Abstract
Objective:Social cognition and Problem Solving (PS) impairments are common characteristics in patients with schizophrenia. Experimental neuropsychological findings support the hypothesis that schizophrenia is characterized by a broad range of heterogeneous cognitive impairments. Since that time Problem Solving Training has been employed as a core strategy in a wide variety of therapeutic settings. Renewed interest in cognitive functioning, including social Problem Solving skills and social cognition in schizophrenia, has led us to reconsider the potential value of metacognitive strategy as a rehabilitation strategy.Methods:The present study reports the results obtained by 24 persons with schizophrenia who were randomly assigned to one of two training session groups: Cognitive-Emotional Rehabilitation (REC) vs Problem Solving Training (PST). Both treatments were administered to small groups composed of subjects suffering from schizophrenic disorders over a 12 months period: primary measures of clinical, social outcomes and secondary measures of cognitive and Problem Solving functions were conducted at 0, and 12 months.Results:Results showed that both training methods were found to be effective in psychopathological measures and in social functioning. On cognitive function improvements were specific to the rehabilitative approach. PST are mainly improved capacities for planning and memory, while the REC improved measures such as social cognition Theory of mind and emotion recognition.Conclusion:The results confirmed that it is no necessary to divide the rehabilitation training in treatments directed to specific domains. The conceptualization and applicability of PST and REC its implications for persons with schizophrenia, and future studies in this research area have also been discussed.
Highlights
Schizophrenia is a chronic and profoundly disabling psychiatric disorder
The present study reports the results obtained by 24 persons with schizophrenia who were randomly assigned to one of two training session groups: Cognitive-Emotional Rehabilitation (REC) vs Problem Solving Training (PST)
The results confirmed that it is no necessary to divide the rehabilitation training in treatments directed to specific domains
Summary
Schizophrenia is a chronic and profoundly disabling psychiatric disorder. Diagnosis is predicated on a marked decline in social and occupational or educational functioning. People affected by schizophrenia show major deficits in Theory of Mind (ToM) [10, 11]; it has been proposed that many symptoms in schizophrenic disorder may reflect a deficit in patients’ ability to represent their own and other people’s mental states [12]. According to Frith’s model [12], the main aspect of metarepresentational processes is the ability to reason about how to represent the world, our thoughts and our actions. Such an aspect is termed "metarepresentation" and is the “data structure” underling self-awareness [13]. The ToM represent a distinct module from the others neurocognitive competences; it is innate and related to the concept of “metacognition” introduced by Flavell [14], further divided by the other authors into several components: the metamemory, the meta-
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