Theory of mind and emotion processing training for patients with schizophrenia: Preliminary findings

Impairments in social cognition are critical predictors of social functioning in
patients with schizophrenia. Emotion processing (EP) and theory of mind (ToM) are
hypothesized to influence real-world behavior more directly than basic cognition
and represent important targets of intervention. The use of video scenes
depicting human interactions could constitute an appropriate tool to enhance
understanding of characters behavior and stimulate inferences on mental states.
The aim of our pilot study was to evaluate longitudinally, with a controlled
trial, the feasibility and the efficacy of a single-paradigm emotion recognition
and ToM training designed for outpatients affected by schizophrenia, with the
goal to create an ecological treatment, overcoming artificial laboratory biases,
by the use of specific videotaped material. Fifty-two outpatients were randomly
assigned to an EP and ToM video-based training (n=27) or to a standard social
cognitive rehabilitation treatment (n=24). They were assessed before and after
12weeks of intervention and compared to a time-matched control group (n=24). Our
results show a statistically significant improvement in ToM abilities, confirming
the hypothesis of the enhancing potential of social cognitive interventions, but
no changes with respect to EP; despite the need for a deeper examination, these
data support further development of this treatment approach.