Social Functioning Interventions in Psychosis: A Systematic Review

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-05-29 DOI:10.1002/cpp.70090

M. Vinu, A. Georgiades

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Abstract

Objective

A decline in social functioning is a hallmark of psychosis and is evident across the psychosis continuum. However, no study to date has summarised the existing evidence base regarding social functioning interventions in psychosis, nor have they synthesised the factors associated with high or low social functioning in psychosis.

Method

A systematic review was conducted to summarise the extant literature regarding social functioning interventions in psychosis.

Results

Sixty-five studies were eligible for inclusion. Physical exercise, art therapy, social recovery therapy, social skills training, virtual reality, online programmes and psychosocial interventions improved social functioning and reduced both positive and negative symptoms of psychosis. Factors associated with low social functioning in psychosis included self-perception (self-esteem, self-efficacy, internalised stigma), symptoms (social anxiety, depression, positive and negative symptoms), emotion (reduced emotional awareness/regulation, emotional suppression, negative affect), cognition (appraisals, negative self-beliefs, dependency and enmeshment schema, negative self-statements, defeatist performance beliefs, metacognitive beliefs), social cognition (ToM, neurocognition) and behaviours (motivation, social relatedness, avoidance). Factors associated with high social functioning in psychosis included emotional awareness, acceptance of emotions, positive affect, cognitive reappraisal, positive performance beliefs and adaptive coping.

Conclusions

A number of factors were associated with high or low social functioning in psychosis, which highlights important clinical intervention targets for devising novel social functioning interventions. The cognitive model of social functioning in psychosis could facilitate the development of personalised and idiosyncratic formulations and targeted interventions in CBTp to enhance social functioning in psychosis.

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精神病的社会功能干预：系统回顾

目的社会功能下降是精神病的一个标志，在整个精神病连续体中都很明显。然而，到目前为止，还没有一项研究总结了精神病患者社会功能干预的现有证据基础，也没有综合分析精神病患者社会功能高低的相关因素。方法对现有有关精神病患者社会功能干预的文献进行系统综述。结果65项研究符合纳入条件。体育锻炼、艺术疗法、社会康复疗法、社会技能培训、虚拟现实、在线方案和心理社会干预措施改善了社会功能，减少了精神病的阳性和阴性症状。与精神病患者社会功能低下相关的因素包括自我感知（自尊、自我效能、内化耻辱）、症状（社交焦虑、抑郁、积极和消极症状）、情绪（情绪意识/调节减少、情绪抑制、消极影响）、认知（评价、消极自我信念、依赖和依恋图式、消极自我陈述、失败主义表现信念、元认知信念）、社会认知(ToM、神经认知)和行为（动机，社会关系，回避）。与精神病患者高社会功能相关的因素包括情绪意识、情绪接受、积极影响、认知重评、积极表现信念和适应性应对。结论影响精神病患者社会功能高低的因素有很多，这为设计新的社会功能干预措施提供了重要的临床干预目标。精神病患者社会功能的认知模型可以促进个性化和特殊配方的发展，以及CBTp中有针对性的干预措施，以增强精神病患者的社会功能。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.