Pilot study : effectiveness of integrated social skills training (ISST) with social cognition component for people with schizophrenia : a clinical control trial

Abstract

Social skills deficit has been a long-standing functional impairment among people with Schizophrenia. This pervasive problem affects multiple aspects in life. Most interventions focus on the enhancement of expressive social skills; in the contrary, receptive social skills are less emphasized. However, receptive skills such as social intelligence and theory of mind (ToM) are the pre-requisites and foundation of expressive skills. Researches also suggested that people with schizophrenia have various extent of impairment in social cognition, i.e. receptive skills. Incorporation of receptive skills modules into convention intervention may be effective to enhance overall social and occupational performance.

The Integrated Social Skill Training (ISST) is a hybrid intervention introducing social cognition components into convention skills training model. The effectiveness on the mental state, and social occupational function was evaluated through a pilot study. 12 Subjects were recruited in a local psychiatric day training unit and were divided into control and experimental group. The experimental group went through the 8-sessions ISST on top of day training; while control group were put on the waiting list and received purely day training within the research period. Psychopathology was measured with Positive and Negative Syndrome Scale (PANSS) and the level of social and occupational functions was measured by Social and Occupational Functioning Assessment Scale (SOFAS). Measurements were taken before and after the administration of ISST on both groups of subjects.

Repeated measures ANOVA and paired samples t-test were used for between-group and within-group data analysis respectively. Results suggested a neutral effect of ISST to mental states; whereas a positive effect of ISST was reported on improving the social occupational performance for subjects within the experimental group but not within the control group. However, the magnitude of improvement was yet to meet a statistical difference when compared with that of the control group.

By incorporating social cognition elements into convention skills training model can improve the social and occupational performance of people with schizophrenia. Further refinement of the ISST is to be made to achieve a higher efficacy.