Fennell Melanie J V
Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, UK.
Behav Res Ther. 2004 Sep;42(9):1053-67. doi: 10.1016/j.brat.2004.03.002.
Negative biases in processing information about the self have long been recognised as a central feature in the development and maintenance of clinical depression. In practice, however, it may not be easy to distinguish between patients whose negative thinking about the self is primarily an aspect of current mood state, and those for whom it represents a reflection of more enduring issues (low self-esteem). The paper speculates that, in both cases, metacognitive awareness (acceptance of the idea that thoughts, assumptions and beliefs are mental events and processes rather than reflections of objective truth) may be an important precursor to active engagement in therapy on the part of the patient, and considers what aspects of cognitive therapy might be used to promote it in clinical practice.
长期以来，人们一直认为在处理关于自我的信息时存在的消极偏见是临床抑郁症发展和维持的核心特征。然而，在实际中，要区分那些对自我的消极思考主要是当前情绪状态的一个方面的患者，和那些其消极思考反映了更持久问题（低自尊）的患者，可能并非易事。该论文推测，在这两种情况下，元认知意识（接受思想、假设和信念是心理事件和过程而非客观真理的反映这一观点）可能是患者积极参与治疗的一个重要前提，并探讨了认知疗法的哪些方面可在临床实践中用于促进这种元认知意识。
