Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: Despite the introduction of improved pharmacological treatments, most people with schizophrenia continue to suffer from marked social disability and diminished functional capacity. Recent research has suggested that cognitive deficits associated with the processing and interpretation of social and emotional information may be key rate-limiting factors to a more complete functional recovery from the illness. Unfortunately, effective treatments to address these deficits in social cognition have been sparse. Cognitive Enhancement Therapy (CET; www.CognitiveEnhancementTherapy.com) is an integrated approach to the remediation of social-cognitive and neurocognitive deficits in schizophrenia that has shown strong clinical efficacy in improving social cognition among long-term, chronic outpatients. However, previous research on CET has been limited by the use of novel and unblinded measures of social cognition. Further, its efficacy among less chronic patients has not been examined. This study examines the social-cognitive effects of CET on a less chronic population, by employing a unique, performance-based measure of emotional intelligence to objectively assess treatment-induced changes in the processing and management of emotional information in a group of individuals in the early course of the illness.

Methods: Individuals diagnosed with schizophrenia or schizoaffective disorder within the past five years were recruited from acute inpatient units and community clinics, and randomly assigned to either CET (n = 16) or an active, supportive treatment control condition (n = 16). Social cognition was assessed at baseline and after one year of treatment using the Mayer-Salovey-Caruso Emotional Intelligence Test. Analysis of covariance was used to examine the the differential effects of CET on emotional intelligence compared to the active control.

Results: After one year of treatment, significant and large differential effects favoring CET were observed on overall emotional intelligence, F(1, 29) = 12.38, p = .001, d = 1.24. Analysis of improvement on specific components of emotional intelligence revealed strong CET effects for improving participant's ability to understand and manage emotions, F(1, 29) = 12.12, p = .002, d = 1.23. Significant, but weaker effects were observed favoring CET for improving participant's ability to accurately perceive and use emotions to guide their behavior, F(1, 29) = 6.68, p = .015, d = .91.

Implications: These preliminary results confirm previous findings showing the efficacy of CET for improving social-cognitive deficits in schizophrenia, and indicate that this treatment can help individuals in the early course of the illness improve their ability to understand, manage, and process emotional information. Such abilities are vital for adaptive social functioning. Social work practitioners working with this population can benefit from knowledge of this important and effective treatment, in order to help the individuals they serve achieve a more complete functional recovery from the illness. Additionally, social work researchers need to continue to examine the long-term effects of this treatment for improving "real world" functional outcomes among this population.