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Positive Emotions Program for Schizophrenia (PEPS): a randomized controlled study on improving pleasure and motivation in schizophrenia

English title Positive Emotions Program for Schizophrenia (PEPS): a randomized controlled study on improving pleasure and motivation in schizophrenia
Applicant Favrod Jérôme
Number 163355
Funding scheme Project funding (Div. I-III)
Research institution Institut & Haute Ecole de la Santé La Source HES-SO
Institution of higher education University of Applied Sciences and Arts Western Switzerland - HES-SO
Main discipline Psychology
Start/End 01.01.2016 - 31.12.2018
Approved amount 395'400.00
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All Disciplines (3)

Discipline
Psychology
Health
Neurology, Psychiatry

Keywords (8)

schizophrenia; negative symptoms; apathy; anhedonia; psychological intervention; motivation; pleasure; recovery

Lay Summary (French)

Lead
Les symptômes négatifs sont depuis longtemps reconnus comme une caractéristique centrale de la schizophrénie depuis les premières descriptions de Kraepelin et Bleuler. Ils affectent négativement l’évolution fonctionnelle et professionnelle des patients ainsi que leur rétablissement. Toutefois, l’efficacité des traitements pharmacologiques et psychologiques sur les symptômes négatifs primaires reste très limitée. Cette étude vise à tester l’efficacité d’une nouvelle intervention pour améliorer les symptômes négatifs.
Lay summary

 Contenu et objectifs du travail de recherche

La littérature récente a distingué les symptômes négatifs associés à une réduction de l’expérience comme une diminution de la capacité d’éprouver de l’envie de s’engager dans des activités de ceux qui sont associés à une diminution de la capacité d’exprimer les émotions ou du langage. Le syndrome de réduction de l’expérience tend à être associé avec un moins bon pronostic que celui lié à une réduction de l’expression, suggérant qu’il s’agit d’un aspect plus sévère de la psychopathologie. La distinction entre ces deux syndromes permet une approche plus spécifique du problème.
Le projet va tester l’efficacité du Programme Émotions Positives pour la Schizophrénie (PEPS) qui cherche à améliorer le contrôle cognitif des émotions, notamment l’anticipation, le maintien et la mémorisation du plaisir qui sont associés à ce syndrome d’expérience diminuée. Il s’agit d’un programme de huit séances d’une heure pour des groupes de 5 à 10 participants. Suite à une étude pilote qui montre des résultats encourageants, il est maintenant nécessaire d’étudier l’efficacité de l’intervention dans le cadre d’une étude contrôlée afin de vérifier la validité des premiers résultats obtenus et le maintien de ceux-ci un semestre après l’intervention.

Contexte scientifique et social du projet de recherche

Les symptômes négatifs de la schizophrénie affectent la qualité de vie et la productivité des personnes qui en souffrent. Ils interfèrent avec le rétablissement et la possibilité de mener une vie riche et pleine. Le projet relève de la recherche d’intervention pour réduire les atteintes des symptômes négatifs sur le fonctionnement social et professionnel de personnes atteintes de schizophrénie à l’aide d’une intervention psychologique groupale brève.


