The effectiveness of metacognitive training on impairments in social cognition in patients with schizophrenia: mental health nursing practice in a community mental health center

Abstract

Background

Social cognition is an independent structure from the positive symptoms of schizophrenia and contributes to negative symptoms, neurocognitive impairment, and social functioning.

Aim

To examine the effectiveness of the metacognitive training intervention on social cognition in people with schizophrenia.

Design

This study was conducted as a randomized quasi-experimental (pre-test/post-test and follow-up) design with a control group.

Methods

Thirty-nine patients with schizophrenia were enrolled and randomly assigned to either the control group (n = 19) or the metacognitive training group (n = 20). A 10-week metacognitive training program was offered to the intervention group. The study involved a pre-test/post-test design with a 3-month follow-up assessment. The primary outcome was social cognition, as measured by the Facial Emotion Discrimination/Identification Tests, Reading the Mind in the Eyes Test, and Attributional Style Questionnaire. The secondary outcome was measured by the metacognitive training subjective efficacy form.

Results

Completion at follow-up was high (92.3%). The results show that the changes over time in the False Belief Task 1st level, Attributional Style Questionnaire negative events global-specific dimension, and positive events stable-unstable dimension mean scores, time interaction, were statistically significant. Metacognitive Training was efficacious on the theory of mind and in performing more functional attributions. Patients in the intervention group showed high-level positive feedback.

Conclusion

Metacognitive Training applied by psychiatric and mental health nurses demonstrated a user and practitioner-friendly, safe and effective program on social cognition. Also, the social and cultural feasibility and effectiveness of the Metacognitive Training program were shown for the first time in a Turkish population.

Keywords:

• Schizophrenia
• metacognitive training
• social cognition
• randomized controlled trial
• mental health nurses

Ethical approval

The study was approved by the Ethics Committee of the Medipol University Ethics Committee (Approval Number: 06.08.2015-399).

Disclosure statement

Authors declare that there is no any financial support or relationships that may pose conflict of interest. No potential conflict of interest was reported by the author(s).

Authorship statement

All authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors, the authors are in agreement with the manuscript.