School of Medicine, University of Pennsylvania, USA.
Psychiatry Res. 2010 May 15;177(1-2):65-70. doi: 10.1016/j.psychres.2010.01.005. Epub 2010 Feb 16.
Poor social and vocational outcomes have long been observed in schizophrenia, and therapeutic outcomes have been modest. Most studies have identified neurocognition and emotion perception as important contributors to social functioning. Recent research has suggested that personal beliefs, attitudes, and expectancies contribute to negative symptoms. However, the impact of specific beliefs and expectancies on social withdrawal in schizophrenia has not been examined. The present study explored: 1. whether asocial beliefs made a significant contribution to social functioning after accounting for neurocognitive performance and emotion perception; and, 2. whether asocial beliefs predicted asocial behavior in a longitudinal design. 123 outpatients diagnosed with schizophrenia or schizoaffective disorder completed tests of neurocognitive performance, emotion perception, asocial beliefs, symptomatology, and functional outcome. A subset of 13 outpatients was retested one year after the initial assessment. Hierarchical regression indicated that asocial beliefs accounted for 18% of the variability in social functioning. Depression and negative symptoms explained another 9% of the dispersion. Contrary to expectations, neurocognition and emotion perception accounted for less than 1% of the variance. In the longitudinal study, baseline asocial beliefs predicted asocial behavior one year later. Asocial beliefs predict poor social functioning in schizophrenia, and may be modifiable by psychological interventions.
精神分裂症患者的社交和职业预后一直较差，治疗效果也不尽如人意。大多数研究都认为神经认知和情绪感知是社交功能的重要影响因素。最近的研究表明，个人信念、态度和期望也会对阴性症状产生影响。然而，特定信念和期望对精神分裂症患者社交退缩的影响尚未得到检验。本研究旨在探讨：1. 在考虑神经认知表现和情绪感知的情况下，非社交信念是否对社交功能有显著贡献；2. 在纵向设计中，非社交信念是否可以预测非社交行为。123 名被诊断为精神分裂症或分裂情感障碍的门诊患者完成了神经认知表现、情绪感知、非社交信念、症状和功能结果的测试。其中 13 名门诊患者的一个亚组在初始评估一年后进行了重新测试。分层回归表明，非社交信念可以解释社交功能变异的 18%。抑郁和阴性症状解释了另外 9%的离散度。与预期相反，神经认知和情绪感知只占方差的不到 1%。在纵向研究中，基线非社交信念可以预测一年后患者的非社交行为。非社交信念可以预测精神分裂症患者的社交功能不良，并且可以通过心理干预进行改变。
