Effectiveness of social management training on executive functions in males with Klinefelter syndrome (47, XXY)

Abstract

Men with an extra X chromosome are at risk for social difficulties in which executive functions are known to play an important role. The aim of this study was to examine the potential efficacy of a novel neurocognitive-behavioral treatment program tailored to the specific vulnerabilities of Klinefelter syndrome (47, XXY). Social Management Training (SMT) aimed to increase the ability of individuals to regulate their thoughts, emotions and behaviors in ways that are socially adaptive. 16 Adolescents and men with Klinefelter Syndrome participated in SMT. This novel group treatment program consists of 10 sessions and includes psychoeducation, cognitive-behavioral skills training, home-assignments, and relaxation exercises. There were pre- and posttest cognitive assessments (five months apart) of executive functioning including sustained attention, inhibition, cognitive flexibility and working memory, as well as self-evaluation of executive functioning in daily life. Significant pre- to posttest improvements in inhibitory control (performance test) and metacognition skills (self-report) were found, with effects sizes of 1.3 and 0.5, respectively. No effects of intervention were found on sustained attention, cognitive flexibility and working memory. These findings suggest that SMT, with a key focus on executive dysfunction and tailored to the behavioral and cognitive profile of males with Klinefelter syndrome, may be a promising and potentially efficacious treatment approach for improving self-control and social adaptation, although larger and randomized controlled studies are warranted.