Entrenamiento en habilidades sociales orientado a la metacognición (MOSST)Marco teórico, metodología de trabajo y descripción del tratamiento para pacientes con esquizofrenia

  1. Felix Inchausti 2
  2. Nancy V. García-Poveda 3
  3. Javier Prado-Abril 2
  4. Javier Ortuño-Sierra 1
  5. Ignacio Gaínza-Tejedor
  1. 1 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  2. 2 Hospital Virgen del Camino
    info

    Hospital Virgen del Camino

    Pamplona, España

    ROR https://ror.org/046wwv897

  3. 3 Unidad de Psiquiatría, Hospital San Juan de Dios de Santurce, Spain
Montrer des affiliations +
Revue:
Papeles del psicólogo

ISSN: 0214-7823,  1886-1415

Année de publication: 2017

Volumen: 38

Número: 3

Pages: 204-215

Type: Article

DOI: 10.23923/PAP.PSICOL2017.2840 DIALNET GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: Papeles del psicólogo

Objectifs de Développement Durable

Résumé

Los déficits en el funcionamiento social son un síntoma característico de la esquizofrenia y han sido ampliamente descritos en la literatura. Como resultado, el entrenamiento en habilidades sociales (EHS) se considera una parte esencial del tratamiento integral para la esquizofrenia y su inclusión se recomienda en diversas guías clínicas internacionales del trastorno. Sin embargo, diferentes estudios han revelado que los programas actuales de EHS tienen un efecto limitado en cuanto a sus beneficios potenciales sobre el funcionamiento psicosocial cotidiano de los pacientes. El presente trabajo tiene por objetivo presentar un nuevo marco de intervención que integra el entrenamiento metacognitivo y el EHS para pacientes con esquizofrenia: el entrenamiento en habilidades sociales orientado a la metacognición (MOSST). La justificación teórica de MOSST se sustenta en los recientes hallazgos que sugieren el papel central de los déficits metacognitivos en el funcionamiento psicosocial de estos pacientes. Por este motivo, MOSST pretende no solo entrenar las habilidades interpersonales sino también mejorar la comprensión de los estados mentales propios y ajenos, así como la relación entre estos y el comportamiento social efectivo. Para facilitar la descripción de MOSST, su implementación se ilustra a través de un paciente con esquizofrenia que finalizó con éxito el programa completo. Por último, se discuten las implicaciones clínicas de los resultados disponibles hasta la fecha con MOSST, sus limitaciones y las direcciones futuras de investigación.

