Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy

• Published in: Psychological medicine Vol. 48; no. 2; pp. 261 - 268
• Main Authors: Grant, P. M., Perivoliotis, D., Luther, L., Bredemeier, K., Beck, A. T.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.01.2018
• Subjects: Achievement; Adult; Affect - physiology; Analogue; Behavior change; Beliefs; Cognition; Cognitive ability; Cognitive behavioral therapy; Cognitive Dysfunction - etiology; Cognitive Dysfunction - therapy; Cognitive therapy; Cognitive Therapy - methods; Community involvement; Community participation; Disability; Emotional behavior; Executive Function - physiology; Female; Humans; Illnesses; Intervention; Male; Mental disorders; Middle Aged; Mood; Negative symptoms; Objectives; Original Articles; Outcome Assessment (Health Care); Psychiatry; Psychotherapy; Recovery; Recovery (Medical); Responsiveness; Schizophrenia; Schizophrenia - complications; Schizophrenia - physiopathology; Schizophrenia - therapy; Self Concept; Success; Treatment methods; Cognitive therapy; negative symptoms; schizophrenia
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S003329171700160X

Negative symptoms significantly contribute to disability and lack of community participation for low functioning individuals with schizophrenia. Cognitive therapy has been shown to improve negative symptoms and functional outcome in this population. Elucidation of the mechanisms of the therapy would lead to a better understanding of negative symptoms and the development of more effective interventions to promote recovery. The objective of this study was to determine (1) whether guided success at a card-sorting task will produce improvement in defeatist beliefs, positive beliefs about the self, mood, and card-sorting performance, and (2) whether these changes in beliefs and mood predict improvements in unguided card-sorting. Individuals with schizophrenia having prominent negative symptoms and impaired neurocognitive performance (N = 35) were randomized to guided success (n = 19) or a control (n = 16) condition. Controlling for baseline performance, the experimental group performed significantly better, endorsed defeatist beliefs to a lesser degree, reported greater positive self-concept, and reported better mood than the control condition immediately after the experimental session. A composite index of change in defeatist beliefs, self-concept, and mood was significantly correlated with improvements in card-sorting. This analogue study supports the rationale of cognitive therapy and provides a general therapeutic model in which experiential interventions that produce success have a significant immediate effect on a behavioral task, mediated by changes in beliefs and mood. The rapid improvement is a promising indicator of the responsiveness of this population, often regarded as recalcitrant, to cognitively-targeted behavioral interventions.