اثربخشی آموزش شناخت اجتماعی و تعامل بر نظریه ذهن شناختی و عاطفی سالمندان بدون مشکلات شناختی

One of the new psychosocial interventions designed to address social cognitive deficits is Social Cognition and Interaction Training (SCIT). To date, this educational approach has not been applied to improve social cognition in older adults without cognitive impairments. Therefore, the aim of this study was to evaluate the effectiveness of SCIT in enhancing cognitive and affective theory of mind in older adults without cognitive impairments. The study was quasi-experimental research with a pretest-posttest-follow-up design. The statistical population consisted of individuals with healthy cognitive functions, aged 65 to 75 years in Tehran, Iran. A total of 46 participants were selected with a convenience method and based on eligibility criteria. Participants were randomly assigned to an experimental group (22 members) and a control group (24 members). The experimental group received twenty 60-minute training sessions, held three times a week. This study utilized the Montreal Cognitive Assessment and the Yoni task for cognitive and affective theory of mind. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS version 23. The results indicated that SCIT significantly improved both cognitive and affective theory of mind scores in the experimental group in posttest and follow-up (with a four-week time interval) phases (p<.01). Based on these findings, SCIT can be considered as an effective method for reducing social cognitive challenges in older adults and improving their social interactions.
EXTENDED ABSTRACT
 Introduction
Research indicates that cognitive abilities, including social cognition, tend to decline with age. Social cognition is a broad concept divided into various subdomains, among which theory of mind has received the most research attention. This complex ability consists of two components: an affective component, which involves understanding others’ emotions, and a cognitive component, which involves understanding the intentions behind their actions. Recent studies have confirmed that impairments in social cognition and theory of mind lead to difficulties in effective interactions and healthy social communication among older adults. Furthermore, such issues are associated with the emergence of other serious cognitive, psychological, physical, and social challenges in later life. One promising psychosocial intervention designed to address social cognitive difficulties and enhance theory of mind is Social Cognition and Interaction Training (SCIT). Although the effectiveness of this intervention has been well-documented, there has been little research specifically examining its impact on the affective and cognitive aspects of theory of mind in older adults. Considering this gap in the literature, the present study aims to investigate the effectiveness of SCIT on the affective and cognitive theory of mind in cognitively healthy older adults.
Method
The present study was quasi-experimental research using a pretest-posttest-follow-up with a control group design. The statistical population included individuals aged 65 to 75 years in Tehran, Iran in 2023, among whom 46 participants were selected using a convenience sampling method and based on eligibility criteria. Participants were randomly assigned to an experimental group (22 members) and a control group (24 members). The inclusion criteria were (1) being aged 65 to 75 years, (2) the absence of cognitive impairment, (3) literacy in reading and writing, and (4) a score above 26 on the Montreal Cognitive Assessment. The exclusion criteria were (1) presence of psychological, physical, or other conditions interfering with the study process, and (2) sensory or motor impairments preventing task performance. All participants completed the Montreal Cognitive Assessment and Yoni task for affective and cognitive theory of mind as pretests. Subsequently, the experimental group underwent a group-based SCIT program, while the control group remained on a waiting list without any training at the same time. The intervention consisted of twenty 60- minute training sessions, held three times a week. Following the intervention period, the Yoni task was re-administered to both groups as a posttest, and again after four weeks as a follow-up assessment. Data analysis was conducted using univariate analysis of covariance (ANCOVA) in SPSS-23 software.
Results
Before data analysis, the Kolmogorov-Smirnov test confirmed the normal distribution of the scores for all variables. The assumptions of homogeneity of variances (using Levene's test) and homogeneity of regression coefficients (via interaction effects of the independent variable and pretest scores on posttest and follow-up scores for each dependent variable) were also verified. Hypotheses were tested using ANCOVA. The ANCOVA results for differences between the two groups in affective and cognitive theory of mind at the posttest phase showed that the F-value for cognitive theory of mind (23.864) was significant (p<.001). Similarly, the F-value for affective theory of mind (5.187) was significant (p<.001). These findings indicate significant differences between the experimental and control groups at the posttest phase. Therefore, SCIT resulted in a significant increase in the mean scores of both cognitive and affective theory of mind in the experimental group.
The ANCOVA results for differences between the two groups at the follow-up phase showed that the F-value for cognitive theory of mind (6.311) was significant (p<.05), and the F-value for affective theory of mind (31.487) was significant (p<.001). These findings demonstrate significant differences between the two groups at the follow-up phase as well. Accordingly, SCIT led to sustained and significant increases in the scores of both cognitive and affective theory of mind at the follow-up phase compared to their pretest in the experimental group. This indicates that SCIT was effective in the enhancing scores of cognitive and affective theory of mind, with these improvements persisting up to four weeks after the end of intervention.
Conclusion
Two types of social cognitive dysfunction, deficits and biases, commonly emerge in later life. This treatment addresses deficits by teaching strategies aimed at improving neurocognitive functions such as memory and concentration. Bias-focused methods involve identifying potential biases, reshaping individuals’ perspectives on them, and practicing skills to reduce their influence. Through this educational approach, individuals learn to integrate interventions targeting both deficits and biases to better gather social cues and evaluate evidence for more accurate social judgments.
Initially, participants are encouraged to generate alternative interpretations to correct distorted social judgments. Over time, the focus expands to understanding how different judgments can lead to various social and emotional outcomes. Rather than promoting rigidly correct but unproductive thinking, this approach emphasizes the gradual development of flexible and functional thought patterns. Participants are also encouraged to increase their awareness of thoughts and emotions, experiencing them as reflections of both themselves and the external world. Additionally, they are guided to adopt others’ perspectives, recognizing that the way they interpret situations shapes how they feel about themselves and their environment.
Ethical Consideration
Ethical Code
This research has been approved by the Ethics Committee of Payame Noor University and is registered under the ethics code IR.PNU.REC.1401.344.
Financial Support
This study received no financial support.
Authors’ Contributions
A. F: Conceptualization, Methodology, Project administration, Supervision, Writing - Original Draft; T. D: Data Curation, Software, Validation, Formal analysis, Writing - Review & Editing
Conflict of Interest
The authors had no conflicts of interest.
Acknowledgments
Hereby, heartfelt gratitude is extended to all the older adults who participated in this research.
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