Abstract

Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who participated in a 24-week randomized trial of cognitive behavioral social skills training (CBSST) and either intranasal oxytocin or placebo (NCT01752712). Participants (n = 57) were prompted with EMA surveys seven times per day for seven days during the baseline, 12-week, and 24-week timepoints to sample sedentary behavior ratings, positive and negative affect, interpersonal interactions, and interpersonal interaction appraisals. Results revealed that sedentary behavior and social interactions did not significantly change over the 24-week clinical trial; however, positive and negative affect and defeatist interaction appraisals improved with treatment, and oxytocin produced modest additional improvements in these EMA outcomes. Greater momentary positive affect was significantly associated with greater activity and greater frequency of interactions. Overall, CBSST was effective at improving functioning, momentary affect, and defeatist interaction appraisals, although it did not reduce sedentary behavior; therefore, targeting these factors is not sufficient to reduce sedentary behavior, and adjunct interventions are needed.

Highlights

  • IntroductionDue to physical health conditions, primarily cardiovascular disease, individuals with schizophrenia-spectrum disorders (SSDs) have a substantially shortened life expectancy compared to those without schizophreniaspectrum disorders (SSDs) [1]

  • The central purpose of the present study was to explore longitudinal changes in real-world sedentary behavior of individuals with schizophreniaspectrum disorders (SSDs) who participated in a clinical trial of cognitive behavioral social skills training (CBSST) and intranasal oxytocin or placebo [25]

  • As the present analysis focused exclusively on ecological momentary assessment (EMA)-measured variables, only these measures and the EMA procedure are described in detail here

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Summary

Introduction

Due to physical health conditions, primarily cardiovascular disease, individuals with schizophrenia-spectrum disorders (SSDs) have a substantially shortened life expectancy compared to those without SSDs [1]. High levels of sedentary behavior in this population (up to 11 h/day) likely contribute to this poor health status and associated premature mortality [2,3,4]. A systematic review and meta-analysis of 47 studies found that increased sitting time was associated with a heightened risk of cardiovascular disease, type. As such, reducing sedentary behavior among individuals with SSDs is a critical first step in the facilitation of their improved health, quality of life, and survival. In order to adequately intervene and promote sustainable healthy behavioral changes it is important to consider the potential mechanisms underlying the high levels of sedentary behavior in this population

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