Références bibliographiques

  • Almerie, M. Q., Okba Al Marhi, M., Jawoosh, M., Alsabbagh, M., Matar, H. E., Maayan, N., y Bergman, H. (2015). Social skills programmes for schizophrenia. Cochrane Database of Systematic Reviews(6), Cd009006. doi: 10.1002/14651858.CD009006.pub2
  • Apiquian, R., Elena Ulloa, R., Herrera-Estrella, M., MorenoGomez, A., Erosa, S., Contreras, V., y Nicolini, H. (2009). Validity of the Spanish version of the Personal and Social Performance scale in schizophrenia. Schizophrenia Research, 112(1-3), 181-186. doi: 10.1016/j.schres.2009.03.028
  • Bandura, A. (1969). Principles of behavior modification. New York: Holt, Rinehart and Winston.
  • Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.
  • Barbato, M., Liu, L., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., McGlashan, T. H., . . . Addington, J. (2015). Theory of Mind, Emotion Recognition and Social Perception in Individuals at Clinical High Risk for Psychosis: findings from the NAPLS-2 cohort. Schizophrenia Research. Cognition, 2(3), 133-139. doi: 10.1016/j.scog.2015.04.004
  • Bellack, A. S., Green, M. F., Cook, J. A., Fenton, W., Harvey, P. D., Heaton, R. K., . . . Wykes, T. (2007). Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop. Schizophrenia Bulletin, 33(3), 805-822. doi: 10.1093/schbul/sbl035
  • Bellack, A. S., Mueser, K. T., Gingerich, S., y Agresta, J. (2004). Social skills training for schizophrenia: A step-bystep guide (2nd ed.). New York: Guilford Press.
  • Benton, M. K., y Schroeder, H. E. (1990). Social skills training with schizophrenics: a meta-analytic evaluation. Journal of Consulting and Clinical Psychology, 58(6), 741-747.
  • Brekke, J. S., Hoe, M., Long, J., y Green, M. F. (2007). How Neurocognition and Social Cognition Influence Functional Change During Community-Based Psychosocial Rehabilitation for Individuals with Schizophrenia. Schizophrenia Bulletin, 33(5), 1247-1256. doi: 10.1093/schbul/sbl072
  • Brown, J. R., Donelan-McCall, N., y Dunn, J. (1996). Why talk about mental states? The significance of children's conversations with friends, siblings, and mothers. Child Development, 67(3), 836-849.
  • Brüne, M. (2005). "Theory of mind" in schizophrenia: a review of the literature. Schizophrenia Bulletin, 31(1), 21-42. doi: 10.1093/schbul/sbi002
  • Caponigro, J. M., Moran, E. K., Kring, A. M., y Moskowitz, J. T. (2014). Awareness and coping with emotion in schizophrenia: acceptability, feasibility and case illustrations. Clinical Psychololgy and Psychotherapy, 21(4), 371-380. doi: 10.1002/cpp.1839
  • Combs, D. R., Drake, E., y Basso, M. R. (2014). An Overview of Social Cognitive Treatment Interventions. In P. H. Lysaker, G. Dimaggio y M. Brüne (Eds.), Social Cognition and Metacognition in Schizophrenia (pp. 163-178). San Diego: Academic Press.
  • de Jong, S., van Donkersgoed, R., Pijnenborg, G. H., y Lysaker, P. H. (2016). Metacognitive Reflection and Insight Therapy (MERIT) With a Patient With Severe Symptoms of Disorganization. Journal of Clinical Psychology, 72(2), 164174. doi: 10.1002/jclp.22249
  • Dilk, M. N., y Bond, G. R. (1996). Meta-analytic evaluation of skills training research for individuals with severe mental illness. Journal of Consulting and Clinical Psychology, 64(6), 1337-1346.
  • Dimaggio, G., Montano, A., Popolo, R., y Salvatore, G. (2015). Metacognitive interpersonal therapy for personality disorders: A treatment manual. London: Routledge.
  • Dixon, L. B., Dickerson, F., Bellack, A. S., Bennett, M., Dickinson, D., Goldberg, R. W., . . . Kreyenbuhl, J. (2010). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophrenia Bulletin, 36(1), 48-70. doi: 10.1093/schbul/sbp115
  • Fonagy, P., Bateman, A., y Bateman, A. (2011). The widening scope of mentalizing: A discussion. Psychology and Psychotherapy: Theory, Research and Practice, 84(1), 98-110. doi: 10.1111/j.2044-8341.2010.02005.x
  • Fonagy, P., Luyten, P., y Bateman, A. (2015). Translation: Mentalizing as treatment target in borderline personality disorder. Personali ty Disorders, 6(4), 380-392. doi: 10.1037/per0000113
  • Granholm, E., Holden, J., Link, P. C., y McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173-1185. doi: 10.1037/a0037098
  • Granholm, E., Holden, J., Link, P. C., McQuaid, J. R., y Jeste, D. V. (2013). Randomized controlled trial of cognitive behavioral social skills training for older consumers with schizophrenia: defeatist performance attitudes and functional outcome. The American Journal of Geriatric Psychiatry, 21(3), 251-262. doi: 10.1016/j.jagp.2012.10.014
