The effectiveness of social skill training on depressive symptoms, self- esteem and interpersonal difficulties among Schizophrenic patients

  • Authors

    • Maaly I. El Malky
    • Mervat Atia Faculty of nursing, Menoufia University, Egypt
    • Faten H.Alam
    2016-01-04
    https://doi.org/10.14419/ijans.v5i1.5386
  • Schizophrenia, Social Skill, Social Skill Training.

  • Abstract

    Patients with social skills deficits such as problems with communication with other people, social withdrawal, problems with activities of daily living should be offered to social skills training. Patients with schizophrenia usually have social skills deficits. Social skills training is a set of systematic techniques and strategies useful for teaching interpersonal skills that are based on social learning theory. It is a widely used treatment of a range of psychiatric disorders as schizophrenia. The aim of this study was to examine the effectiveness of social skill training program on self-esteem, depression and interpersonal difficulties among schizophrenic patients. Design: Quasi-experimental design (one group pretest posttest design) was used to achieve the aim of the study. Setting: The study was conducted at The Psychiatric Hospital in Tanta and the Psychiatric Hospital in Mit-Khalf at Menoufyia, Egypt. Sample: A convince sample (50) was selected in the chosen setting inpatient department. Tools: four tools were used for data collection. Tool one: a structured: socio-demographic questionnaire to obtain demographic data about the studied sample. Tool two: The depression, anxiety and stress scale (DASS).In this paper the researcher used the depression scale only which consists of 14 items in the form of rating scale. The depression scale assesses dysphoria, hopelessness, and devaluation of life, self- deprecation, and lack of interest and anhedonia. Tool three: Self- Esteem Inventory Scale: It evaluates attitudes of individuals toward themselves and consists of 25 items. Tool four: Relationship Scales Questionnaire. It consists of 13 items five points Likert- scale. The results: There is a highly significant reduction of the mean score of depressive symptoms and interpersonal difficulties at 0.001 while highly significant increase of the mean score of self-esteem at 0.001 post program than pre program. Conclusion: The social skills training program had a positive effect on interpersonal difficulties, depressive symptoms and self-esteem of the schizophrenic patients after receiving social skill training program. Recommendations: Generalized of social skill training program for all psychotic patients in hospital to improve their social competence and self-esteem.

  • References

    1. [1] Videbeck, S. L. (2011): Psychiatric-mental health nursing. (5thed.). Walters Kluwer, Lippincott Williams & Wilkins, China.PP.234- 266.

      [2] Gogtay, N., Vyas, N. S., Testa, R., Wood, S., &Pantelis, C. (2011): Age of onset of schizophrenia: Perspectives from Structural Neuroimaging Studies, Oxford Journals. Schizophrenia Bulletin, 37(3): 504-513. http://dx.doi.org/10.1093/schbul/sbr030.

      [3] Mueser, K. T., Pratt, S. I., & Cather, C. (2010): Neuro-cognition and social skill in older persons with schizophrenia and major mood disorders: An analysis of gender and diagnosis effects. Journal of Neurolinguistics. 23-(3):297-317. http://dx.doi.org/10.1016/j.jneuroling.2009.08.007.

      [4] Brüne, M., Schaub, D., Juckel, G., & Langdon, R. (2010): Social skills and behavioral problems in schizophrenia: The role of mental state attribution, neurocognition and clinical symptomatology. Psychiatry Res, 190(1): 9-17. http://dx.doi.org/10.1016/j.psychres.2010.03.015.

      [5] Fennell, M. (2009): Overcoming low self-esteem, a self –help guide using cognitive behavioral techniques. Create Britain, London. P: 7.

      [6] Borras, L., Boucherie, M., Mohr, S., Lecomte, T., Perroud, N., & Huguelet, P. (2009): Increasing self-esteem: efficacy of a group intervention for individuals with severe mental disorders European Psychiatry, 24: 307-316. http://dx.doi.org/10.1016/j.eurpsy.2009.01.003.

      [7] Pedersen, T. (2012): Low self-esteem affects treatment outcomes in schizophrenia.http://psychcentral.com/news/2012/09/28/low-self-esteem-affects-treatment-outcomes-in-schizophrenia/45270.html. Retrieved on: 28/6/2013

      [8] Vieru, T. (2012): Schizophrenia therapy efficiency reduced by low self-esteem. Available at:http://news.softpedia.com/newsImage/Schizophrenia-Therapy-Efficiency-Reduced-by-Low-Self-Esteem-2.jpg/. Retrieved on: 10/4/2013.

      [9] Bharathi, G. D., Huang, N., & Lu, Z. (2011): Psychosocial Interventions for Patients with Schizophrenia. Shanghai Archives of Psychiatry, 23(6): 368-375.

      [10] Kern, R. S., Glynn, S. M., Horan, W. P. &Marder, S. R. (2009): Psychosocial treatments to promote functional recovery in schizophrenia. Schizophrenia Bulletin, 35(2): 347-361. http://dx.doi.org/10.1093/schbul/sbn177.

