The Effectiveness of Recovery-Oriented Cognitive Therapy on Positive and Negative Symptoms and Cognitive Insight in Patients with Chronic Schizophrenia

Eyvazzadeh Gharajeh, Hadise; Talebi, Samira; Farzizadeh, Shayan; Atadokht, Akbar

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The Effectiveness of Recovery-Oriented Cognitive Therapy on Positive and Negative Symptoms and Cognitive Insight in Patients with Chronic Schizophrenia

Hadise Eyvazzadeh Gharajeh

, Samira Talebi

, Shayan Farzizadeh

, Akbar Atadokht ^*

Department of Clinical Psychology, University of Mohaghegh Ardabili, Ardabil, Iran , khadijeh_eyvazzadeh.1398@yahoo.com

Abstract: (40 Views)

Introduction: Chronic schizophrenia is one of the most disabling psychiatric disorders, characterized by positive and negative symptoms, as well as deficits in cognitive insight. Given the limited effectiveness of pharmacological treatments, examining novel psychological interventions is of particular importance. This study aimed to evaluate the effectiveness of recovery-oriented cognitive therapy in reducing positive and negative symptoms and enhancing cognitive insight in patients with chronic schizophrenia. Materials and Methods: This semi-experimental study employed a pretest–posttest design with a control group and one-month follow-up. The sample consisted of 30 patients with chronic schizophrenia residing in rehabilitation centers in Ardabil, Iran, who were selected through convenience sampling and randomly assigned to experimental and control groups in equal numbers. The experimental group received eight 60-minute recovery-oriented cognitive therapy sessions over four weeks, while the control group received no intervention. The data were collected using the Positive and Negative Syndrome Scale and the Beck Cognitive Insight Scale. Results: The results indicated that recovery-oriented cognitive therapy led to a significant reduction in positive symptoms, negative symptoms, and disorganization within the experimental group over time; however, the interaction effect between group and time did not reach statistical significance. Moreover, recovery-oriented cognitive therapy significantly improved cognitive insight, including increased self-reflectiveness and decreased self-certainty. These changes remained stable at the one-month follow-up. Conclusion: Recovery-oriented cognitive therapy may serve as a complementary approach to partially reducing psychotic symptoms and enhancing cognitive insight in patients with chronic schizophrenia. The relative stability of these effects indicates that the implementation of recovery-oriented cognitive therapy within psychiatric rehabilitation centers may offer meaningful clinical benefits.

Keywords: Cognitive Behavioral Therapy, Psychotic Disorders, Rehabilitation, Cognition, Chronic Disease

Full-Text [PDF 1832 kb] (4 Downloads)

Type of Study: Research --- Open Access, CC-BY-NC | Subject: Psycology

References

1. El-Ashry AM, Abd Elhay ES, Taha SM, Khedr MA, Attalla Mansour FS, Alabdullah AAS, Farghaly Abdelaliem SM, El-Sayed MM. Effect of applying nursing-based cognitive defusion techniques on mindful awareness, cognitive fusion, and believability of delusions among clients with schizophrenia: a randomized control trial. Front Psychiatry. 2024; 15: 1369160. [DOI:10.3389/fpsyt.2024.1369160]

2. McClain L, Mansour H, Ibrahim I, Klei L, Fathi W, Wood J, et al. Age dependent association of inbreeding with risk for schizophrenia in Egypt. Schizophr Res. 2020; 216: 450-9. [DOI:10.1016/j.schres.2019.10.039]

3. Patel R, Smith A, Jones L. Psychological and psychosocial interventions for schizophrenia: a systematic review. Eur Psychiatry. 2024; 72: 45-56.

4. Iranian Welfare Organization. 700 schizophrenia patients covered by residential rehabilitation centers in Khorasan Razavi. Tehran: Iranian Welfare Organization; 2023.