Direct link to Lay Summary Last update: 20.01.2016

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
The relationship between self-stigma and depression among people with schizophrenia-spectrum disorders: a longitudinal study.
Pellet Joanie, Golay Philippe, Nguyen Alexandra, Suter Caroline, Ismailaj Alban, Bonsack Charles, Favrod Jérôme (2019), The relationship between self-stigma and depression among people with schizophrenia-spectrum disorders: a longitudinal study., in Psychiatry Research, 275, 115-119.
Confirmatory Factor Analysis of the French Version of the Savoring Beliefs Inventory
Golay Philippe, Thonon Bénédicte, Nguyen Alexandra, Fankhauser Caroline, Favrod Jérôme (2018), Confirmatory Factor Analysis of the French Version of the Savoring Beliefs Inventory, in Frontiers in Psychology, 9(181), 1-7.
Améliorer le plaisir et la motivation dans la schizophrénie
FavrodJérôme, NguyenAlexandra, Frobert Laurent, IsmailajAlban, PelletJoanie (2018), Améliorer le plaisir et la motivation dans la schizophrénie, in Franck Nicolas (ed.), Elsevier Masson, Paris, 677-684.
On était scotché de voir leurs capacités
Nguyen Alexandra, Frobert Laurent, Pellet Joanie, Favrod Jérôme (2017), On était scotché de voir leurs capacités, in Santé mentale, (221), 60-65.
Impact of self-disclosure of professionals on empowerment of patients: a conversational analysis
Nguyen Alexandra, Favrod Jérôme, Frobert Laurent, Pellet Joanie (2017), Impact of self-disclosure of professionals on empowerment of patients: a conversational analysis, in Eur Arch Psychiatry Clin Neurosci, (Suppl 1), S89-S89.
Positive emotions program for schizophrenia: a randomized clinical trial
Favrod Jérôme, Nguyen Alexandra, Golay Philippe, Bonsack Charles (2017), Positive emotions program for schizophrenia: a randomized clinical trial, in Eur Arch Psychiatry Clin Neurosci, (Suppl 1), S38-S38.
Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale
Chaix Joséphine, Golay Philippe, Fankhauser Caroline, Nguyen Alexandra, Goodin Diane C., Favrod Jérôme (2017), Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale, in Front Psychol, 8(1296), 1296-6.
Anhédonie et psychologie positive
FavrodJérôme, NguyenAlexandra, FrobertLaurent, PelletJoanie (2017), Anhédonie et psychologie positive, in Santé mentale, (221), 54-59.
Programme Emotions positives pour la schizophrénie (PEPS)
Favrod Jérôme, Nguyen Alexandra, Frobert Laurent, McCluskey Iannis, Fankhauser Caroline, Rexhaj Shyhrete (2016), Programme Emotions positives pour la schizophrénie (PEPS), in Franck Nicolas (ed.), Elsevier Masson, Paris, 127-142.
Development of the Positive Emotions Program for Schizophrenia (PEPS): an intervention to improve pleasure and motivation in schizophrenia
Nguyen Alexandra, Frobert Laurent, McCluskey Iannis, Golay Philippe, Bonsack Charles, Favrod Jérôme (2016), Development of the Positive Emotions Program for Schizophrenia (PEPS): an intervention to improve pleasure and motivation in schizophrenia, in Frontiers in psychiatry, 7, 13.
Schizophrénie : réduire l’anhédonie et l’apathie
Nguyen Alexandra, Frobert Laurent, Favrod Jérôme (2016), Schizophrénie : réduire l’anhédonie et l’apathie, in Santé mentale, (206), 70-75.
Improving pleasure and motivation in schizophrenia: a randomized controlled clinical trial
Favrod J., Nguyen A., Chaix J., Pellet J., Frobert L., Fankhauser C., Ismailaj A., Brana A., Tamic G., Suter C., Rexhaj S., Golay P., Bonsack C., Improving pleasure and motivation in schizophrenia: a randomized controlled clinical trial, in Psychother Psychosom.
La supervision à la compétence du dévoilement de soi professionnel en psychiatrie : perspective interactionnelle d’un dispositif de formation et d’une recherche
Nguyen Alexandra, Frobert Laurent, Pellet Joanie, Favrod Jérôme, La supervision à la compétence du dévoilement de soi professionnel en psychiatrie : perspective interactionnelle d’un dispositif de formation et d’une recherche, in Chrétien Fanny, Chatigny Céline, Rémery Vanessa (ed.), Presses universitaires de Rouen et du Havre, Rouen.

Collaboration

Group / person Country
Types of collaboration
Interaction et Formation, FAPSE, University of Geneva Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Community psychiatry service, Departement of psychiatry, CHUV Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
European negative symptoms research network Norway (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Department of Psychology, University of Wisconsin-Madison United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Psychology and Neuroscience of Cognition Research Unit, University of Liège Belgium (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
French network of Schizophrenia Expert Centers developed by the Foundation Fondamental France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Colloque de Recherche UNAFAM: Vaincre la stigmatisation des maladies psychiques Talk given at a conference Schizophrénie, auto-stigmatisation et perspectives d’intervention 30.10.2018 Paris, France Pellet Joanie;
9th International conference of the EARLI SIG 14 Talk given at a conference Supervision in psychiatry: interactional analysis to learn self-disclosure competence 12.09.2018 Genève, Switzerland Favrod Jérôme;
First congress of European Society of Social Psychiatry Poster Relationship between self-stigma and depression in patients with schizophrenia 03.07.2018 Genève, Switzerland Bonsack Charles; Favrod Jérôme; Pellet Joanie;
First congress of European Society of Social Psychiatry Individual talk HOP ! Dépasser la barrière de l’auto-stigmatisation 03.07.2018 Genève, Switzerland Chaix Joséphine; Suter Caroline; Pellet Joanie; Favrod Jérôme;
First congress of European Society of Social Psychiatry Talk given at a conference Positive Emotions Program for Schizophrenia (PEPS): A randomized controlled clinical trial 03.07.2018 Genève, Switzerland Bonsack Charles; Favrod Jérôme; Chaix Joséphine; Pellet Joanie;
First congress of European Society of Social Psychiatry Poster e-PEPS, une formation en ligne pour l’animation du programme thérapeutique PEPS 03.07.2018 Genève, Switzerland Favrod Jérôme;
First congress of European Society of Social Psychiatry Talk given at a conference Self-Disclosure as professional competence to promote patients’ participation and empowerment 03.07.2018 Genève, Switzerland Favrod Jérôme; Pellet Joanie;
10ème congrès de Rehab’ Talk given at a conference Allez HOP! On positive et on déstigmatise! 31.05.2018 Lyon, France Suter Caroline; Pellet Joanie;
Journées Internationales du Centre Collaborateur de l’OMS Talk given at a conference Allez HOP ! En avant l’auto-déstigmatisation! 29.03.2018 Lille, France Pellet Joanie; Suter Caroline;
6th European Conference on Schizophrenia Research: Advancing Research—Promoting Recovery Talk given at a conference Positive emotions program for schizophrenia: a randomized clinical trial 14.09.2017 Berlin, Germany Favrod Jérôme; Bonsack Charles;
6th European Conference on Schizophrenia Research: Advancing Research—Promoting Recovery Poster Impact of self-disclosure of professionals on empowerment of patients: a conversational analysis 14.09.2017 Berlin, Germany Favrod Jérôme; Pellet Joanie;
SHËNDETI MENDOR, SFIDË E SHËNDETIT PUBLIK Talk given at a conference Shërimi nga shizofrenia 26.05.2017 Pristina, Kosovo (Interim. Gov. UNO) Favrod Jérôme;
L’Expérience Vécue de la Première Rencontre entre Soignant et Soigné. Talk given at a conference Les enjeux de la première rencontre soignant-soigné pour l’alliance thérapeutique en psychiatrie 29.03.2017 Lyon, France Favrod Jérôme;
VIIIeJournée R3, Réseau romand pour le rétablissement : Décider pour se rétablir Talk given at a conference Former les professionnels à la relation de partenariat 18.11.2016 Lausanne, Switzerland Favrod Jérôme;
4ème Congrès de Réhabilitation Psychosociale Talk given at a conference Booster les émotions positives pour améliorer la motivation et le plaisir dans la schizophrénie 13.10.2016 Marseille, France Favrod Jérôme;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved


Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions Inauguration et portes ouvertes du nouveau site de La Source à Beaulieu Western Switzerland 2019
Talks/events/exhibitions 1er congrès national des patients Italian-speaking Switzerland German-speaking Switzerland Western Switzerland 2018
Media relations: radio, television Stimuler les émotions positives des personnes avec une schizophrénie RTS La première Western Switzerland 2016

Abstract

Background: The core features of schizophrenia include negative symptoms, which manifest themselves as absences or decreases in normal emotions and behaviors, and positive symptoms, which reflect excesses or distortions of normal functions. Drug-based treatments are highly effective on positive symptoms, such as hallucinations and delusions, but have limited efficacy on negative symptoms. Nonspecific psychosocial treatments have also shown few clinical effects on negative symptoms. Just as the psychosocial treatment of positive symptoms has improved by focusing more closely on delusion or hallucination, perhaps the psychosocial treatment of negative symptoms should also address specific targets. Recent literature has distinguished the negative symptoms associated with a diminished capacity to experience (apathy, anhedonia) from symptoms associated with a limited capacity for expression (emotional blunting, alogia). Anhedonia, which is defined as a reduction in the ability to experience pleasure, and apathy, which is related to a difficulty in anticipating the future, are good candidates for the development of a more specific psychosocial approach. Studies have shown that individuals with schizophrenia experience similar consummatory pleasure to controls, but less anticipatory pleasure. The combination of all these aspects led us to develop an intervention based on training the emotional and cognitive skills specifically needed to increase anticipatory pleasure in patients complaining of anhedonia or a lack of desire to engage in activities. A pilot study for the Positive Emotions Program for Schizophrenia (PEPS) demonstrated the intervention’s feasibility. Preliminary results indicated that participation in PEPS was accompanied by a significant reduction of anhedonia, apathy, and depression in a group of patients diagnosed with schizophrenia or schizoaffective disorders. Aim: Using a randomized clinical trial (RCT), the proposed study will compare the efficacy of using PEPS to reduce symptoms of anhedonia and apathy against treatment as usual (TAU). Methods: Eighty participants diagnosed with a schizophrenia spectrum disorder will undergo one or the other intervention for eight weeks. The study’s main hypothesis is that patients who have attended 8 one-hour sessions of PEPS will have lower total apathy-avolition and anhedonia-asociality scores on the Scale for the Assessment of Negative Symptoms (SANS), in comparison to the control group. The secondary hypotheses are that PEPS will increase patients’ capacity to savor pleasure, anticipatory pleasure, and consummatory pleasure. The study will also monitor the sustainability of PEPS’ potential benefits at a six-month follow-up. The necessary sample size was estimated using the results of the pilot study. Socio-demographic and clinical data will be collected using validated psychometric instruments, as will levels of psychotic symptoms, depression, and ability to savor, anticipate and consummate pleasure. Between-group differences in pre- and post-test values will be examined using an analysis of covariance (ANCOVA) for each outcome variable. Cohen’s d effect sizes will be calculated: between subjects at post-test and follow-up and within-subjects between pre- and post-tests in correcting for dependence among means in order to directly compare the effect sizes from other studies. Expected results and impact: This RCT will test the clinical efficacy and potential sustainability of PEPS. Increasing the ability of individuals with schizophrenia to experience pleasure may have an impact on key elements of their recovery process, such as hope and motivation. The short duration of the training needed for professionals, and brief intervention itself, make PEPS quite easy to implement in a variety environments.
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