Schizophrenia is a disabling illness, characterized by severe impairments in social, occupational, and community function. Moreover, social impairments are identified as key unmet treatment needs by the very individuals who suffer from this disorder. Existing psychosocial treatments for schizophrenia fall short of significantly improving social and community function. There is ample evidence of neurocognitive impairments in schizophrenia, and these impairments have in turn been identified as key determinants of social and other functional outcomes, and as rate-limiters for skill acquisition in psychosocial rehabilitation. More recent research indicates that social cognition, or how an individual processes, interprets, and responds to social information, may mediate the relationship between neurocognition and functioning and may be a more proximal treatment target for interventions aimed at improving functional outcomes in schizophrenia. Potential targets for social cognitive training include affect recognition, social knowledge /social perception, and attributional style (AS)/Theory of Mind (ToM). While a number of researchers have reported success in remediating affect recognition deficits, there has been little treatment development focusing on AS/ToM impairments. The few studies that have targeted these domains specifically have had limited success, suggesting that further development of such interventions may be of benefit. The primary aim of this application is to develop, refine, manualize and assess the feasibility and preliminary efficacy of a brief, narrowly-focused social cognitive intervention targeting attributional bias/Theory of Mind in schizophrenia. This individually administered treatment will focus on remediating established elements of atttributional style/Theory of Mind, but unlike previous efforts will utilize training methods that have been successfully used in bottom-up neurocognitive remediation approaches that reduce the cognitive load necessary to learn the relevant skill areas, including massed drill and practice, graded increases in task difficulty, scaffolding and errorless learning. Study methods include preliminary treatment and manual development based on series of uncontrolled cases, manual refinement, and a small feasibility/efficacy trial of the newly developed intervention.

Public Health Relevance

Schizophrenia is a disabling illness characterized by severe impairments in social functioning. Social cognition has been identified as a proximal treatment target for interventions aimed at improving functional outcomes. Primary aim of this application is to develop, manualize, and assess the preliminary efficacy of a new social cognitive intervention which uses methods from bottom-up approaches to neurocognitive remediation to train social cognitive content.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Adult Disorders (ITVA)
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Kozak, Michael J
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Yale University
Schools of Medicine
New Haven
United States
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