A randomized study on the efficacy of the Social Cognition Training Program-brief version in a sample of patients with schizophrenia.

OBJECTIVE: In recent years, various interventions have been developed to train social cognition in schizophrenia, which have been shown to be effective in improving emotional processing, theory of mind and social perception, as well as community functioning. One of these interventions is the Social Cognition Training Program (SCTP), a program consisting of 24 sessions. For the present study we developed a brief version of 12 sessions with the aim to improve its applicability. To evaluate the effectiveness of this version, a randomized controlled trial was conducted comparing the SCTP to a neurocognitive training. METHOD: The trial was conducted with a sample of 299 patients with schizophrenia, with assessments conducted at baseline, posttreatment, and 6- and 12-month follow up. The assessment protocol included tests of emotion recognition, theory of mind, attributional style, symptomatology, community functioning, and neurocognitive functioning. RESULTS: The results obtained showed that the patients of the experimental group improved in the recognition of the emotions of sadness, anger, and fear, and in the first- and second-order theory of mind. However, no significant improvement was observed in the measures of community functioning. Improvements in first- and second-order theory of mind but not emotion recognition persisted at follow ups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Results obtained showed that deficits in social cognition can be ameliorated, although it could be necessary to have booster sessions to maintain the benefits of the training and to complement the SCPT with another type of interventions aimed specifically at transferring the benefits of social cognition training to "real" life. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotion recognition in patients with schizophrenia: the role of sex / Reconocimiento de emociones en pacientes con esquizofrenia: el papel del sexo

BACKGROUND: Despite the abundant research on emotion recognition in schizophrenia, there are still some issues about which there is no conclusive data. The present study examined one these issues: the role that sex plays in emotion recognition. Method: The sample consisted of 440 participants, 220 patients with schizophrenia and 220 controls. Measures of the six basic emotions, psychopathology, and cognitive functioning were taken. The data were analyzed by repeated measures analysis of variance. RESULTS: Controls perceived all emotions, except happiness, better than patients. In the patient group three main results were obtained: 1) men recognized disgust and neutral expressions better than women; 2) happiness and sadness were better recognized on female faces, while disgust and neutral expressions were better recognized on male faces; and 3) a significant interaction was seen between the stimulus sex and the participant sex only for the fear emotion. CONCLUSIONS: The results obtained support the hypothesis that deficits in the recognition of emotions is a core feature of schizophrenia that affects both men and women to the same extent. There is no clear pattern of interaction between the sex of the perceiver and the sex of the photograph used as a stimulus

ANTECEDENTES: a pesar de haber abundante investigación sobre el reconocimiento de emociones en esquizofrenia, hay algunas cuestiones sobre las que no hay datos concluyentes. El presente estudio valoró una de esas cuestiones: el papel del género en el reconocimiento de emociones. MÉTODO: la muestra estuvo compuesta por 440 sujetos, 220 pacientes con esquizofrenia y 220 controles. Se tomaron medidas de las seis emociones básicas, psicopatología y funcionamiento cognitivo. Los datos se analizaron mediante un ANOVA de medidas repetidas. RESULTADOS: los controles percibieron todas las emociones mejor que los pacientes, excepto la alegría. En los pacientes destacaron tres resultados: 1) los hombres reconocieron mejor el asco y la expresión neutra; 2) las emociones de alegría y tristeza se reconocieron mejor en caras femeninas, y el asco en masculinas; 3) se observó un efecto de interacción entre el género de la fotografía y del participante solo para la emoción de miedo. CONCLUSIONES: los resultados apoyan que el déficit en el reconocimiento de emociones es un rasgo característico de la esquizofrenia, que afecta tanto a hombres como a mujeres. No se observa un patrón claro de interacciones entre el género del participante y el género de la imagen usada como estímulo

Emotion recognition in patients with schizophrenia: The role of sex.

BACKGROUND: Despite the abundant research on emotion recognition in schizophrenia, there are still some issues about which there is no conclusive data. The present study examined one these issues: the role that sex plays in emotion recognition. METHOD: The sample consisted of 440 participants, 220 patients with schizophrenia and 220 controls. Measures of the six basic emotions, psychopathology, and cognitive functioning were taken. The data were analyzed by repeated measures analysis of variance. RESULTS: Controls perceived all emotions, except happiness, better than patients. In the patient group three main results were obtained: 1) men recognized disgust and neutral expressions better than women; 2) happiness and sadness were better recognized on female faces, while disgust and neutral expressions were better recognized on male faces; and 3) a significant interaction was seen between the stimulus sex and the participant sex only for the fear emotion. CONCLUSIONS: The results obtained support the hypothesis that deficits in the recognition of emotions is a core feature of schizophrenia that affects both men and women to the same extent. There is no clear pattern of interaction between the sex of the perceiver and the sex of the photograph used as a stimulus.

