title: Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies.
abstract: Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.
authors.affiliation: Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Middletown, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States. Electronic address: mkurtz@wesleyan.edu.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Kurtz
authors.affiliation: Department of Psychology, University of North Carolina - Chapel Hill, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Gagen
authors.affiliation: Polytechnic Institute of Porto, School of Allied Health Technologies, Porto, Portugal.
authors.forename: Nuno B F
authors.initials: NB
authors.lastname: Rocha
authors.affiliation: Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Machado
authors.affiliation: Department of Psychology, University of North Carolina - Chapel Hill, United States; Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Penn
mesh_terms: D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D017063:Outcome Assessment, Health Care; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D012938:Social Perception; D056345:Theory of Mind / Q000502:physiology*
keywords: Affect recognition; Psychosocial treatments; Schizophrenia; Social cognition; Theory-of-mind