Attention Shaping Procedures for Improving Psychosocial Skills Among Adults With Schizophrenia

Effectiveness Trial of Attention Shaping for Schizophrenia

This study will evaluate the effectiveness of attention shaping procedures in improving attentiveness and learning abilities in people undergoing psychosocial skills training treatment for schizophrenia.

Study Overview

• Status: Completed
• Conditions: Schizophrenia
• Intervention / Treatment: Behavioral: Social skills training with attention shaping procedures; Behavioral: Social skills training without attention shaping

Detailed Description

Schizophrenia is a disabling mental disorder that can interfere with a person's ability to function both alone and in social situations. Various treatments have been effective in treating schizophrenia, including antipsychotic medications and cognitive therapy. Psychosocial skills training, a type of cognitive therapy, is often used to help people with schizophrenia cope with their condition and improve social functioning in day-to-day life. However, many individuals with schizophrenia experience difficulty paying attention, and this is a significant barrier to successful outcomes in psychosocial skills training interventions. Attention shaping procedures (ASP) is a behavioral intervention that helps individuals with impaired attention capacities to benefit from skills-based treatment. This study will evaluate the effectiveness of ASP in improving attentiveness and learning abilities in people undergoing psychosocial skills training treatment for schizophrenia.

Participants in this 5-month, single-blind study will be randomly assigned to ASP plus basic conversation skills training (BCS), which is a social skills training group, or BCS alone. Training sessions for both groups will be held when participants attend regular hospital visits. During the first month, participants will complete two sessions of interviews, self-report scales, and social and cognitive functional assessments. Over the next 3 months, training sessions for both groups will occur twice a week for approximately 1 hour. ASP sessions will focus on setting goals and increasing the quality and duration of participants' attentiveness during psychosocial interventions. BCS will train participants in the following five skill areas: recognizing verbal and non-verbal cues; starting a friendly conversation; keeping conversation going; ending a conversation politely; and incorporating all of these skills together. During the last month, participants will attend two interview sessions lasting approximately 4 hours each. One follow-up session will occur 6 months after completing the intervention.

• Study Type: Interventional
• Enrollment (Actual): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New Jersey
    • Monmouth Junction, New Jersey, United States, 08852
      • University Behavioral Healthcare
    • New Brunswick, New Jersey, United States, 08901
      • University Behavioral Healthcare

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Diagnosis of schizophrenia, as confirmed by a diagnostic interview
• Has experienced difficulty paying attention while in groups during a treatment program, as determined by program staff
• Has experienced problems with social skills, as determined by program staff and study clinicians
• Social skill deficits, as determined by study clinicians

Exclusion Criteria:

• Diagnosis of mental retardation (including borderline or mild mental retardation)
• Diagnosis of autism, Asperger's syndrome, or another childhood disorder involving learning or relating to other people
• History of a neurological disorder, including epilepsy, traumatic brain injury with loss of consciousness, coma, stroke, Parkinson's disease, etc.
• Diagnosis of active substance abuse (history of a substance abuse disorder without a current substance abuse problem will not be a criterion for exclusion)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: 1; Participants will receive social skills training with attention shaping procedures	Behavioral: Social skills training with attention shaping procedures; Social skills training with attention shaping procedures includes behavioral procedures to increase the frequency, intensity, and duration of attentive behaviors and to reduce the frequency of inattentive behaviors.
ACTIVE_COMPARATOR: 2; Participants will receive social skills training without attention shaping procedures	Behavioral: Social skills training without attention shaping; Social skills training without attention shaping is based on the UCLA Basic Conversation Skills Training Module, used without attention shaping procedures.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Observational ratings of in-group attentiveness	Measured two times per week for 16 weeks
Observational ratings of in-group attentiveness in non-study groups	Measured at Month 6 follow-up
Changes in knowledge of information about social skills taught in the study	Measured at pre- and post-treatment and at Month 6 follow-up
Changes in ability to demonstrate behavioral skills taught in the study	Measured at pre- and post-treatment and at Month 6 follow-up
Level of social functioning	Measured at pre- and post-treatment and at Month 6 follow-up

Secondary Outcome Measures

Outcome Measure	Time Frame
Self-efficacy	Measured at pre- and post-treatment and at Month 6 follow-up
Working alliance	Measured at pre- and post-treatment and at Month 6 follow-up
Satisfaction with treatment	Measured at pre- and post-treatment and at Month 6 follow-up

Collaborators and Investigators

• Sponsor: University of Medicine and Dentistry of New Jersey
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Steven M. Silverstein, PhD, University of Medicine and Dentistry of New Jersey

Publications and helpful links

General Publications

• Silverstein SM, Hatashita-Wong M, Solak BA, Uhlhaas P, Landa Y, Wilkniss SM, Goicochea C, Carpiniello K, Schenkel LS, Savitz A, Smith TE. Effectiveness of a two-phase cognitive rehabilitation intervention for severely impaired schizophrenia patients. Psychol Med. 2005 Jun;35(6):829-37. doi: 10.1017/s0033291704003356.
• Silverstein SM, Spaulding WD, Menditto AA, Savitz A, Liberman RP, Berten S, Starobin H. Attention shaping: a reward-based learning method to enhance skills training outcomes in schizophrenia. Schizophr Bull. 2009 Jan;35(1):222-32. doi: 10.1093/schbul/sbm150. Epub 2008 Jan 22.

Study record dates

Study Major Dates

• Study Start: January 1, 2007
• Primary Completion (ACTUAL): June 1, 2011
• Study Completion (ACTUAL): June 1, 2011

Study Registration Dates

• First Submitted: October 20, 2006
• First Submitted That Met QC Criteria: October 20, 2006
• First Posted (ESTIMATE): October 24, 2006

Study Record Updates

• Last Update Posted (ESTIMATE): September 28, 2012
• Last Update Submitted That Met QC Criteria: September 27, 2012
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: Cognitive Rehabilitation; Behavior Therapy
• Additional Relevant MeSH Terms: Mental Disorders; Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia
• Other Study ID Numbers: R01MH074650 (NIH); DATR A2-A1SZ