5. Finnerty MT, Khan A, You K, Wang R, Gu G, Layman D, et al. Prevalence and incidence measures for schizophrenia among commercial health insurance and Medicaid enrollees. Schizophrenia (Heidelb). 2024; 10(1): 68. [DOI:10.1038/s41537-024-00490-0]

6. Orsolini L, Pompili S, Volpe U. Schizophrenia: a narrative review of etiopathogenetic, diagnostic and treatment aspects. J Clin Med. 2022; 11(17): 4978. [DOI:10.3390/jcm11175040]

7. Moura BM, Isvoranu AM, Kovacs V, Van Rooijen G, Van Amelsvoort T, Simons CJP, et al. The puzzle of functional recovery in schizophrenia-spectrum disorders-replicating a network analysis study. Schizophr Bull. 2022; 48(4): 871-80. [DOI:10.1093/schbul/sbac018]

8. Correll CU, Schooler NR. Negative symptoms in schizophrenia: a review and clinical guide for recognition, assessment, and treatment. Neuropsychiatr Dis Treat. 2020; 16: 519-34. [DOI:10.2147/NDT.S225643]

9. Krynicki CR, Upthegrove R, Deakin JFW, Barnes TRE. The relationship between negative symptoms and depression in schizophrenia: a systematic review. Acta Psychiatr Scand. 2018; 137(5): 380-90. [DOI:10.1111/acps.12873]

10. Miller GA, Lenzenweger MF. Schizophrenia research in the 21st century. Annu Rev Clin Psychol. 2012; 8: 223-47.

11. Chen EYH, Lui SSY, Ho KKY, Hung KSY, Wang Y, Cheung EFC. Impairments in social cognition and their associations with negative symptoms and functioning in schizophrenia. Front Psychiatry. 2020; 11: 593.

12. Green MF, Horan WP, Lee J. Social cognition in schizophrenia. Nat Rev Neurosci. 2015; 16(10): 620-31. [DOI:10.1038/nrn4005]

13. Riggs SE, Grant PM, Perivoliotis D, Beck AT. Assessment of cognitive insight: a review. Schizophr Bull. 2012; 38(2): 261-72. [DOI:10.1093/schbul/sbq085]

14. Halaj A, Strauss AY, Zlotnick E, Zalaznik D, Fradkin I, Andersson G, et al. Clinical and cognitive insight in panic disorder: phenomenology and treatment effects in internet cognitive behavior therapy. J Psychiatr Res. 2024; 172: 164-70. [DOI:10.1016/j.jpsychires.2024.02.011]

15. Konstantakopoulos G. Cognitive insight in psychosis: new developments. Psychosis. 2019;11(2):131-40.

16. McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry. 2023; 28(5): 1902-18. [DOI:10.1038/s41380-023-01949-9]

17. Ben-Zeev D, Young MA, Corrigan PW. DSM-V and the stigma of mental illness. J Ment Health. 2012; 19(4): 318-27. [DOI:10.3109/09638237.2010.492484]

18. Nazari Serenjeh F, Lotfi-Ghadikolaii N, Mohsenipour S, Ghasemzadeh Z. Human-Induced Pluripotent Stem Cells are a Unique Approach for Modeling Schizophrenia: Calcium Homeostasis. The Neuroscience Journal of Shefaye Khatam. 2022; 10(3): 98-112. [DOI:10.52547/shefa.10.3.98]

19. Ghasemzadeh Z, khanjani-Jelodar S, Nazari-Serenjeh F, Lotfi Ghadikolaii N. The Role of microRNA in the Pathogenesis of Schizophrenia. The Neuroscience Journal of Shefaye Khatam. 2022; 11(1): 119-132. [DOI:10.52547/shefa.11.1.119]

20. Leucht S, Komossa K, Rummel-Kluge C, Corves C, Hunger H, Schmid F, et al. A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia. Am J Psychiatry. 2009; 166(2): 152-63. [DOI:10.1176/appi.ajp.2008.08030368]

21. Case M, Stauffer VL, Ascher-Svanum H, Conley R, Kapur S, Kane JM, et al. The heterogeneity of antipsychotic response in the treatment of schizophrenia. Psychol Med. 2011; 41(6): 1291-300. [DOI:10.1017/S0033291710001893]

22. Khanmohammadi R, Sheikh M, Bagherzadeh F, Homanian D, Khajavi D. The Effect of Transcranial Direct Stimulation on Balance in Men with Schizophrenic and Depressive Disorder. The Neuroscience Journal of Shefaye Khatam. 2020; 9(1): 56-67. [DOI:10.52547/shefa.9.1.56]

23. Jauhar S, McKenna PJ, Radua J, Fung E, Salvador R, Laws KR. Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias. Br J Psychiatry. 2014; 204(1): 20-9. [DOI:10.1192/bjp.bp.112.116285]

24. Van Der Gaag M, Valmaggia LR, Smit F. The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: a meta-analysis. Schizophr Res. 2014; 156(1): 30-7. [DOI:10.1016/j.schres.2014.03.016]

25. Garety PA, Fowler DG, Freeman D, Bebbington P, Dunn G, Kuipers E. Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. Br J Psychiatry. 2008; 192(6): 412-23. [DOI:10.1192/bjp.bp.107.043570]

26. Davidson L, Rakfeldt J, Strauss JS. The roots of the recovery movement in psychiatry: lessons learned. Oxford: Wiley-Blackwell; 2008.

