ABSTRACT
Social cognitive impairment is a core limiting factor of functional recovery among persons with first episode psychosis (FEP). Social Cognition and Interaction Training (SCIT) is a group-based, manualized training with demonstrated evidence in improving social cognitive performance among people with schizophrenia. However, there are few studies on the effect of SCIT for people with FEP and for people in non-Western societies. This study evaluated the feasibility, acceptability and initial effectiveness of the locally-adapted SCIT in improving social cognitive functioning in Chinese people with FEP. The SCIT was delivered two sessions per week over a 10-weeks period, each session lasted for 60-90 min. A total of 72 subjects with FEP were recruited from an outpatient clinic and randomized to conventional rehabilitation ("Rehab") and experimental ("SCIT and Rehab") groups. Primary outcome measures included four social cognitive domains including emotion perception, theory-of-mind, attributional bias and jumping-to-conclusion, and secondary measures included neurocognition, social competence and quality of life. Participants were assessed at baseline, post-treatment, and 3-months post-treatment. Repeated measures ANCOVAs, with baseline scores as covariates, were used to compare the group differences in various outcomes across time. The results showed that the SCIT was well-accepted, with a satisfactory completion rate and subjective ratings of relevance in the experimental group. Moreover, treatment completers (n = 28) showed evidence of an advantage, over conventional group (n = 31), in reduced attributional bias and jumping-to-conclusions at treatment completion, lending initial support for the SCIT in Chinese people with FEP. Future research should address the limitations of this study, using more refined outcome measurements and higher treatment intensity of the SCIT.
ABSTRACT
Social cognition is a core limiting factor of functional recovery among persons with schizophrenia. However, there is a lack of standardized and culturally relevant assessment tools for evaluating social cognitive performance in Chinese persons with schizophrenia. The purposes of this study were to (1) develop and validate two social cognitive instruments, the Chinese Facial Emotion Identification Test (C-FEIT) and the Chinese Social Cognition and Screening Questionnaire (C-SCSQ), that assess three key domains of social cognition and (2) to evaluate preliminary psychometric properties of the two assessments. The results demonstrated that the C-FEIT and the social cognitive subscales of C-SCSQ possess satisfactory content-related validity and test-retest reliability (ICC ranging from 0.76 to 0.85). Subscales of the C-FEIT and the C-SCSQ showed low to medium correlation with two concurrent neurocognitive measures (absolute values of r ranging from 0.22 to 0.45) and concurrent measures of functional performance (absolute values of r ranging from 0.22 to 0.46). Our findings generally support the use of the C-FEIT and the C-SCSQ as reliable and valid tools for assessing emotion perception, theory of mind (intention-inferencing), and hostile attributional style, which are the key outcome indicators of social cognitive interventions for persons with schizophrenia.
