Schizophrenia Spectrum Disorders, Social Cognition
Conditions
Keywords
Schizophrenia, Psychosis, Social Cognition, Mentalizing, Theory of Mind, Cognitive Remediation, Metacognition, Perspective-Taking, Visual Illusions, Viewpoint Illusions, Bottom-Up Intervention, Sensorimotor Rehabilitation, Faux Pas Test, Hinting Task, Social Interaction, Rehabilitation in Psychosis
Brief summary
This study aims to explore whether the observation of complex visual objects can help improve social cognition in people living with psychotic disorders. Social cognition refers to the ability to understand what others think, feel, or intend, and plays a key role in social relationships and daily interactions. Main questions this study aims to answer: * Does dyadic exposure to complex visual objects improve mental state attribution, as measured by the Faux Pas Test? * Does the intervention enhance related domains of social cognition, including implicit intention inference (Hinting Task), interpretation of complex interactions (Movie for the Assessment of Social Cognition, MASC), and reduction of hostile attribution biases (Ambiguous Intentions Hostility Questionnaire, AIHQ)? * Are improvements maintained after one month, and do patients who receive the intervention later (waitlist group) show the same benefits once exposed?
Detailed description
This study is a randomized, controlled, monocentric trial evaluating a novel sensory-motor rehabilitation approach for social cognition. The study is based on the hypothesis that perception is interpretative and viewpoint-dependent, and that realizing this through concrete experience could generalize to higher-level cognitive processes required for social understanding. Participants will attend three visits and complete questionnaires and tasks that assess social understanding before and after the activity, and again one month later. Two groups will take part: one completing the workshop shortly after inclusion, and one completing it after a delay, allowing comparison over time. Participants will be randomized in one condition. This research does not involve medication. It consists of simple tasks such as observing and describing visual stimuli, followed by a facilitated discussion. Neuropsychological tests and questionnaires will be used to measure changes over time. Expected impact: By inducing concrete perspective-shifts, the intervention aims to improve mentalizing, reduce egocentric biases, and strengthen interpretation of social cues. This bottom-up sensory-motor approach may overcome limitations of classical cognitive remediation programs by promoting deep experiential learning rather than top-down instruction. If effective, the method may support long-term social reintegration, psychosocial functioning, and inspire wider clinical applications due to its low cost, ease of deployment, and strong ecological engagement.
Interventions
BEHAVIORALVisual-illusion social cognition session (immediate)
A guided session of approximately 45 minutes. The core rehabilitation tool consists of multiple-perspective illusion boxes. Each participant stands on one side of the box and perceives a different shape than their partner. The session unfolds in 3 structured phases: 1. For each illusion : Participants observe objects silently and draw what they see. 2. Perspective confrontation + Card selection: Drawings and interpretation cards are exchanged and discussed. 3. Perspective switching : Participants swap positions to reveal the alternative visual interpretation. The session is followed by a short structured discussion with a psychologist focused on perspective-taking and interpretation of social cues.
BEHAVIORALVisual-illusion social cognition session (delayed)
A guided session of approximately 45 minutes. The core rehabilitation tool consists of multiple-perspective illusion boxes. Each participant stands on one side of the box and perceives a different shape than their partner. The session unfolds in 3 structured phases: 1. For each illusion : Participants observe objects silently and draw what they see. 2. Perspective confrontation + Card selection: Drawings and interpretation cards are exchanged and discussed. 3. Perspective switching : Participants swap positions to reveal the alternative visual interpretation. The session is followed by a short structured discussion with a psychologist focused on perspective-taking and interpretation of social cues. Delivered after a delay following baseline assessment.
Sponsors
Hôpital le Vinatier
INSERM 1028
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Two groups will take part: one completing the workshop shortly after inclusion, and one completing it after a delay, allowing comparison over time.
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18 to 40 years * Fluent French speaker * Has provided written informed consent * For individuals under guardianship (curatorship): inclusion is permitted if the curator is available to assist or advise when needed. * Established diagnosis of schizophrenia, schizoaffective disorder, schizophreniform disorder, or brief psychotic disorder according to theDiagnostic and statistical manual of mental disorders (DSM-5-TR) criteria * Presence of social cognition impairment, defined by:subjective complaint reported by the participant or identified by care teams regarding difficulties in social interaction and clinical confirmation of observable difficulties (e.g., social withdrawal, misinterpretation of others' intentions, inappropriate social behaviour) * Membership or entitlement to a social security plan
Exclusion criteria
* Clinical state incompatible with participation in group-based activities (e.g., severe psychomotor agitation, severe behavioural disturbance) * Concurrent participation in another social cognition remediation program * Diagnosis of intellectual disability * Insufficient comprehension of French for verbal interaction and test completion * Significant change in psychotropic medication within the past month * Uncorrectable visual impairment preventing participation * Pregnant women * Individuals under full guardianship (tutorship)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| "Faux Pas" test total score | Change from pre to post intervention (up to 3 hours) | 1. Total of correctly recognised "Faux Pas" Score range : 0 - 30 Minimum (0) : no correct detection of faux pas Maximum (30) : all faux pas correctly detected 2. Total of identified absence of "Faux Pas" Score range : 0 - 10 Minimum (0) : incorrectly identifies absence of faux pas Maximum (10) : correctly identifies absence of faux pas 3. Total score of control question comprehension Score range : 0 - 20 Minimum (0) : poor comprehension Maximum (20) : Full comprehension |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hinting Task | Change from pre to post intervention (up to 3 hours) | 1. Number of correctly inferred items with hint 1 Score range : 0 - 20 Minimum (0) : No correct inference of intentions Maximum (20) : All intentions correctly inferred 2. Number of correctly inferred items with hint 2 Score range : 0 - 20 Minimum (0) : No correct inference of intentions Maximum (20) : All intentions correctly inferred |
| MASC performance | Change from pre intervention to follow-up session (up to a month and a half) | Number of correct responses Score range 0 - 45 Minimum (0) : No correct mental state inference Maximum (45) : All mental states correctly inferred |
Countries
France
Contacts
CONTACTJoy El KHOURY
CONTACTMéline Devaluez, PhD
Outcome results
None listed