A meta‐analysis of the effects of social‐cognitive training in schizophrenia: The role of treatment characteristics and study quality

Abstract

Objectives. This meta-analysis was designed to assess the effects of social-cognitive training (SCT) and whether study quality, treatment approach, treatment context, and sample characteristics influence these effects.Methods. Electronic databases were searched up to 5 August 2020 using variants of keywords: 'social cognition', 'training', 'rehabilitation', 'remediation', and 'schizophrenia'. Methodological moderators were extracted through the Clinical Trials Assessment Measure and verified by authors. This study was pre-registered on PROSPERO (CRD42020154026).Results. Forty-two controlled trials with 1,868 participants were identified. The metaanalysis revealed moderate effects on emotion recognition, mental state attribution, and social perception. No significant effects were evident on psychiatric symptoms or social functioning. A small signal was evident for the generalization of treatment gains to executive function. Moderator analyses revealed that studies of lower methodological quality reported larger effects, and samples with lower mean years of education were associated with larger effects of SCT on mental state attribution. Treatment effects did not differ by other moderator variables such as treatment context and intervention types.Conclusions. SCT benefits people with schizophrenia on a variety of social-cognitive outcomes. Differences in baseline symptoms, gender distribution, antipsychotic medication dose, IQ, and other sample features did not create barriers to treatment benefits. Future studies should aim to enhance the generalization of training effects on broader clinical outcomes.Social cognition in schizophrenia is thought to be composed of four subdomains: social perception, emotion processing, theory of mind, and attributional style/bias (Green et al., 2019;Pinkham et al., 2014). Social perception refers to identifying social cues and making accurate inferences about the social role, rules, context, and relationships. Emotion processing encompasses the ability to identify and understand emotions of others and to manage emotions of oneself. Theory of mind, also called mental state attribution, is the

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