Social Cognition Intervention
Condition: Psychosis
MeSH terms: Psychotic Disorders
Study type: Interventional

Summary: 
      Veterans with schizophrenia and schizoaffective disorder experience high levels of disability
      and poor community outcome, and these poor functional outcomes constitute a major public
      health concern. The treatment of schizophrenia spectrum disorders has shifted fundamentally
      from a focus on symptom reduction to a focus on recovery and improving aspects of
      functioning. Needed improvements in community outcome for patients with these disorders will
      not occur simply through better control of clinical symptoms. Instead, it is necessary to
      find new treatments that address the key determinants of poor functional outcome, including
      social cognition. Both basic (non-social) cognition and social cognition are considered key
      determinants of functional outcome for schizophrenia and schizoaffective disorder. Basic
      cognition includes the domains of: learning and memory, vigilance / attention, speed of
      processing, reasoning and problem solving, and working memory. Social cognition generally
      refers to mental operations that underlie social interactions, including perceiving,
      interpreting, managing, and generating responses to socially relevant stimuli, including the
      intentions and behaviors of others. As part of the investigators' previous Merit grant, they
      have developed a training program for social cognition and are in the process of validating
      it. Initial results suggest that the program improves performance on measures of social
      cognition and functional capacity.

      In this study, the investigators will evaluate whether adding an in vivo component (training
      activities that occur in the community) to the current social cognition intervention
      facilitates generalization of training effects to community outcome and subjective
      satisfaction. Outcome measures of social cognition and functional capacity will be examined
      during the 12 week training program, and durability of benefits will be assessed at a 3-month
      follow up. Generalization to community functioning and subjective satisfaction will be
      assessed at the end of training and at the 3-month follow up. The investigators will enroll
      105 patients across the 5 years of the study with random assignment to training group (social
      cognition intervention with in vivo exercises, social cognition intervention without in vivo
      exercises and control). Subjects will receive assessments at baseline, 6 weeks (mid-point),
      completion of training (12 weeks), and the 3-month follow up.
    


Intervention name(s): social cognitive training with in vivo augmentation; social cognitive training; non-social skills training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): 24 sessions of social cognitive training plus 6 sessions of in vivo exercises; 30 sessions of social cognitive training without in vivo exercises; 30 sessions of skills training that has no specific social content
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: social cognition; training intervention