Department of Psychology, Wesleyan University, Middletown, CT 06459, USA.
Schizophr Bull. 2012 Sep;38(5):1092-104. doi: 10.1093/schbul/sbr036. Epub 2011 Apr 27.
A wealth of evidence has revealed that deficits in social cognitive skills (including facial affect recognition (FAR), social cue perception, Theory of Mind (ToM), and attributional style) are evident in schizophrenia and are linked to a variety of domains of functional outcome. In light of these associations, a growing number of studies have attempted to ameliorate these deficits as a means of improving outcome in the disorder through the use of structured behavioral training. This study used quantitative methods of meta-analysis to assess the efficacy of behavioral training programs designed to improve social cognitive function. A total of 19 studies consisting of 692 clients were aggregated from relevant databases. Outcome measures were organized according to whether they were social cognitive tests proximal to the intervention or whether they represented measures of treatment generalization (symptoms, observer-rated community, and institutional function). With respect to social cognitive measures, weighted effect-size analysis revealed that there were moderate-large effects of social cognitive training procedures on FAR (identification, d = 0.71 and discrimination, d = 1.01) and small-moderate effects of training on ToM (d = 0.46), while effects on social cue perception and attributional style were not significant. For measures of generalization, weighted effect-size analysis revealed that there were moderate-large effect on total symptoms (d = 0.68) and observer-rated community and institutional function (d = 0.78). Effects of social cognitive training programs on positive and negative symptoms of schizophrenia were nonsignificant. Moderating variables and implications for future research and treatment development are discussed.
大量证据表明，精神分裂症患者存在社交认知技能缺陷（包括面部情感识别（FAR）、社交线索感知、心理理论（ToM）和归因风格），并且这些缺陷与各种功能结果领域相关。鉴于这些关联，越来越多的研究试图通过使用结构化行为训练来改善这些缺陷，从而改善该障碍的结果。本研究使用荟萃分析的定量方法来评估旨在改善社交认知功能的行为训练计划的疗效。从相关数据库中汇总了 19 项研究，共涉及 692 名患者。根据结果测量是与干预措施直接相关的社交认知测试，还是代表治疗泛化的措施（症状、观察评定的社区和机构功能）进行了分类。就社交认知措施而言，加权效应大小分析表明，社交认知训练程序对 FAR（识别，d=0.71 和辨别，d=1.01）有较大的影响，对 ToM（d=0.46）有较小到中等的影响，而对社交线索感知和归因风格的影响则不显著。对于泛化措施，加权效应大小分析表明，对总症状（d=0.68）和观察评定的社区和机构功能（d=0.78）有较大的影响。社交认知训练计划对精神分裂症的阳性和阴性症状的影响不显著。讨论了调节变量以及对未来研究和治疗发展的意义。
