Clinical Psychology and Psychotherapy, Department of Psychology, University of Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany.
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S23-32. doi: 10.1093/schbul/sbr066.
How to improve treatment for negative symptoms is a continuing topic of debate. Suggestions have been made to advance psychological understanding of negative symptoms by focusing on the social cognitive processes involved in symptom formation and maintenance.
Following the recommendations by the National Institute of Mental Health workshop on social cognition in schizophrenia, this study investigated associations between negative symptoms and various aspects of social cognition including Theory of Mind (ToM), attribution, empathy, self-esteem, and interpersonal self-concepts in 75 patients with schizophrenia spectrum disorders and 75 healthy controls.
Negative symptoms were significantly associated with difficulties in ToM, less readiness to be empathic, lower self-esteem, less self-serving bias, negative self-concepts related to interpersonal abilities, and dysfunctional acceptance beliefs. Different aspects of social cognition were mildly to moderately correlated and interacted in their impact on negative symptoms: Difficulties in ToM were associated with negative symptoms in persons with low but not in persons with medium or high levels of self-esteem. Taken together, the social cognition variables and their hypothesized interaction explained 39% of the variance in negative symptoms after controlling for neurocognition and depression.
The results highlight the relevance of self-concepts related to social abilities, dysfunctional beliefs, and global self-worth alone and in interaction with ToM deficits for negative symptoms and thereby provide a helpful basis for advancing psychosocial interventions.
如何改善阴性症状的治疗是一个持续的争论话题。有人建议通过关注涉及症状形成和维持的社会认知过程，来提高对阴性症状的心理理解。
本研究遵循国家心理健康研究所关于精神分裂症社会认知的研讨会的建议，调查了阴性症状与各种社会认知方面的关联，包括精神分裂症谱系障碍患者 75 名和健康对照组 75 名的心理理论（ToM）、归因、同理心、自尊和人际自我概念。
阴性症状与 ToM 困难、同理心准备程度较低、自尊较低、自我服务偏差较小、与人际能力相关的消极自我概念以及功能失调的接受信念显著相关。不同方面的社会认知轻度至中度相关，并相互作用影响阴性症状：在自尊水平较低的人群中，ToM 困难与阴性症状相关，但在自尊水平中等或较高的人群中则不相关。综合来看，社会认知变量及其假设的相互作用在控制神经认知和抑郁后，可解释阴性症状 39%的变异。
这些结果强调了与社会能力、功能失调信念和整体自我价值相关的自我概念的相关性，以及与 ToM 缺陷的相互作用对阴性症状的重要性，从而为推进心理社会干预提供了有益的基础。
