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Objective: The main aim of the scoping review is to explore interventions that target identity and self-concept in different patient groups, including people with severe mental illnesses, acquired brain injury and intellectual disability. A second objective is to discuss the implications of these results for the treatment of people with severe mental illness. The field of mental health care might benefit from a transdiagnostic approach, and especially from interventions targeting different groups of people who often cope with identity challenges and/or cognitive difficulties. Introduction: People with a (severe) mental illness, acquired brain injury or intellectual disability often face identity challenges, for example because of stigma, the impact of illness-roles, cognitive deficits and difficulties with social integration. The illness experience and the associated losses can impact identity-development and provoke a focus on illness-related self-concepts. Strengthening of a more balanced identity is central to recovery-oriented care. The current systematic scoping review provides a transdiagnostic perspective on interventions that aim to broaden and develop multifaceted identities. Inclusion criteria: Included studies target identity with interventions for adults with a severe mental illness, schizophrenia, psychosis, bipolar disorder, severe psychotic depression, acquired brain injury or intellectual disability. Studies should be peer-reviewed and should have a pre-specified aim to help individuals to develop, broaden, rebuild or reflect about multiple aspects of their identity and/or self-concept. No specific further inclusion criteria were formulated regarding study-design or intervention type, to ensure a broad range of studies. Methods: Studies related to identity, self-concept, illness-identity and “illness engulfment” will be searched in a broad range of databases. Qualitative and quantitative data regarding the program mechanisms and content, theoretical background, experiences and outcomes of interventions will be extracted and described. The full protocol of this study can be found in the attached document.

Background: Many people with psychotic disorder experience problems in social functioning, such as finding and maintaining jobs and relationships, which have been shown to be strongly related to deficits in social cognition. A class of interventions called Social Cognition Training (SCT) aims to improve social cognition through practice and strategy training. SCT has been shown to have positive effects on social cognition. (Social) cognition training, however, is known to optimally translate to functional skills when it is applied to and integrated with different areas of daily life. To promote the transfer of training skills to functional domains, it may therefore be beneficial to provide SCT in virtual reality (VR), since it closely resembles real-life social situations. VR is highly realistic and interactive, allowing for practice of social situations in ecologically valid environments. VR is also controllable, allowing for personalization of situations and difficulty level. In the present study, we tested the acceptance and feasibility of a newly developed VR SCT called 'DiSCoVR' (Dynamic Interactive Social Cognition Training in Virtual Reality). Methods: Twenty-two individuals with a psychotic disorder were recruited from three mental health institutions in the Netherlands. All participants received a VR SCT, which was aimed at three domains: 1) emotion perception (identifying virtual characters' emotions in a virtual street); 2) social perception and theory of mind (understanding social situations and the thoughts, emotions and behavior of virtual characters); and 3) practicing social interactions with a virtual character. The intervention strongly emphasized practice with social situations in VR between, and with, virtual characters. Participants also learned strategies to cope with difficulties they experienced in social situations. Participants were assessed at baseline and post-treatment. Acceptance of the intervention was evaluated at post-treatment using a questionnaire. Social cognition was also assessed (emotion perception, social perception and theory of mind) using video/photo tasks and stories. Finally, psychotic symptoms, social anxiety, paranoia, self-esteem and depression were measured using an interview and questionnaires. Results: The results of this pilot study will be presented, focusing on the findings regarding acceptance and feasibility, but also social cognition and other secondary outcome domains. Discussion: The implications of the findings of the pilot study will be discussed in the context of the preparation of a randomized controlled trial of DiSCoVR (for example, necessary alterations to the protocol and/or VR software). Plans for this randomized controlled trial will be discussed.

Mensen met psychische aandoeningen hebben vaak te maken met sociale afwijzing en uitsluiting. Het stigma op psychische problemen speelt een belangrijke rol bij het in stand houden van belemmeringen voor maatschappelijke participatie, zelfs nadat mensen hersteld zijn. Daarnaast heeft het stigma vaak een negatieve invloed op het persoonlijk herstel. In een samenleving waarin van alle burgers wordt verwacht dat zij meedoen en naar vermogen bijdragen, is het noodzakelijk aandacht te hebben voor destigmatisering: het succesvol tegengaan van stigmatisering. Voor destigmatisering is een gecoördineerde inzet van allerlei maatschappelijke actoren nodig. Dit handboek is het eerste Nederlandstalige standaardwerk over destigmatisering bij psychische aandoeningen. In drie delen (theorie, praktijk en verdieping) gaat het boek in op publiek stigma, zelfstigma en stigma in de hulpverlening. Daarnaast worden effectieve strategieën en interventies beschreven om deze vormen van stigmatisering te verminderen en te voorkomen. Het legt daarmee een basis voor de verdere ontwikkeling van zowel de theoretische fundering als van effectieve destigmatiserende praktijken.

Oral presentation on the results of a feasibility study which aimed to investigate the feasibility of a novel body-oriented resilience training with elements of kickboxing targeted at (risk factors of) victimization of individuals with a psychotic disorder

Deficits in metacognitive capacity in schizophrenia can be conceptualized as existing along a spectrum from more discrete to more synthetic activities. While each represents an equally important focus of study, synthetic metacognitive activities may be more difficult to measure given they are more a matter of assessing complexity of thought rather than concrete accuracy; and therefore have received less attention. This review summarizes research on synthetic metacognition using a paradigm in which metacognitive capacity is rated within personal narratives. Results across the work reviewed here provides evidence that these deficits are detectable in patients with schizophrenia and that deficits are related to, but not reducible to, symptom severity and poorer neurocognitive function. Independent of symptoms and neurocognition, deficits in synthetic metacognition are related to a range of mental activities including reasoning style, learning potential and insight. These deficits may also play a role in long term outcome via their impact on the ability to function in work settings and to think about and sustain social connections.