Neurocognition functioning as a prerequisite to intact social cognition in schizophrenia.

Introduction: There are mixed findings regarding the relationships between neurocognition and social cognition in schizophrenia. This study aims to provide new empirical evidence to help determine the relationships between these constructs in schizophrenia.Methods: 299 stabilised patients with schizophrenia aged 18-65 years old were recruited. After having into account exclusion criteria, final sample was contained 284 patients. The Emotion Recognition Assessment Test (ERAT) was used to assess six basic emotions. To assess the theory of mind (ToM), the Hinting Task and the Faux-Pas Test were used, and the Screen for Cognitive Impairment in Psychiatry (SCIP) was administered to assess cognitive functioning. Bivariate and multivariate analyses (partial correlations, canonical correlation, regression analysis, and confirmatory and exploratory factor analysis) were conducted.Results: Statistically significant relationships were found between the subtests of the SCIP and social cognitive measures. The redundancy coefficient in the canonical analysis was 0.13. The CFA analysis showed that the best model has a two-factor structure, in which neurocognition and social cognition are correlated factors. Less than 10% of patients with impaired cognitive functioning have a performance within normal range on social cognition tests.Conclusions: The findings show that neurocognition and social cognition are independent but related constructs.

Adaptación al español de la escala Internalized Stigma of Mental Illness para valorar el estigma personal / Adaptation into Spanish of the Internalised Stigma of Mental Illness scale to assess personal stigma

Introducción: En ocasiones los pacientes con esquizofrenia asumen como propio el estigma social relacionado con la enfermedad y se origina el denominado estigma personal. El estigma personal implica el autoestigma (interiorización de estereotipos negativos), el estigma percibido (percepción de rechazo) y el estigma experimentado (experiencias de discriminación). El estigma personal se relaciona con peor adherencia al tratamiento y peor funcionamiento social; por tanto, es importante contar con medidas adecuadas del estigma personal. Una de las medidas más utilizadas es la escala Internalized Stigma of Mental Illness (ISMI). Esta escala está disponible en español, aunque la versión diseñada no se sometió a un análisis psicométrico riguroso. El presente estudio se plantea analizar las propiedades psicométricas de una nueva versión en español de la ISMI. Material y métodos: La nueva versión se tradujo como Estigma Interiorizado de Enfermedad Mental (EIEM). Se calcularon la consistencia interna y la fiabilidad test-retest en una muestra de 69 pacientes diagnosticados de esquizofrenia o trastorno esquizoafectivo. También se analizó el porcentaje de pacientes que mostraban estigma, y su relación con variables sociodemográficas y clínicas. Resultados: La nueva versión obtuvo valores adecuados de consistencia interna y fiabilidad test-retest para el total de la prueba (0,91 y 0,95 respectivamente) y para las 5 subescalas que integran la EIEM, salvo la subescala de Resistencia al estigma (alfa de Cronbach 0,42). Conclusiones: La EIEM parece una escala adecuada para valorar el estigma personal en población española con trastorno mental grave, al menos en personas con diagnóstico de esquizofrenia o trastorno esquizoafectivo

Introduction: Patients with schizophrenia sometimes internalise social stigma associated to mental illness, and they develop personal stigma. Personal stigma includes self-stigma (internalisation of negative stereotypes), perceived stigma (perception of rejection), and experienced stigma (experiences of discrimination). Personal stigma is linked with a poorer treatment adherence, and worst social functioning. For this reason, it is important to have good measurements of personal stigma. One of the most frequently used measurements is the Internalised Stigma of Mental Illness (ISMI) scale. There is a Spanish version of the scale available, although its psychometric properties have not been studied. The main aim of this study is to analyse the psychometric properties of a new Spanish version of the ISMI scale. Material and methods: The new version was translated as Estigma Interiorizado de Enfermedad Mental (EIEM). Internal consistency and test-retest reliability were calculated in a sample of 69 patients with a diagnosis of schizophrenia or schizoaffective disorder. The rate of patients showing personal stigma was also studied, as well as the relationship between personal stigma and sociodemographic and clinical variables. Results: The adapted version obtained good values of internal consistency and test-retest reliability, for the total score of the scale (0.91 and 0.95 respectively), as well as for the five subscales of the EIEM, except for the Stigma Resistance subscale (Cronbach's alpha 0.42). Conclusions: EIEM is an appropriate measurement tool to assess personal stigma in a Spanish population with severe mental disorder, at least in those with a diagnosis of schizophrenia or schizoaffective disorder

Faux-Pas Test: A Proposal of a Standardized Short Version.

