Can writing be used to study and improve the socio-cognitive functioning of individuals diagnosed with schizophrenia?

Abstract

Impairments in social and cognitive functioning are some of the most disabling features of the schizophrenia. They result in poorer communication with others, difficulties in maintaining employment status and decrease in community involvement. Recently, cognitive remediation therapy (CRT), which relies on computer-based drill and practice exercises, has emerged as a nonpharmacological intervention that aims to target and improve cognitive and social functions. Given the recent success of CRT based approaches, the question arises: can other nonpharmacological interventions which aim to augment and improve socio-cognitive functions be effective? Building upon Vygotsky's (1934) theorizing, we conducted an 8-week long study involving 19 participants. The study uses the methodology of narrative inquiry to examine participants’ ability to employ varied socio-cognitive functions (affect, causation, perceptive-taking, logical/hypothetical inference, etc.) when writing about everyday activities and attempting to resolve conflicts in narratives. Prompts employed in this study directed participants to write about three different socio-cultural contexts: (1) inpatient; (2) outpatient and (3) a fictional context. The fictional context aimed to examine participant's ability to imagine and express alternative futures/scenarios. Data show significantly higher frequency of occurrence of linguistic devices tied to cognitive functions in (3) fictional narrative context when compared to either (1) inpatient or (2) outpatient context. Use of affect was the only statistically significant difference between contexts (1) and (2). Findings indicate that individuals diagnosed with schizophrenia are able to vary the use of social and cognitive functions across narrative contexts, suggesting that future socio-cognitive interventions can be anchored in mindfully planned narrative activities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.