  • Granholm, E., McQuaid, J. R., McClure, F. S., Link, P. C., Perivoliotis, D., Gottlieb, J. D., . . . Jeste, D. V. (2007). Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up. Journal of Clinical Psychiatry, 68(5), 730-737.
  • Harvey, P. D., y Penn, D. (2010). Social cognition: the key factor predicting social outcome in people with schizophrenia? Psychiatry (Edgmont), 7(2), 41-44.
  • Heinssen, R. K., Liberman, R. P., y Kopelowicz, A. (2000). Psychosocial skills training for schizophrenia: lessons from the laboratory. Schizophrenia Bulletin, 26(1), 21-46.
  • Horan, W. P., Kern, R. S., Shokat-Fadai, K., Sergi, M. J., Wynn, J. K., y Green, M. F. (2009). Social cognitive skills training in schizophrenia: an initial efficacy study of stabilized outpatients. Schizophrenia Research, 107(1), 47-54. doi: 10.1016/j.schres.2008.09.006
  • Inchausti, F., Garcia-Poveda, N. V., Ballesteros-Prados, A., Fonseca-Pedrero, E., Ortuño-Sierra, J., Sánchez-Reales, S., . . . Mole, J. (en revisión). A pilot study on feasibility, acceptance and effectiveness of metacognitive-oriented social skills training in schizophrenia.
  • Inchausti, F., Ortuño-Sierra, J., Garcia-Poveda, N. V., y Ballesteros-Prados, A. (2016). Metacognitive abilities in adults with substance abuse treated in therapeutic community. Adicciones, 719. doi: 10.20882/adicciones.719
  • James, A. V., Hasson-Ohayon, I., Vohs, J., Minor, K. S., Leonhardt, B. L., Buck, K. D., . . . Lysaker, P. H. (2016). Metacogni t ion moderates the re lat ionship between dysfunctional self-appraisal and social functioning in prolonged schizophrenia independent of psychopathology. Comprehensive Psychiatry, 69 , 62-70. doi: 10.1016/j.comppsych.2016.05.008
  • Kern, R. S., Glynn, S. M., Horan, W. P., y Marder, S. R. (2009). Psychosocial treatments to promote functional recovery in schizophrenia. Schizophrenia Bulletin, 35(2), 347361. doi: 10.1093/schbul/sbn177
  • Kurtz, M. M., y Mueser, K. T. (2008). A meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76(3), 491504. doi: 10.1037/0022-006x.76.3.491
  • Kurtz, M. M., y Richardson, C. L. (2012). Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophrenia Bulletin, 38(5), 1092-1104. doi: 10.1093/schbul/sbr036
  • Linehan, M. M. (1997). Validation and psychotherapy. In A. C. Bohart y L. S. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (pp. 353–392). Washington, DC: American Psychological Association.
  • Lysaker, P. H., Buck, K. D., Carcione, A., Procacci, M., Salvatore, G., Nicolo, G., y Dimaggio, G. (2011). Addressing metacognitive capacity for self reflection in the psychotherapy for schizophrenia: a conceptual model of the key tasks and processes. Psychology and Psychotherapy, 84(1), 58-69; discussion 98-110. doi: 10.1348/147608310x520436
  • Lysaker, P. H., Carcione, A., Dimaggio, G., Johannesen, J. K., Nicolo, G., Procacci, M., y Semerari, A. (2005). Metacognition amidst narratives of self and illness in schizophrenia: associations with neurocognition, symptoms, insight and quality of life. Acta Psychiatrica Scandinavica, 112(1), 6471. doi: 10.1111/j.1600-0447.2005.00514.x
  • Lysaker, P. H., Kukla, M., Dubreucq, J., Gumley, A., McLeod, H., Vohs, J. L., . . . Dimaggio, G. (2015). Metacognitive deficits predict future levels of negative symptoms in schizophrenia controlling for neurocognition, affect recognition, and self-expectation of goal attainment. Schizophrenia Research, 168(1-2), 267-272. doi: 10.1016/j.schres.2015.06.015
  • Lysaker, P. H., Shea, A. M., Buck, K. D., Dimaggio, G., Nicolo, G., Procacci, M., . . . Rand, K. L. (2010). Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders. Acta Psychiatrica Scandinavica, 122(5), 405-413. doi: 10.1111/j.1600-0447.2010.01554.x
  • Macbeth, A., Gumley, A., Schwannauer, M., Carcione, A., Fisher, R., McLeod, H. J., y Dimaggio, G. (2014). Metacognition, symptoms and premorbid functioning in a first episode psychosis sample. Comprehensive Psychiatry, 55(2), 268273. doi: 10.1016/j.comppsych.2013.08.027
  • McLeod, H. J., Gumley, A. I., Macbeth, A., Schwannauer, M., y Lysaker, P. H. (2014). Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis. Journal of Psychiatric Research, 54, 109115. doi: 10.1016/j.jpsychires.2014.03.018
  • Moritz, S., y Woodward, T. S. (2007). Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinion in Psychiatry, 20(6), 619-625. doi: 10.1097/YCO.0b013e3282f0b8ed