Previous research on theory of mind suggests that people with schizophrenia have difficulties with complex mentalization tasks that involve the integration of cognition and affective mental states. One of the tools most commonly used to assess theory of mind is the Faux-Pas Test. However, it presents two main methodological problems: 1) the lack of a standard scoring system; 2) the different versions are not comparable due to a lack of information on the stories used. These methodological problems make it difficult to draw conclusions about performance on this test by people with schizophrenia. The aim of this study was to develop a reduced version of the Faux-Pas test with adequate psychometric properties. The test was administered to control and clinical groups. Interrater and test-retest reliability were analyzed for each story in order to select the set of 10 stories included in the final reduced version. The shortened version showed good psychometric properties for controls and patients: test-retest reliability of 0.97 and 0.78, inter-rater reliability of 0.95 and 0.87 and Cronbach's alpha of 0.82 and 0.72.

Adaptation into Spanish of the Internalised Stigma of Mental Illness scale to assess personal stigma. / Adaptación al español de la escala Internalized Stigma of Mental Illness para valorar el estigma personal.

INTRODUCTION: Patients with schizophrenia sometimes internalise social stigma associated to mental illness, and they develop personal stigma. Personal stigma includes self-stigma (internalisation of negative stereotypes), perceived stigma (perception of rejection), and experienced stigma (experiences of discrimination). Personal stigma is linked with a poorer treatment adherence, and worst social functioning. For this reason, it is important to have good measurements of personal stigma. One of the most frequently used measurements is the Internalised Stigma of Mental Illness (ISMI) scale. There is a Spanish version of the scale available, although its psychometric properties have not been studied. The main aim of this study is to analyse the psychometric properties of a new Spanish version of the ISMI scale. MATERIAL AND METHODS: The new version was translated as Estigma Interiorizado de Enfermedad Mental (EIEM). Internal consistency and test-retest reliability were calculated in a sample of 69 patients with a diagnosis of schizophrenia or schizoaffective disorder. The rate of patients showing personal stigma was also studied, as well as the relationship between personal stigma and sociodemographic and clinical variables. RESULTS: The adapted version obtained good values of internal consistency and test-retest reliability, for the total score of the scale (0.91 and 0.95 respectively), as well as for the five subscales of the EIEM, except for the Stigma Resistance subscale (Cronbach's alpha 0.42). CONCLUSIONS: EIEM is an appropriate measurement tool to assess personal stigma in a Spanish population with severe mental disorder, at least in those with a diagnosis of schizophrenia or schizoaffective disorder.

Efficacy of the Social Cognition Training Program in a Sample of Outpatients with Schizophrenia.

OBJECTIVE: Social cognition is recognized to be a deficit in individuals suffering from schizophrenia. Numerous studies have explored the relationship between social cognition and social functioning in outpatients with schizophrenia through the use of different social cognition training programs. This study examines the efficacy of the Social Cognition Training Program (PECS in Spanish) in adults with a diagnosis of schizophrenia. METHODS: Data were derived from a sample of 44 non-hospitalized adult patients who presented with a DSM-IV-TR Axis I diagnosis of schizophrenia and 39 healthy controls. The 44 patients were divided into an experimental group (n=20) and a control task group (n=24) that received cognitive training. Healthy controls did not receive any treatment. Sociodemographic and clinical variables correlates were computed. The 2-way ANOVA was conducted to examine differences between groups in pre- and post-treatment measures. Intragroup differences were explored using the paired-samples t-test. RESULTS: At the end of the training, patients in the experimental group showed a higher performance compared to patients in the control task group in the Hinting Task Test and in the emotion recognition of sadness, anger, fear, and disgust. CONCLUSIONS: The PECS proved to be effective in the improvement of some areas of theory of mind and emotion recognition in outpatients with schizophrenia. The PECS is one of the first programs developed in Spanish to train social cognition, and the data obtained support the importance of expanding the social cognition programs to non-English language samples.

Efficacy of the Social Cognition Training Program in a sample of schizophrenic outpatients.

