SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA; Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116A), San Diego, CA 92120, USA.
Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116A), San Diego, CA 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive (0603), La Jolla, CA 92093, USA.
Psychiatry Res. 2021 Jan;295:113620. doi: 10.1016/j.psychres.2020.113620. Epub 2020 Dec 1.
The current study examined the feasibility and acceptability of an integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training (CBSST-CCT) intervention compared with Goal-Focused Supportive Contact (SC) in a pilot randomized controlled trial for people with schizophrenia with high negative symptom severity. The sample included 55 participants from five community settings; masters-level study clinicians delivered interventions on-site. Participants completed assessments of cognitive, functional, and psychiatric symptoms at baseline, mid-treatment, post-treatment (12.5 weeks), and 6-month follow-up. Enrollment goals were not initially met, necessitating the addition of a fifth site; however, all groups and assessments were completed on-site. Study procedures were acceptable, as evidenced by 100% enrollment and completion of baseline assessments following informed consent; however, over 1/3rd of participants dropped out. No modifications were necessary to the intervention procedures and CBSST-CCT fidelity ratings were acceptable. The intervention was deemed acceptable among participants who attended ≥1 session, as evidenced by similar attendance rates in CBSST-CCT compared to SC. Among CBSST-CCT participants, lower positive symptoms were significantly associated with better attendance. Overall, we found mixed evidence for the feasibility and acceptability of the CBSST-CCT protocol in people with schizophrenia with high negative symptoms. Challenges are highlighted and recommendations for future investigations are provided.
本研究在一项针对高阴性症状严重程度精神分裂症患者的试点随机对照试验中，比较了认知-行为社会技能训练与补偿性认知训练（CBSST-CCT）综合干预与目标导向支持性接触（SC）的可行性和可接受性。该样本包括来自五个社区环境的 55 名参与者；硕士水平的研究临床医生在现场提供干预措施。参与者在基线、治疗中期、治疗后（12.5 周）和 6 个月随访时完成认知、功能和精神症状评估。最初的入组目标没有达到，需要增加第五个地点；然而，所有的组和评估都在现场完成。研究程序是可以接受的，证据是在知情同意后 100%的入组和完成基线评估；然而，超过三分之一的参与者退出了。干预措施没有必要进行修改，CBSST-CCT 的保真度评分是可以接受的。对于参加了至少 1 次会议的参与者来说，干预措施是可以接受的，这一点从 CBSST-CCT 与 SC 的相似出席率中可以看出。在 CBSST-CCT 参与者中，较低的阳性症状与更好的出勤率显著相关。总的来说，我们发现了在高阴性症状精神分裂症患者中 CBSST-CCT 方案的可行性和可接受性的混合证据。挑战被强调，并为未来的研究提供了建议。
