient, the biographic development that led him to have his current “self” and, in relation with this concept, to what extent his mental disorder is related with the whole biographical picture (AU)

El proceso de integración social del inmigrante. A propósito de un caso / The social integration of immigrants. Report of a case

Se presenta el caso de una mujer sudamericana con residencia en España, que desarrolla un Trastorno Psicótico Breve asociado al inicio de los trámites para obtener la nacionalidad española. Fue imprescindible conocer en detalle la situación migratoria de la paciente y los procedimientos legales que deben hacerse ante el registro civil para obtener la nacionalidad, antes de decidir si sus ideas autorreferenciales eran o no delirantes, y no solo tener en cuenta su intensidad y el menoscabo familiar y social que provocaron(AU)

We report a case of a South American woman living in Spain who developed a Brief Psychotic Disorder associated with the onset of proceedings to obtain Spanish citizenship. It was essential to know in detail the patients immigration status and the legal procedures that the civil registry requires for obtaining citizenship, before deciding if her ideas were or were not delusional self-referential, and not only taking into account the produced intensity, relative impairment and social challenges(AU)