Regular Research ArticleRandomized Controlled Trial of Cognitive Behavioral Social Skills Training for Older Consumers With Schizophrenia: Defeatist Performance Attitudes and Functional Outcome
Section snippets
Design
All study procedures were approved by the institutional review board of the University of California, San Diego. After informed consent and baseline assessments, participants were randomly assigned by an independent statistician to one of two treatment conditions: CBSST or GFSC. Participants were then treated for 9 months and followed longitudinally for 9 months after treatment, with baseline, 4.5-month (mid-treatment), 9-month (end-of-treatment), 13.5-month (mid-follow-up) and 18-month
Sample
The flow of participants through the 18-month protocol is shown in Figure 1. After dropout and exclusion of participants for missing data, 81% of randomized participants were included in analyses. The groups did not differ significantly in dropout rates at any assessment point. The average age of the final sample at baseline was 55.0 (SD = 6.6; range = 46–78). The majority of the participants were Caucasian (66%), male (55%), unmarried (95%), with a high school education (M years of education =
Discussion
The results indicated that CBSST is an effective psychosocial intervention to improve functioning in older consumers with schizophrenia. Functioning trajectories over time improved in CBSST but declined in GFSC. These findings replicated the results of our prior trial6, 14 and showed that the benefits of CBSST cannot be attributed to nonspecific therapist factors, alone. Self-reported everyday functioning improved to a greater extent in CBSST than in GFSC, suggesting specific CBT and SST
References (38)
- et al.
Functional adaptation skills training (FAST): a randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders
Schizophr Res
(2006) - et al.
The role of effort, cognitive expectancy appraisals and coping style in the maintenance of the negative symptoms of schizophrenia
Psychiatry Res
(2009) - et al.
Further support for the role of dysfunctional attitudes in models of real-world functioning in schizophrenia
J Psychiatr Res
(2010) - et al.
A randomized controlled pilot study of cognitive behavioral social skills training for older patients with schizophrenia
Schizophr Res
(2002) - et al.
Dimensional structure of psychotic symptoms: an item-level analysis of SAPS and SANS symptoms in psychotic disorders
Schizophr Res
(1999) - et al.
Investigating self-esteem in individuals with schizophrenia: relevance of the Self-Esteem Rating Scale-Short Form
Psychiatry Res
(2006) - et al.
Aging and outcome in schizophrenia
Acta Psychiatr Scand
(2003) Translating scientific opportunity into public health impact: a strategic plan for research on mental illness
Arch Gen Psychiatry
(2009)- et al.
The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009
Schizophr Bull
(2010) - et al.
Enhanced skills training and health care management for older persons with severe mental illness
Community Ment Health J
(2004)
Psychosocial rehabilitation and quality of life for older adults with serious mental illness: recent findings and future research directions
Curr Opin Psychiatry
A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia
Am J Psychiatry
Medication nonadherence in older people with serious mental illness: prevalence and correlates
Psychiatr Rehabil J
Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor
Schizophr Bull
Social skills training with schizophrenics: a meta-analytic evaluation
J Consult Clin Psychol
A meta-analysis of controlled research on social skills training for schizophrenia
J Consult Clin Psychol
Group cognitive-behavioral social skills training for older outpatients with chronic schizophrenia
J Cog Psychother Int Quart
Development of an integrated cognitive-behavioral and social skills training intervention for older patients with schizophrenia
J Psychother Pract Res
Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up
J Clin Psychiatry
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2021, Psychiatry ResearchCitation Excerpt :With regard to community-based mental health settings specifically, Carrion and colleagues (1993) found that forgetting appointments, needing to work, and transportation-related difficulties most impacted retention rates in a study of outpatients with schizophrenia. It is possible that suboptimal public transportation also contributed to our dropout rate, given evidence for better session attendance in prior CBSST trials when transportation was provided (Granholm et al., 2013), compared to when it was not (Granholm et al., 2014). Overall, our rates of dropout and attendance align with high rates of nonadherence (17-64%) found in general community mental health clinic populations, including patients with psychosis (Cullen 2018; Dworkin et al., 1986; Üçok et al., 2007).
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2020, Journal of Psychiatric ResearchCitation Excerpt :Training for perspective-taking based on the relational frame theory (RFT) could be promising in individuals with social-cognitive dysfunctions, such as schizophrenia (Hendriks et al., 2016). DPB, which contributes to social functioning and QOL in patients with schizophrenia and shares characteristics with social anxiety, as mentioned above, has recently become a treatment target to improve functional outcome (Campellone et al., 2016; Granholm et al., 2013, 2014; Horan et al., 2010). Psychosocial treatments that include not only DPB, but also social anxiety as treatment targets may be more effective and lead to community participation (Thomas et al., 2017).