Jul 27 2012
By Mark Cowen
Social cognition and interaction training (SCIT) may improve certain aspects of social cognition and functioning in patients with affective disorders, results from a preliminary study suggest.
The team found that bipolar disorder and schizoaffective disorder patients who received SCIT plus treatment as usual (TAU) showed greater improvements in emotion perception and theory of mind, as well as a significant reduction in hostile attribution bias, compared with those who received TAU only.
"To our knowledge, this is the first controlled study on social cognition training for affective disorders, providing preliminary evidence that SCIT is feasible among bipolar and schizoaffective outpatients and may improve social cognition," say Guillermo Lahera (University of Alcala, Madrid, Spain) and team.
Thirty-three adult outpatients with bipolar disorder and four with schizoaffective disorder were randomly assigned to receive TAU plus SCIT (n=21) or TAU only (n=16).
SCIT comprised an 18-24-week, group-based program that focused on emotional training (definition of emotions, facial expression training, understanding of paranoid symptoms as an emotion), role-play social situations (distinguishing facts from guesses, jumping to conclusions, understanding bad events), and integration of learning in 60-minute sessions. TAU consisted of standard follow up including clinical management and medication by a psychiatrist.
All of the participants were assessed at baseline and at completion of the SCIT using the Face Emotion Identification Task (FEIT), the Face Emotion Discrimination task (FEDT), Emotion Recognition-40 (ER40) task, the Hinting Task, which assesses theory of mind, and the Ambiguous Intentions Hostility Questionnaire (AIHQ).
Over the study period, individuals who received SCIT showed a greater improvement in scores on the FEIT than TAU-only patients, from 7.81 to 11.24 versus from 7.75 to 8.31. SCIT patients also showed a significant improvement in FEDT scores, from 23.90 to 26.13, compared with a reduction in TAU-only patients, from 25.00 to 24.19. A similar pattern was observed for scores on the ER40.
In addition, patients who received SCIT showed improvements in theory of mind, with Hinting Task scores increasing from 17.29 to 18.43, compared with a reduction in scores among TAU-only patients, from 18.25 to 17.69.
Furthermore, patients who received SCIT showed a reduction in hostile attribution bias, with AIHQ subscale scores falling from 2.05 to 1.78, compared with an increase among TAU patients, from 1.56 to 1.80.
However, the researchers note that SCIT was not associated with improvements in global functioning or AIHQ aggressivity bias.
"The results of this trial partially supported our hypothesis that SCIT would improve social cognition and social functioning in individuals with bipolar and schizoaffective disorder," comment the authors in the Journal of Affective Disorders.
They add that further research is needed to confirm their findings.
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