Social functioning and social cognition in at-risk and first episode psychosis

Kennedy, Paul (2019) Social functioning and social cognition in at-risk and first episode psychosis. Doctoral thesis, University of East Anglia.

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Reduced social functioning is a key characteristic of the psychosis continuum. However, it is currently unclear how effective a range of psychological interventions are in improving social functioning in at risk mental states (ARMS) and first episode psychosis (FEP) populations. One treatment target that has received increased interest is social cognitive function. However, there has not yet been a comprehensive analysis of the literature investigating the relationship between social cognition, social functioning, and psychotic symptomatology. To this end we conducted a systematic review and meta-analysis to determine the effectiveness of psychological interventions on social functioning, and to determine the nature of relationship between social cognition, social functioning and psychotic symptoms in ARMS and FEP. Our systematic review demonstrated that CBT, multicomponent and service level interventions have efficacy in FEP, whilst there is currently no evidence that CBT, and limited evidence that other therapeutic modalities, are efficacious in improving social functioning in ARMS populations. Overall methodological quality was highly variable and there was a high risk of bias in many domains. Our meta-analysis revealed that in ARMS participants, better overall social cognitive performance and emotion recognition were related to better social functioning, and better emotion recognition performance was related to lower psychotic symptoms. In FEP, significant relationships were identified in all domains indicating that better social cognitive performance is related to enhanced social functioning and lower psychotic symptoms. Effect sizes for all meta-analyses were small (range r=0.1 to 0.3). Together, our findings indicate that there is a need for future trials targeting social functioning, particularly in ARMS populations. Moreover, considering the consistent significant relationship between social cognitive performance, social functioning and psychotic symptoms, interventions designed to target social cognition specifically in ARMS and FEP may prove beneficial in improving deficits in this domain, and potentially functioning and psychotic symptomatology.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 11011 not found.
Date Deposited: 18 Oct 2019 12:25
Last Modified: 18 Oct 2019 12:25


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