  • Nakagami, E., Hoe, M., y Brekke, J. S. (2010). The prospective relationships among intrinsic motivation, neurocognition, and psychosocial functioning in schizophrenia. Schizophrenia Bulletin, 36(5), 935-948. doi: 10.1093/schbul/sbq043
  • Ottavi, P., D'Alia, D., Lysaker, P., Kent, J., Popolo, R., Salvatore, G., y Dimaggio, G. (2014a). Metacognition-oriented social ski l ls training for individuals with long-term schizophrenia: methodology and clinical illustration. Clinical Psychology and Psychotherapy, 21(5), 465-473. doi: 10.1002/cpp.1850
  • Ottavi, P., Pasinetti, M., Popolo, R., Salvatore, G., Lysaker, P. H., y Dimaggio, G. (2014b). Metacognition-Oriented Social Skills Training. In P. Lysaker, G. Dimaggio y M. Brüne (Eds.), Social Cognition and Metacognition in Schizophrenia (pp. 285-300). San Diego: Academic Press.
  • Payne, M. (2002). Terapia narrativa: una introducción para profesionales. Madrid: Editorial Paidós
  • Penn, D. L., Roberts, D. L., Combs, D., y Sterne, A. (2007). Best practices: The development of the Social Cognition and Interaction Training program for schizophrenia spectrum disorders. Psychiatric Services, 58(4), 449-451. doi: 10.1176/appi.ps.58.4.449
  • Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Martindale, B., . . . Morgan, C. (2002). Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychological Medicine, 32(5), 783-791.
  • Pinkham, A. E. (2014). Social cognition in schizophrenia. Journal of Clinical Psychiatry, 75 Suppl 2, 14-19. doi: 10.4088/JCP.13065su1.04
  • Ribeiro, E., Ribeiro, A. P., Goncalves, M. M., Horvath, A. O., y Stiles, W. B. (2013). How collaboration in therapy becomes therapeutic: the therapeutic collaboration coding system.
  • Psychology and Psychotherapy, 86(3), 294-314. doi: 10.1111/j.2044-8341.2012.02066.x
  • Roberts, D. L., Combs, D. R., Willoughby, M., Mintz, J., Gibson, C., Rupp, B., y Penn, D. L. (2014). A randomized, controlled trial of Social Cognition and Interaction Training (SCIT) for outpatients with schizophrenia spectrum disorders. British Journal of Clinical Psychology, 53(3), 281-298. doi: 10.1111/bjc.12044
  • Roder, V., Mueller, D. R., y Schmidt, S. J. (2011). Effectiveness of integrated psychological therapy (IPT) for schizophrenia patients: a research update. Schizophrenia Bulletin, 37 Suppl 2, S71-79. doi: 10.1093/schbul/sbr072
  • Safran, J. D., y Muran, J. C. (2000). Negotiating the therapeutic alliance. A relational treatment guide. New York: Guilford.
  • Salvatore, G., Dimaggio, G., y Lysaker, P. H. (2007). An intersubjective perspective on negative symptoms of schizophrenia: implications of simulation theory. Cognit ive Neuropsychiatry, 12(2), 144-164. doi: 10.1080/13546800600819921
  • Salvatore, G., Dimaggio, G., Popolo, R., y Lysaker, P. H. (2008). Deficits in mindreading in stressful contexts and their relationships to social withdrawal in schizophrenia. Bulletin of the Menninger Clinic, 72(3), 191-209. doi: 10.1521/bumc.2008.72.3.191
  • Sass, L.A., y Parnas, J. (2003). Schizophrenia, consciousness and the Self. Schizophrenia Bulletin, 29, 427-444.
  • Seikkula, J., y Olson, M. E. (2003). The open dialogue approach to acute psychosis: its poetics and micropolitics. Family Process, 42(3), 403-418.
  • Semerari, A., Carcione, A., Dimaggio, G., Falcone, M., Nicolò, G., Procacci, M., y Alleva, G. (2003). How to evaluate metacognitive functioning in psychotherapy? The metacognition assessment scale and its applications. Clinical Psychology and Psychotherapy, 10(4), 238-261. doi: 10.1002/cpp.362
  • Stanghellini, G., y Lysaker, P. H. (2007). The psychotherapy of schizophrenia through the lens of phenomenology: intersubjectivity and the search for the recovery of firstand secondperson awareness. American Journal of Psychotherapy, 61(2), 163-179.
  • Sturges, J. W. (2012). Use of therapist self-disclosure and selfinvolving statements. the Behavior Therapist, 35(5), 90-93.
  • Tungpunkom, P., Maayan, N., y Soares-Weiser, K. (2012). Life skills programmes for chronic mental illnesses. Cochrane Database Systematic Review, 1, Cd000381. doi: 10.1002/14651858.CD000381.pub3
  • van Donkersgoed, R. J., de Jong, S., y Pijnenborg, G. H. (2016). Metacognitive Reflection and Insight Therapy (MERIT) with a Patient with Persistent Negative Symptoms. Journal of Contemporary Psychotherapy, 46(4), 245-253. doi: 10.1007/s10879-016-9333-8
La source de données: Dialnet