University Hospital Heidelberg, Department of Psychiatry, Vossstr. 4, 69115 Heidelberg, Germany.
J Behav Ther Exp Psychiatry. 2010 Sep;41(3):207-11. doi: 10.1016/j.jbtep.2010.01.004. Epub 2010 Jan 28.
The treatment program "Metacognitive training for patients with schizophrenia" (MCT) addresses cognitive deficits and biases assumed to play a crucial role in the pathogenesis of delusions (e.g. jumping to conclusions, theory of mind deficits, bias against disconfirmatory evidence). The feasibility of this approach and its effects on positive symptoms and cognitive biases were investigated in this pilot study.
Thirty inpatients of the Department of Psychiatry of the University Hospital Heidelberg with a schizophrenia spectrum diagnosis were randomly assigned to either MCT or an active control intervention. Both training programs were carried out over a time period of four weeks. Psychopathological, cognitive and metacognitive measures were collected at baseline and after completion of the training. Schizophrenia symptoms were determined blind to group allocation with the Positive and Negative Syndrome Scale (PANSS).
No adverse reactions were noted in the MCT group and patients expressed a greater subjective training success relative to the control condition (d = .57). A stronger improvement on all PANSS subscales was found at a descriptive level; positive symptoms attenuated under MCT with a medium effect size of d = .43. In addition, results showed a reduced jumping to conclusions bias for MCT patients (d = .31). However, none of the effects reached statistical significance. Optimal sample size was calculated for future studies.
The present study confirms the feasibility of MCT and provides preliminary evidence for its efficacy ameliorating positive symptoms and the jumping to conclusions bias.
“精神分裂症患者的元认知训练”（MCT）治疗方案针对的是认知缺陷和偏差，这些缺陷和偏差被认为在妄想的发病机制中起着至关重要的作用（例如，草率结论、心理理论缺陷、对否定证据的偏见）。本研究旨在探讨这种方法的可行性及其对阳性症状和认知偏差的影响。
海德堡大学医院精神病学系的 30 名精神分裂症谱系诊断患者被随机分配到 MCT 或主动对照干预组。两组训练方案均在四周内完成。在基线和培训结束后收集心理病理、认知和元认知测量结果。使用阳性和阴性症状量表（PANSS）对精神分裂症症状进行盲法分组评估。
MCT 组未出现不良反应，患者相对于对照组报告了更大的主观训练成功（d =.57）。在描述性水平上，所有 PANSS 子量表的改善均更为明显；阳性症状在 MCT 下减轻，具有中等效应大小的 d =.43。此外，结果显示 MCT 患者的草率结论偏见减少（d =.31）。然而，这些结果均未达到统计学意义。未来研究计算出了最佳样本量。
本研究证实了 MCT 的可行性，并提供了初步证据表明其能改善阳性症状和草率结论偏见。
