Schizophrenia Clinical Trial
Official title:
Does Group-Based Metacognitive Skills Training Reduce Jumping to Conclusions Bias of Patients With Psychotic Disorders in the Context of Forensic Psychiatric Care
Deficiencies in social cognition are part of the core symptomatology of psychotic disorders. And deficiencies in social cognition, the closely related concept of metacognition, and, for example, paranoid attitudes are all associated with violence. The link between social cognition and violence is also observed through rehabilitation, as both group-based Social Cognition Interaction Training (SCIT) and group-based Metacognitive Skills Training (MCT) have reduced violent behavior in patients with psychotic disorders. Thus, a better knowledge of social cognition and its rehabilitation in psychotic disorders can help to reduce risky behavior and to rehabilitate the significant social difficulties often found in psychotic disorders. This research study aims to examine factors underlying the efficacy of group-based MCT. The goal of the metacognitive skills training group developed by Moritz and partners is to strengthen the social and metacognitive skills of the patients participating in the group. The group consists of 10 sessions during which exercises and discussion are emphasized. The themes of the group sessions are, for example, jumping to conclusions -bias, empathy, and memory. Detailed information is available from the MCT website (https://clinical-neuropsychology.de/metacognitive_training-psychosis/). Overall there is meta-analysis-level evidence for the moderate effectiveness of MCT on positive symptoms of psychotic illnesses, such as delusions. Prior studies have argued that the unique factor underpinning MCT's efficacy is its impact on various cognitive biases, and that participating in the group especially reduces patients' tendency to jump to conclusions, which is a cognitive style associated with delusions and deficits in social perception and reasoning. As delusionality is related to the risk of violence, these results form a logical link between jumping to conclusions, delusionality, and violence. But the results regarding the effectiveness of MCT are still somewhat conflicting, and studies seem to be of varying quality. Additional longitudinal research and research related to the jumping to conclusion bias are also needed. The hypothesis regarding this study is that the MCT group reduces patients' tendency to jump to conclusions. These reductions are presumed to be associated in one-year follow-up with fewer mood symptoms, delusions, paranoia, and more psychological flexibility.
Status | Recruiting |
Enrollment | 85 |
Est. completion date | December 2026 |
Est. primary completion date | December 2026 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria (patients): - Willingness to participate in a scientific study - Diagnosis of a psychosis spectrum disorder - Finnish language skills due to questionnaires and psychological tests being in Finnish Exclusion Criteria (patients): - Psychosis that severely deteriorates the ability to function - Cognitive problems that severely deteriorate the ability to function - Guardianship established for personal matters Inclusion Criteria (non-patient controls): - Willingness to participate in a scientific study - Self-assessed sufficient Finnish language skills due to questionnaires and psychological tests being in Finnish Exclusion Criteria (non-patient controls): - Diagnosis of a psychosis spectrum disorder - Cognitive problems that severely interferes with functioning |
Country | Name | City | State |
---|---|---|---|
Finland | Vanha Vaasa Hospital | Vaasa |
Lead Sponsor | Collaborator |
---|---|
University of Jyvaskyla | Vanha Vaasa Hospital |
Finland,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Jumping to conclusions bias | The bias is measured using a revised version of the beads task. This is a test of optimal performance, meaning that both low and high scores can be problematic. | For the intervention group, the measurement is done before the group and nine months after completion. For the control groups, the time interval is one year. | |
Secondary | Paranoia and psychotic experiences | Paranoia and psychotic experiences assessed with the Symptoms Checklist 90 self-report questionnaire. The scale for paranoia goes from 0 to 24 with higher scores meaning worse outcome. The scale for psychotic experiences goes from 0 to 40 with higher scores meaning worse outcome | For the intervention group, the measurement is done before the group and nine months after completion. For the control groups, the time interval is one year. | |
Secondary | Mood symptoms | Mood symptoms assessed with Symptoms Checklist 90 self-report questionnaire. The sum for scales measuring depression and anxiety goes from 0 to 92 with higher scores meaning worse outcome. | For the intervention group, the measurement is done before the group and nine months after completion. For the control groups, the time interval is one year. | |
Secondary | Psychological flexibility | Psychological flexibility assessed with the the comprehensive assessment of acceptance and commitment therapy processes - Short Form (CompACT-8) self-report questionnaire. The total CompACT score ranges from 0-48, with higher scores indicating greater psychological flexibility: The ability to attend and adapt to situational demands in the pursuit of personally-meaningful longer-term goals. | For the intervention group, the measurement is done before the group and nine months after completion. For the control groups, the time interval is one year. |
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