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

Published online by Cambridge University Press:  22 June 2017

P. M. Grant ,
D. Perivoliotis ,
L. Luther ,
K. Bredemeier  and
A. T. Beck
P. M. Grant*
Affiliation:
Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
D. Perivoliotis
Affiliation:
VA San Diego Healthcare System and Department of Psychiatry, University of California, San Diego, California
L. Luther
Affiliation:
Department of Psychology, Indiana University-Purdue University, Indianapolis, USA
K. Bredemeier
Affiliation:
Center for Health Assessment Research and Translation, College of Health Sciences, University of Delaware, USA
A. T. Beck
Affiliation:
Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
*
*Address for correspondence: P. M. Grant, Ph.D., Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Room 2032, Philadelphia, PA 19104, USA. (Email: pgrant@mail.med.upenn.edu)
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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Cognitive therapynegative symptomsschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 2 , January 2018 , pp. 261 - 268
Copyright
Copyright © Cambridge University Press 2017 

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