Social Cognition and Other Determinants of Perceived Social Support in Individuals With Serious Mental Illness.

ABSTRACT: Social support provides protective effects for those with serious mental illness (SMI), but these effects may be attenuated by factors that hinder positive perceptions of support. Improved understanding of social support and its determinants may hold relevance for clinical interventions and provide avenues to promote recovery and improve functioning. The present study is a cross-sectional, correlational analysis investigating the relationships among social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test-Managing Emotions subscale), social anxiety (Liebowitz Social Anxiety Scale), negative symptoms (Scale for the Assessment of Negative Symptoms), and perceived social support (Interpersonal Support Evaluation List) among individuals with SMI. Data were analyzed for 59 participants from a psychosocial rehabilitation treatment study at a public, urban academic-affiliated medical center in the Midwest. Bivariate Pearson correlations revealed statistically significant associations among perceived social support and social cognition (total perceived social support, p < 0.05; appraisal support, p < 0.01), negative symptoms (appraisal support, p < 0.05), and social anxiety (self-esteem support, p < 0.05). Further, multiple linear regression revealed social cognition remained a significant predictor of perceived social support ( p < 0.05) when controlling for social anxiety and negative symptoms. Overall findings suggest a correlative relationship between social cognition and perceived social support. Conclusions, limitations, and future directions are discussed.

Therapeutic alliance in a cognitive rehabilitation programme for people with serious mental illness: A qualitative analysis.

OBJECTIVE: Therapeutic alliance is an important element of evidence-based treatments for people diagnosed with a serious mental illness. Cognitive enhancement therapy (CET) is an efficacious cognitive rehabilitation programme that emphasizes coach-participant relationships. The purpose of this study was to examine experiences of therapeutic alliance among CET participants. DESIGN: We used an exploratory qualitative approach. METHODS: Semi-structured interviews were conducted with 24 participants diagnosed with a serious mental illness. Interview transcripts were analysed by three independent coders using thematic analysis. RESULTS: Four themes related to therapeutic alliance emerged: (1) positive regard; (2) collaboration; (3) authenticity; (4) negative alliance. CONCLUSIONS: Findings suggest that therapeutic alliance is an important component of CET that bolsters the learning environment and ensures a positive group experience. Our qualitative analyses contribute greater understanding of how strong therapeutic relationships impact people with serious mental illnesses participating in evidence-based treatments beyond psychotherapy context.

Implementation and preliminary outcomes of cognitive enhancement therapy for serious mental illness in an outpatient mental health program.

BACKGROUND: Although numerous evidence-based treatments for serious mental illnesses (SMI) exist, the majority are not widely utilized in clinical settings. Cognitive enhancement therapy (CET) has been tested in randomized trials; however, knowledge regarding implementation and outcomes in naturalistic environments is scarce. AIMS: The current study is an uncontrolled, observational study describing implementation and pre- to post-outcomes of CETCleveland®, a community-based version of CET in an outpatient mental health program in the United States. METHOD: We included n = 34 diverse individuals with SMI. Data include qualitative implementation information and participant outcomes, including measures of cognition, symptoms, satisfaction and adherence. RESULTS: Overall, participant satisfaction was positive, and adherence was comparable with previous studies. Implementation information includes training, clinician and setting characteristics, and barriers and solutions. Preliminary outcomes showed that participants significantly improved in areas of neurocognition and symptoms. CONCLUSIONS: Overall, our results demonstrated successful early implementation of CET in a diverse, outpatient mental health program and provided preliminary support for the clinical utilization of CET. We hope these results will promote further access to CET and other evidence-based psychiatric rehabilitation programs in community clinics.

Inhibitory deficits in prepulse inhibition, sensory gating, and antisaccade eye movement in schizotypy.

Schizotypy is a term that refers to a continuum of personality characteristics, emerging from mental states ranging from organized and normal to unorganized and disordered; with the latter tending to include individuals with high schizotypal scores as well as those diagnosed with schizotypal personality disorder. Evidence from psychophysiological studies has found a relative weakness in the inhibitory functioning, including prepulse inhibition (PPI), sensory gating (SG), and antisaccade eye movement (AEM) in schizotypy and schizophrenia. As schizotypy and schizophrenia are in the same spectrum, understanding the nature of sensory and motor inhibitory weakness associated with schizotypy will optimize the prevention and intervention for both schizotypy and schizophrenia populations. This review aims at examining the deficits of sensory gating, saccade control, and prepulse inhibition in schizotypy; examining the relationship between the three measures and schizotypal symptoms and traits; examining the effect of nicotine on the three measures; and examining the relevant brain regions to the three measures. We searched multiple databases (such as MEDLINE, Pubmed, PsychINFO, Google Scholar) using combinations of the keywords: schizotypy, schizotypal personality disorder, prepulse inhibition, sensory gating and antisaccade for articles published in English since 1980. We found that three measures (SG, PPI and AEM) are associated with major schizotypal symptoms, suggesting that three measures could be used to predict the disease etiology and prognosis. Secondly, the three measures are modulated by nicotine administration at a certain level, providing a potential tool to study the role of nicotine in the cognition and symptom improvement in schizotypy. Thirdly, brain-imaging studies have localized activity in brain regions associated with sensory gating, saccade control, and prepulse inhibition, narrowing the search for brain regions to target for the treatment and prevention of schizotypy. Overall, the three measures are suggested to be a valuable tool to study the inhibitory deficits in schizotypy, and maybe used as a tool for the prevention and treatment of schizotypy as well.