Cognitive behavioral therapy for negative symptoms (CBT-n) in psychotic disorders: A pilot study
Abstract
Background and objectives The treatment of negative symptoms in schizophrenia is a major challenge for mental health care. One randomized controlled trial found that cognitive therapy for low-functioning patients reduced avolition and improved functioning, using an average of 50.5 treatment sessions over the course of 18 months. The aim of our current pilot study was to evaluate whether 20 sessions of Cognitive Behavioral Therapy for negative symptoms (CBT-n) would reduce negative symptoms within 6 months. Also, we wanted to test the cognitive model of negative symptoms by analyzing whether a reduction in dysfunctional beliefs mediated the effects on negative symptoms.Method In an open trial 21 adult outpatients with a schizophrenia spectrum disorder with negative symptoms received an average of 17.5 sessions of CBT-n. At baseline and end-of-treatment, we assessed negative symptoms (PANSS) and dysfunctional beliefs about cognitive abilities, performance, emotional experience, and social exclusion. Bootstrap analysis tested mediation.Results The dropout rate was 14% (three participants). Intention-to-treat analyses showed a within group effect size of 1.26 on negative symptoms (t = 6.16, | Sig = 0.000). Bootstrap analysis showed that dysfunctional beliefs partially mediated the change.Limitations The uncontrolled design induced efficacy biases. Also, the sample was relatively small, and there were no follow-up assessments.Conclusions CBT-n may be effective in reducing negative symptoms. Also, patients reported fewer dysfunctional beliefs about their cognitive abilities, performance, emotional experience, and social exclusion, and this reduction partially mediated the change in negative symptoms. The reductions were clinically important. However, larger and controlled trials are needed.
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A single group design can still contribute to an understanding of mediation processes.
“Nevertheless, as Maric argues, a single group design can still contribute to an understanding of mediation processes, and this is evidenced by several recent investigations of mediation in single treatment groups. 28, 47, 57”
From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [47]
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- Authors
- Staring, A. B. P., ter Huurne, M.-A. B., & van der Gaag, M.
- Affiliations
- Altrecht GGZ (NL)
- Corresponding author
- Staring, Anton B.P.
- ORCID
- Staring, Anton B.P.
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 44
- Issue
- 3
- Pages
- 300-306
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W1968665938
- Cited by
- 95
- References
- 42
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 8 · 2023: 12 · 2022: 2 · 2021: 7 · 2020: 10 · 2019: 7 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 8 · 2014: 6 · 2013: 2
- FWCI
- 6.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- negative symptoms, schizophrenia spectrum disorders, dysfunctional attitudes, mediation, avolition, social exclusion, treatment discontinuation
- MeSH terms
- Adult, Culture, Female, Humans, Male, Middle Aged, Pilot Projects, Psychotic Disorders, Self-Assessment, Cognitive Behavioral Therapy
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