Abstract
Introduction: Difficulties in social functioning are common among people with psychosis. Negative symptoms such as blunted affect or social withdrawal are often linked to these difficulties and worsen real-life outcomes. One important dimension associated with social functioning is social cognition, which refers to the psychological processes that are necessary to perceive, encode, store, retrieve, and regulate social information. Mindfulness-based interventions for people with psychosis are safe and effective in improving anxiety and depressive symptoms; however, no mindfulness-based interventions addressing social cognition have yet been developed. Method: A pilot, single-arm, nonrandomized, noncontrolled feasibility trial is proposed. The main objectives are to assess the tolerability of mindfulness-based social cognition training (SocialMind) and to test the feasibility of a further randomized controlled trial. Results: A final sample of 25 outpatients with schizophrenia spectrum disorders was included. Attrition rate was lower than usual for this population, and most participants completed the training. No adverse effects were identified in terms of hospitalizations, emergency room visits, dissociative and psychotic symptoms, or state of anxiety during the sessions. Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03434405.
Highlights
Difficulties in social functioning are common among people with psychosis
Participants were recruited from the Psychiatry, Clinical Psychology, and Mental Health Department of La Paz University Hospital in Madrid (Spain) during January and February 2018
There were no differences between morning and evening training in age, gender, educational level, job status, and symptoms (SCL-90-R, Positive and Negative Syndrome Scale (PANSS), Dissociative Experiences Scale II (DES-II), State-Trait Anxiety Inventory—State subscale (STAI-S))
Summary
Difficulties in social functioning are common among people with psychosis. Negative symptoms such as blunted affect or social withdrawal are often linked to these difficulties and worsen real-life outcomes. Social cognition is defined as “the psychological processes that are involved in the perception, Feasibility of a Mindfulness-Based Social Cognition Training encoding, storage, retrieval, and regulation of information of other people and ourselves” [6] It is associated with community functioning, with estimated average correlations ranging from 0.31 to 0.48 [7], and its deficits can be observed in the early stages of the psychotic process [8]. Antipsychotic medication improves positive and general psychiatric symptoms, but it has limited effect against negative syndrome, which consists of blunted affect, apathy, lack of spontaneity, and social withdrawal [9] These symptoms often respond to some psychological interventions, such as assertive community treatment, cognitive remediation, social skills training, or cognitive-behavioral therapy [10]; they are usually offered along with antipsychotic treatment [11]. Third-wave cognitive-behavioral interventions are person-centered, emphasize contextual and experiential (rather than behavioral) changes, and explicitly target the functional dimension of psychological phenomena (14, p. 880)
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