Social Mind: Improving Social Functioning in First Episode Psychosis

心理健康和社会生活有着内在的联系。基于动物和人类研究的精神病生物-心理-社会模型指出，社会压力是精神病症状出现的假定机制。我们自己的工作表明，精神病首次发作（FEP）的人经历了高水平的社会压力，这对他们的社会交往产生了负面影响。然而，现有的精神病心理干预措施都没有明确关注社会压力。该项目将涉及社会心理的开发和验证，这是一种新的心理干预措施，旨在帮助患者了解和管理社会压力，最大限度地减少社交退缩的风险，并改善社交互动。这是通过结合社会压力的认知评估和涉及现实生活情况的积极行为组成部分来实现的。我们将在一项可行性研究中试用Social Mind，从两个国家卫生服务（NHS）信托基金会招募60名患者。这项可行性研究将比较除了常规临床支持之外还接受社会心理的人与仅接受常规临床支持的人。我们将收集有关Social Mind的可行性、可接受性、安全性和临床疗效的定量和定性信息。这些信息将用于完善干预措施，并开发一项全面的随机对照试验。在这样的全面验证之后，我们将有一个新的基于证据的干预措施，用于减少FEP患者的社会压力和改善社会互动。社会心理将帮助精神病患者驾驭社会环境，建立和维持有意义的社会关系，过上更独立的生活，并实现他们的教育和职业目标。这将大大减轻服务使用者、其家庭和临床服务的疾病负担。

Mental health and social life are intrinsically connected. Bio-psycho-social models of psychosis, based on animal and human studies, point to social stress as a putative mechanism for the emergence of psychotic symptoms. Our own work suggests that people with first episode of psychosis (FEP) experience high levels of social stress, and that this has negative impact on their social interactions. Yet none of the existing psychological interventions for psychosis has an explicit focus on social stress. This project will involve the development and validation of Social Mind, a new psychological intervention aimed at helping patients understand and manage social stress, minimise risk of social withdrawal and improve social interactions. This is achieved by combining the cognitive appraisal of social stress and an active behavioural component involving real-life situations. We will trial Social Mind in a feasibility study with 60 patients recruited from two National Health Service (NHS) Trusts. This feasibility study will compare people who receive Social Mind in addition to routine clinical support against people who receive routine clinical support alone. We will collect quantitative and qualitative information on the feasibility, acceptability, safety and clinical efficacy of Social Mind. This information will be used to refine the intervention and develop a full-scale randomised control trial. Following such full-scale validation, we will have a new evidence-based intervention for reducing social stress and improving social interactions in people with FEP. Social Mind will help people with psychosis to navigate social situations, establish and sustain meaningful social relationships, live a more independent life and fulfil their educational and occupational objectives. This will greatly reduce the burden of the illness on service users, their families and clinical services.