# Understanding Social Situations (USS): Training to improve social function in people with psychosis

> **NIH VA I01** · VA CONNECTICUT HEALTHCARE SYSTEM · 2020 · —

## Abstract

Schizophrenia and other psychotic spectrum disorders (PSD) are characterized by severe, persistent
impairments in social function, which play a large role in a person’s level of disability, community integration,
and likelihood of relapse. Social functioning has also been identified as a key unmet treatment need by the
very individuals who suffer from PSD. Existing treatments fall short of significantly improving social function.
 Poor social function in PSD has been linked to significant impairments in social cognition, or how a person
processes, interprets and responds to uniquely social information, including complex inferences a person
makes about other people’s thoughts, feelings and actions. In an effort to improve social functioning, a number
of interventions targeting these complex social cognitive skills have been developed in recent years. These
treatments show some promise, but many of the trials have had significant methodological weaknesses, there
is limited data about effects on everyday social functioning outcomes, and nearly all the work has been
conducted in non-Veteran samples.
 Impairments in concentration, memory, and problem solving are also common in PSD and can make it
challenging to learn complex social cognitive skills. With this in mind, we developed a social cognitive training
that leverages successful methods from bottom-up cognitive remediation to reduce cognitive load and aid with
acquisition of complex social cognitive skills. The training was developed under an NIMH R34 grant and is
called Understanding Social Situations (USS). To date, we have developed and refined USS training content,
created a treatment manual, conducted a single-arm pilot of the intervention, and collected preliminary data on
the effects of USS when incorporated into a psychosocial rehabilitation program.
 The current proposal is to conduct a fully powered, rigorous randomized controlled trial to test the efficacy
of USS versus an active control condition. One hundred twenty Veterans with PSD will be randomized to 2
months of USS or an active control (AC) intervention matched for duration, therapist contact, and mode of
delivery. Key social functioning outcomes will be measured using a multi-method approach of self-report, role-
play, and experience sampling, conducted pre-intervention, post-intervention, and at 2 month follow-up, with an
additional limited assessment at treatment mid-point. We will also examine moderators and mediators of
treatment effects.

## Key facts

- **NIH application ID:** 10065065
- **Project number:** 1I01RX003354-01A1
- **Recipient organization:** VA CONNECTICUT HEALTHCARE SYSTEM
- **Principal Investigator:** Joanna M. Fiszdon
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10065065

## Citation

> US National Institutes of Health, RePORTER application 10065065, Understanding Social Situations (USS): Training to improve social function in people with psychosis (1I01RX003354-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10065065. Licensed CC0.

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