27. Beck AT, Grant PM, Inverso E, Brinen AP, Perivoliotis D. Recovery-oriented cognitive therapy for serious mental health conditions. New York: Guilford Press; 2020.

28. Zhang W, Perivoliotis D. Promoting recovery among persons with schizophrenia using recovery-oriented cognitive therapy (CT-R). Schizophr Res. 2022; 250: 125-6. [DOI:10.1016/j.schres.2022.11.014]

29. Grant PM, Huh GA, Perivoliotis D, Stolar NM, Beck AT. Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. Arch Gen Psychiatry. 2012; 69(2): 121-7. [DOI:10.1001/archgenpsychiatry.2011.129]

30. Grant PM, Bredemeier K, Beck AT. Six-month follow-up of recovery-oriented cognitive therapy for low-functioning individuals with schizophrenia. Psychiatr Serv. 2017; 68(10): 997-1002. [DOI:10.1176/appi.ps.201600413]

31. Novak J, Cather C, Penn D. Recovery-oriented cognitive therapy: a systematic review. Schizophr Res. 2020; 215: 45-52.

32. Beck AT, Himelstein R, Bredemeier K, Silverstein SM, Grant P, Wright JH. Successfully breaking a 20-year cycle of hospitalizations with recovery-oriented cognitive therapy for schizophrenia. Psychiatr Serv. 2013; 64(5): 511-3.

33. Chang NA, Grant PM, Luther L, Beck AT. Effects of a recovery-oriented cognitive therapy training program on inpatient staff attitudes and incidents of seclusion and restraint. Community Ment Health J. 2014; 50(4): 415-21. [DOI:10.1007/s10597-013-9675-6]

34. Medalia A, Saperstein AM. Does cognitive remediation for schizophrenia improve functional outcomes? Curr Opin Psychiatry. 2013; 26(2): 151-7. [DOI:10.1097/YCO.0b013e32835dcbd4]

35. Saeedi M, Sharifi Daramadi P, Sharifi Rad Gh. Effectiveness of recovery-oriented cognitive therapy on depression and interpersonal relationships in patients with schizophrenia. Psychodynamic Mood Disorders Quarterly. 2024; 3(1): 62-73. [DOI:10.61838/kman.pdmd.3.1.6]

36. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13(2): 261-76. [DOI:10.1093/schbul/13.2.261]

37. Ghamari-Givi H, Moulavi P, Heshmati R. Exploration of the factor structure of Positive and Negative Syndrome Scale in schizophrenia spectrum disorder. Clin Psychol J. 2010; 2(2): 1-10.

38. Beck AT, Baruch E, Balter JM, Steer RA, Warman DM. A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophr Res. 2004; 68(2-3): 319-29. [DOI:10.1016/S0920-9964(03)00189-0]

39. Yousefi R, Oreyzi HR, Sadeghi S. Assessment of cognitive insight in mental disorder: Beck Cognitive Insight Scale. Journal of Psychology (Iran). 2008; 11(4): 381-93.

40. Beck AT, Grant P, Inverso E, Brinen AP, Perivoliotis D. Recovery-oriented cognitive therapy for serious mental health conditions. New York: Guilford Press; 2020.

41. Atadokht A, Alaei Kalajahi M, Porzoor P. The Effect of Computer-Based Cognitive Rehabilitation on Improving Cognitive Function, Selective Attention, and Sustained Attention in Patients with Schizophrenia. The Neuroscience Journal of Shefaye Khatam. 2025; 13(4): 23-39. [DOI:10.61882/shefa.13.4.23]

42. Khaleghi A, Naderi F, Joharifard R, Javadzadeh M. Comparing the Effectiveness of Task-Oriented Cognitive Rehabilitation and Computer-Based Cognitive Rehabilitation Programs on Cognitive Flexibility in Children with Epilepsy. The Neuroscience Journal of Shefaye Khatam. 2023; 11(3): 25-35. [DOI:10.61186/shefa.11.3.25]

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