      [11] Pfammatter, M., Tunghan, U. M., & Brenner, H. D. (2006): Efficacy of psychological therapy in schizophrenia. Conclusion from meta-analysis. Schizophrenia Bulletin, 32(1): 564-580.

      [12] Shean, G. D. (2013): Empirically based psychosocial therapies for schizophrenia: The disconnection between science and practice. Schizophrenia Research and Treatment.Article ID 792769, 8 pages. http://dx.doi.org/10.1155/2013/792769.

      [13] Okasha, T. A. (2005): Mental Health in Egypt, Isr J Psychiatry RelatSciVol 42 No. 2, .116–125.

      [14] Duckworth, K. (2010): Early onset schizophrenia. National alliance on mental illness. Available at:http://www. nami.org/ Template.cfm? Section = schizophrenia&template=/Content Management/Content Display. cfm&ContentID=103175. Retrieved on: 1/5/2013.

      [15] Zahran, N. S., Khalil, A. H., Okasha, T. A., & Adel Sadek, H. (2006): Systematic review of Egyptian studies on schizophrenia. (Published Master Desertion), Faculty of Medicine. Ain Shams University

      [16] Stuart, G. W. (2009): Principles and practice of psychiatric nursing (9thed.). Mosby Elsevier. Canada. Pp: 580-575.

      [17] Granhol m, E., McQuaid, J., McClure, F. S., Link, P. C, Pervoliotis, D., & Gog-glieb, J.D. (2007): Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up. J Clin Psychiatry, 68: 730-737. http://dx.doi.org/10.4088/JCP.v68n0510.

      [18] Kurtz, M. M. &Mueser, K. T. (2009): A meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76: 491–504. http://dx.doi.org/10.1037/0022-006X.76.3.491.

      [19] Hashemi, F. (2007): Effects of self-expression training on guidance school female students' happiness in Rey city [Thesis]. Tehran, Iran: Training Science Department, AllamehTabatabaei University.

      [20] Mousa, A., Imam, S. &Sharaf, A. (2011): The effect of an assertiveness training program on assertiveness skills and social interaction anxiety of individuals with schizophrenia. Journal of American Sci, 7(12): 454-466.

      [21] Khalil, A. I. (2012): A Community based treatment: Impact of social skills training program on improving social skills among schizophrenic patients. World Applied Sciences Journal, 18(3): 370-378.

      [22] Lee, T. Y., Chang, S. C., Chu, H., Yang, C, Y., Ou, K. L., Chung, M. H., & Chou, K. R. (2013): The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study. J AdvNurs. http://dx.doi.org/10.1111/jan.12142.

      [23] Seo, J. M., AhnAffiliations, S., Byun, K., & Kim, C. (2007): Social skill training as a nursing intervention to improve the social skill and self-esteem of in patients with chronic schizophrenia. Arch PsychiatrNurs; 21(6): 317- 26. http://dx.doi.org/10.1016/j.apnu.2006.09.005.

      [24] Han, K. S., Im, H. S., Yang, B. K., Chung, H. K., &Suh, Y. J. (2005): Effects of assertive training on interpersonal relations, social behavior, and psychiatric symptoms in patients with a mental disorder. TaehanKanhoHakhoe Chi, 35(5): 896-903.

      [25] Lin, Y., We, M., Yang, C., Chen, T., Hse, C., Chang, Y. Tzengw., Chou, Y. & Chou, K. (2008): Evaluation of assertiveness training for psychiatric patients. Journal of clinical nursing, 17: 2875-2885. http://dx.doi.org/10.1111/j.1365-2702.2008.02343.x.

      [26] Hou, S. Y., Sul, Y. C. &Lan, C. M. (2004): Nurse's assertiveness training and cognitive therapy experiences with an outpatient suffering from low self-esteem. Journal of Nursing, 51: 97-103.

      [27] Cheung, R., & NG, R. (2006): Social skills training in Hong Kong Chinese patients with chronic schizophrenia, Hong Kong Journal of Psychiatry, 16: pp.14-20.

      [28] Lauterbach, W., Pelzer. U., &Awiszus, D. (1979): Is social skills training effective in European schizophrenics? Behar. Analysis Modif, (3): 21-31.

      [29] Pan, L. Y., & Dai, X. L. (2008): Study on comprehensive social activity skill exercise on improving the social adaptability of patients with schizophrenia in recovery stage. Nursing and Rehabilitation Journal, 7(5): 325-327.

      [30] Kashani, B., &Bayat, M. (2010): The effect of social skills training (assertiveness) on assertiveness and self-esteem increase of 9 to 11 year-old female students in Tehran, Iran World Applied Sciences Journal, 9(9): 1028-1032.

      [31] Shimizu, T., Kubota, S., Mishima, N., & Nagata, S. (2004): Relationship between self-esteem and assertiveness training among Japanese hospital nurses. J Occup Health, 46(4): 296-8. http://dx.doi.org/10.1539/joh.46.296.

