Episodic future thinking intervention in schizophrenia patients: Effects and neural correlates

Episodic future thinking (EFT) involves the ability to imagine future events and is closely related to personal goals. Schizophrenia patients are impaired in EFT. The best possible self is a representation of personal goals and can be integrated with EFT intervention. Few studies considered the role of personal goals or examined the neural basis of EFT improvements in schizophrenia patients. The present study aimed to fill these gaps. We hypothesized that the Best Possible Self based Future Specificity (BPSFS) intervention could improve EFT in schizophrenia patients and personal goals would play an important role. Moreover, altered functional connectivity in the default mode network may underlie the intervention effect. In our study, sixty schizophrenia patients were recruited, randomly assigned to the intervention group (n = 29) and control group (n = 31), and completed the study. The intervention group completed a four-week eight-session BPSFS training and the control group completed psychoeducation with the same sessions. EFT tasks with different goal types, future goal fluency task, and resting-state magnetic resonance imaging were completed before and after the treatment. The BPSFS intervention significantly improved the EFT specificity, and the future goal fluency improvement partially mediated this effect. Furthermore, the intervention group showed increased functional connectivity between the temporal parietal junction and frontal pole, which was associated with EFT specificity improvement. Taken together, these findings indicate that the BPSFS intervention could enhance EFT ability in schizophrenia patients, and the underlying neural basis might involve increased functional connectivity in the temporal parietal junction.