Objective: Social cognition is recognized to be a deficit in individuals suffering from schizophrenia. Numerous studies have explored the relationship between social cognition and social functioning in outpatients with schizophrenia through the use of different social cognition training programs. This study examines the efficacy of the Social Cognition Training Program (PECS in Spanish) in adults with a diagnosis of schizophrenia. Methods: Data were derived from a sample of 44 non-hospitalized adult patients, who presented with a DSM-IV-R Axis I diagnosis of schizophrenia, and 39 healthy controls. Patients were divided into an experimental group and a control task group, that received cognitive training. Healthy controls did not receive any treatment. Sociodemographic and clinic variables correlates were computed. 2-way ANOVA was conducted to examine differences between groups in pre and post-treatment measures. Intragroup differences were explores using the paired-samples t-test. Results: At the end of the training, patients in the experimental group showed a higher performance compared to patients in the control task group, in the Hinting Task Test and in the emotion recognition of sadness, anger, fear, and disgust. Conclusions: The PECS proved to be effective in the improvement of some areas of theory of mind and emotion recognition, in outpatients with schizophrenia. The PECS is one of the first programs developed in Spanish to train social cognition, and the data obtained support the importance of expand the social cognition programs to non-English language samples.

[Adaptation of the Hinting Task theory of the mind test to Spanish]. / Adaptación al español de la prueba de teoría de la mente Hinting Task.

INTRODUCTION: Many studies have found that patients with schizophrenia have a deficit in theory of mind. Some authors associate this deficit with the presence of symptoms, while others maintain that it can also be observed in patients in the remission phase. There is no reference test to assess theory of mind in schizophrenia, although one of the most used is the Hinting Task. The aim of the present study consists of adapting and validating, in Spanish, the 10 histories that make up this test. MATERIAL AND METHODS: The study was conducted on a sample of 39 control subjects and 40 patients with schizophrenia. The internal consistency and the between-observer reliability and test-retest were assessed in both sample groups. The performance of the patients and control subjects were also compared. RESULTS: Good reliability data was obtained in the inter-observer and test-retest in the two samples. On the other hand, the internal consistency was somewhat low for all of the 10 histories. For this reason, and starting from a previous study, a reduced version of 5 histories was prepared, which showed good internal consistency. The patients with schizophrenia obtained a significantly lower score than the control subjects in 8 out of the 10 histories. CONCLUSIONS: The reduced Spanish version of the Hinting Task demonstrated good psychometric properties. When compared to the control group, the patients with schizophrenia had a deficit in theory of mind.

El insight en la esquizofrenia y su relación con variables afectivas, cognitivas y psicopatológicas / Insight into schizophrenia and its relationship to affective, cognitive and psychopathological variables

La investigación sobre el insight ha concluido que se trata de una variable multidimensional, que se relaciona con otras variables como la sintomatología psicótica, el deterioro cognitivo y la depresión. En el presente estudio, realizado con una muestra de 136 sujetos diagnosticados de esquizofrenia, los autores plantean verificar un estudio anterior en el que establecían la existencia de dos factores del insight: un factor psicótico y un factor cognitivo. El primero hace referencia a un conocimiento general de la enfermedad, que correlaciona con la sintomatología psicótica. El factor cognitivo se refiere a un conocimiento más amplio y específico de la enfermedad y requiere el funcionamiento preservado de ciertas áreas cognitivas. Asimismo, se plantea estudiar la relación entre las diferentes dimensiones del insight y variables como la depresión, la ansiedad y las ideas de suicidio. Los resultados obtenidos corroboran la existencia de ambos factores. El factor psicótico se relacionó con la depresión y la ansiedad, mientras que el factor cognitivo no. Se discuten las consecuencias terapéuticas de estos resultados.

[Cognitive complaints in schizophrenia: relationship with insight and other cognitive measures]. / Percepción subjetiva de déficit cognitivos en esquizofrenia: su relación con insight y otras medidas cognitivas.

INTRODUCTION: Individuals diagnosed with schizophrenia have significant cognitive deficits. However, the subjective perception of these deficits do not always coincide with the neuropsychological test and clinical ratings. METHODOLOGY: This study evaluates the cognitive performance of 46 outpatients with schizophrenia, in a Psychosocial Rehabilitation Program, by three different measures: neuropsychological tests (objective assessment), cognitive factor of PANSS (clinical ratings), and subjective scale of cognition, SSTICS (patient self-report). Also studies the possible relationship between subjective assessment of cognitive symptoms and insight of the mental disorder (SUMD). RESULTS: SSTICS total score correlated only with some neuropsychological subtest, but not with cognitive factor of PANSS. The clinical ratings is more consistent with neuropsychological test than the cognitive complaints. No relationship between SUMD and SSTICS. CONCLUSIONS: Because of the lack of correspondence among several measures, it is possible to think that have been evaluated different cognitive areas. So, it is important to consider all options of assessment in order to create cognitive rehabilitation programs. Cognitive complaints seems to be an independent variable of insight.