      [32] Lin, Y., Shiahb, I., Changc, Y., Laid, T., Wange, K., &Chouf, K. (2004): Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Journal of Nurse Education Today, 24:656– 65. http://dx.doi.org/10.1016/j.nedt.2004.09.004.

      [33] Killaspy, H., Bebbinton, P., Blizard, R., Johnson, S., Nolan, F., Pilling, S & King, M. (2006): The REACT study: Randomized evaluation of assertive community treatment in north London. British Medical Journal, 32: 815-820. http://dx.doi.org/10.1136/bmj.38773.518322.7C.

      [34] M ichel F. (2008): Assert yourself. Module (6): How to Say “No†Assertively. Perth, Western Australia: Centre for Clinical Interventions.

      [35] Michel, F. (2008): Assert yourself. Module (7): How to Deal Assertively with Criticism. Perth, Western Australia: Centre for Clinical Interventions.

      [36] Alwan, C., & Reeve, N. (2005): Assertiveness - A self-help guide. Norfolk and Waveney Mental Health Care NHS Trust.Avaliable at: www.heron.nhs.uk/.../assertiveness_self-help_large_prin. Retrieved on: 14/2/2014.

      [37] Segrin, C. (2008): Social skills training, in cognitive behavioral therapy: Applying empirically supported techniques in your practice. (2nded.), Wiley, New Jersey, p.502–509.

      [38] Kopelowicz, A., Liberman, R. P. &Zarate, R. (2006): Recent advances in social skills training for schizophrenia. Schizophrenia Bulletin, 32(S1): S12- S23. doi:10.1093/schbul/sbl023. http://dx.doi.org/10.1093/schbul/sbl023.

      [39] Tavakoli, P., Setoodeh, G., Dashtbozorgi, B., Sani, K. &Pakseresht, S. (2014): The influence of assertiveness training on self-esteem in female students of government high-schools of Shiraz, Iran: A randomized controlled trial. Nurs Pract Today, 1(1): 17-23.

      [40] Ratson, M. (2011): The importance of assertiveness and self-esteem. Availableat:http://www.spiral2grow.com/the-importance-of assertiveness-and-self-esteem/. Retrieved on: 7/9/2014.

      [41] Ibrahim, S. (2010): Factors affecting assertiveness among student nurses. Journal of Nurse Education Today, 31(4): 356-60. http://dx.doi.org/10.1016/j.nedt.2010.07.006.

      [42] Kirst, L. K. (2011): Investigating the relationship between assertiveness and personality characteristics. University of Central Florida Orlando, Florid.

      [43] Marcon, N. (2010): Assertive rights-you’re right to be treated well. Available at :( http://ezinearticles.com/?Assertive-Rights-Your-Right-To-Be-Treated-Well&id=4202679. Retrieved on: 15/4/2013.

      [44] Ku, J., Han, K., Lee, H. R., Jang, H. J., Kim, K. U., & Park, S. H. (2007): VR-based conversation training program for patients with schizophrenia: a preliminary clinical trial. Cyberpsychology& Behavior, 10(4): 567-574. http://dx.doi.org/10.1089/cpb.2007.9989.

      [45] Shamsunnisah, A. B., &Hasanah, C. I. (2008): Self-esteem of out patients with schizophrenia: The association of self-esteem and socio-demographic and clinical characteristic. Priory Lodge Education Limited.

      [46] Hemmati, M., Taghipour, M., & Asgar, M. H. (2014): Investigation between self-esteem and assertiveness and employees performance in national Iranian bank, Journal of Applied Environmental Sciences and Biolog, 4(4):182-187.

      [47] Abdel-Aleem, M. (2007): Factors affecting assertiveness among head nurses and staff nurses.(Unpublished Master Thesis). Faculty of Nursing. Suez Canal University, 46.

      [48] Lovibond, S.H. &Lovibond, P.f. Manual for the Depression Anxiety Stress Scales. (2nd Ed) Sydney: Psychology Foundation. 1995.

      [49] Kotb F. Social support, psychological distress and suicidal tendency of depressed patient. Unpublished master thesis. Faculty of nursing, CairoUniversity.2007:170-172.

      [50] Coopersmith, S. (1967). The antecedents of self-esteem. San Francisco: W. H. Freeman & Co

      [51] Kurdek, L. A. (2002).On being insecure about the assessment of attachment styles. Journal of Social and Personal Relationships, 19, 811–834. http://dx.doi.org/10.1177/0265407502196005.

  • Downloads

  • How to Cite

    I. El Malky, M., Atia, M., & H.Alam, F. (2016). The effectiveness of social skill training on depressive symptoms, self- esteem and interpersonal difficulties among Schizophrenic patients. International Journal of Advanced Nursing Studies, 5(1), 43-50. https://doi.org/10.14419/ijans.v5i1.5386

    Received date: 2015-09-29

    Accepted date: 2015-11-22

    Published date: 2016-01-04