Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S63-70. doi: 10.1093/schbul/sbr071.
In the last decade, several social cognitive remediation programs have been developed for use in schizophrenia. Though existing evidence indicates that such programs can improve social cognition, which is essential for successful social functioning, it remains unclear whether the improvements generalize to social cognitive domains not primarily addressed by the intervention and whether the improved test performance transfers into everyday social functioning. The present study investigated whether, beyond its known effects on facial affect recognition, the Training of Affect Recognition (TAR) has effects on prosodic affect recognition, theory of mind (ToM) performance, social competence in a role-play task, and more general social and occupational functioning. Thirty-eight inpatients with a diagnosis of schizophrenia or schizoaffective disorder were randomly assigned to 6 weeks of treatment with the TAR--primarily targeted at facial affect recognition-or Cognitive Remediation Training (CRT)--primarily targeted at neurocognition. Intention-to-treat analyses found significantly larger pre-post improvements with TAR than with CRT in prosodic affect recognition, ToM, and social competence and a trend effect in global social functioning. However, the effects on ToM and social competence were no longer significant in the smaller group of patients who completed treatment according to protocol. Results suggest that TAR effects generalize to other social cognitive domains not primarily addressed. TAR may also enhance social skills and social functioning, although this has to be confirmed. Results are discussed with regard to the need to improve functional outcome in schizophrenia against the background of current evidence from other social cognitive remediation approaches.
在过去的十年中，已经开发出了几种用于精神分裂症的社会认知矫正方案。尽管现有证据表明，这些方案可以改善社会认知，这对于成功的社交功能至关重要，但仍不清楚这些改善是否可以推广到干预措施主要未涉及的社会认知领域，以及改善的测试表现是否可以转化为日常社交功能。本研究调查了 Training of Affect Recognition（TAR）是否除了已知的对面部情感识别的影响之外，是否对韵律情感识别、心理理论（ToM）表现、角色扮演任务中的社交能力以及更一般的社交和职业功能有影响。38 名被诊断为精神分裂症或分裂情感障碍的住院患者被随机分配接受 6 周的 TAR 治疗（主要针对面部情感识别）或认知矫正训练（CRT）（主要针对神经认知）。意向治疗分析发现，TAR 在韵律情感识别、ToM 和社交能力方面的改善明显大于 CRT，而在整体社交功能方面则存在趋势效应。然而，在根据方案完成治疗的较小患者群体中，ToM 和社交能力的影响不再显著。结果表明，TAR 的效果可以推广到其他主要未涉及的社会认知领域。TAR 还可能增强社交技能和社交功能，尽管这需要得到证实。结果讨论了在当前其他社会认知矫正方法的证据背景下，改善精神分裂症的功能结果的必要性。
