功能失调性态度在精神分裂症阴性症状及功能模型中的作用。
The role of dysfunctional attitudes in models of negative symptoms and functioning in schizophrenia.
作者信息
Quinlan Thomas, Roesch Scott, Granholm Eric
机构信息
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States.
VA San Diego Healthcare System, San Diego, United States; Department of Psychiatry, University of California, United States.
出版信息
Schizophr Res. 2014 Aug;157(1-3):182-9. doi: 10.1016/j.schres.2014.05.025. Epub 2014 Jun 10.
Abstract
Neurocognitive impairment is associated with negative symptoms and poor real world functioning in schizophrenia. Dysfunctional attitudes (e.g., "If I fail partly, it is as bad as being a complete failure") have been found to mediate these relationships between neurocognition and negative symptoms and functioning. In this study, these relationships were examined in 179 participants with schizophrenia or schizoaffective disorder using structural equation modeling. Defeatist attitudes were found to mediate the relationship between neurocognition and negative symptoms but not the relationships between neurocognition and performance-based or self-reported functioning. A full model with the best fit showed mediation between neurocognition and self-reported functioning through two different pathways: One from neurocognition to functional skill capacity to real-world functioning, and a second from neurocognition to defeatist attitudes to negative symptoms to real-world functioning. These results may implicate skill deficits and defeatist attitudes as a separate treatment targets for negative symptoms and functioning in schizophrenia.
摘要
神经认知障碍与精神分裂症的阴性症状及现实世界功能不良相关。研究发现，功能失调性态度（例如，“如果我部分失败，那就和完全失败一样糟糕”）在神经认知与阴性症状及功能之间的这些关系中起中介作用。在本研究中，使用结构方程模型对179名精神分裂症或分裂情感性障碍患者的这些关系进行了检验。结果发现，失败主义态度在神经认知与阴性症状之间起中介作用，但在神经认知与基于表现或自我报告的功能之间不起中介作用。拟合度最佳的完整模型显示，神经认知与自我报告功能之间通过两条不同途径起中介作用：一条是从神经认知到功能技能能力再到现实世界功能，另一条是从神经认知到失败主义态度再到阴性症状再到现实世界功能。这些结果可能意味着技能缺陷和失败主义态度是精神分裂症阴性症状及功能的独立治疗靶点。
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