The Effects of Cognitive Rehabilitation on Social Knowledge in Patients with Schizophrenia

Abstract

This study examined the extent to which cognitive rehabilitation alleviates cognitive deficits in schizophrenia compared to treatment as usual, and explored the mediating and moderating effects on cognitive improvement. Two groups who received cognitive rehabilitation and treatment as usual were assessed at baseline, three months (immediately post-intervention) and at follow-up (three months post-intervention). Cognitive rehabilitation focused on deficits in social knowledge and was conducted once a week for three months. The principles of errorless leaning and scaffolding informed the intervention. Outcomes were assessed using Script Test measures of social cognition. Other cognitive functions (executive functions and memory) and clinical symptoms were also assessed. Script Test for social knowledge and Rule Shift Test for cognitive flexibility scores were significantly better post-intervention in the cognitive rehabilitation group, while in the control group only free recall Script Test scores improved. Cognitive rehabilitation focused on social knowledge deficits can contribute to improvements in the social cognitive abilities of schizophrenic patients. Improvements in social cognitive functioning were durable at three-month follow-up. Cognitive rehabilitation can clearly benefit schizophrenic patients, at least when combined with atypical antipsychotic medication.

Key words:

• cognitive rehabilitation
• errorless learning
• schizophrenia
• script
• social knowledge

ACKNOWLEDGMENT

This study was supported by a Grant-in-Aid for Scientific Research, 16530445 from the Japan Society for the Promotion of Science (JSPS), and a Grant from the Research Group for Schizophrenia, Japan.

Notes

Note. SAPS = Scale for Assessment of Positive Symptoms; SANS = Scale for Assessment of Negative Symptoms.

∗∗p < 0.01, ∗p < 0.05.