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Neurocognition and social cognition training as treatments for violence and aggression in people with severe mental illness

Published online by Cambridge University Press:  28 June 2019

Mackenzie T. Jones Open the ORCID record for Mackenzie T. Jones [Opens in a new window]  and
Philip D. Harvey Open the ORCID record for Philip D. Harvey [Opens in a new window]
Mackenzie T. Jones
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, Miami, Florida, United States
Philip D. Harvey*
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, Miami, Florida, United States >Research Service, Miami VA Healthcare System, Miami, Florida, United States
*
*Address correspondence to: Philip D. Harvey, PhD, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1450, Miami, Florida 33136, United States. (Email: philipdharvey1@cs.com)
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Abstract

Aggressive and violent behavior, including both verbal and physical aggression, have considerable adverse consequences for people with schizophrenia. There are several potential causes of violent behavior on the part of people with severe mental illness, which include intellectual impairments, cognitive and social-cognitive deficits, skills deficits, substance abuse, antisocial features, and specific psychotic features. This review explores the interventions that have been tested to this date. Computerized Cognitive Training (CCT) or Computerized Social-Cognitive Training (CSCT) have been associated with reductions in violence. Combined CCT and CSCT have been found to improve social cognition and neurocognition, as well as everyday functioning when combined with rehabilitation interventions. These interventions have been shown to reduce violence in schizophrenia patients across multiple environments, including forensic settings. The reductions in violence and aggression have manifested in various ways, including reduced violent thinking and behavior, reduced physical and violent assaults, and reduced disruptive and aggressive behaviors. Effects of cognitive training may be associated with improvements in problem-solving and the increased ability to deploy alternative strategies. The effect of social cognition training on violence reduction appears to be direct, with improvements in violence related to the extent of improvement in social cognition. There are still remaining issues to be addressed in the use of CCT and CSCT, and the benefits should not be overstated; however, the results of these interventions are very promising.

Keywords

Violencesocial cognitionneurocognitionschizophreniacomputerized trainingaggression
Type
Review
Information
CNS Spectrums , Volume 25 , Issue 2 , April 2020 , pp. 145 - 153
Copyright
© Cambridge University Press 2019

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