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首发精神病中的元认知:与症状及参与度关联的项目水平分析

Metacognition in First Episode Psychosis: Item Level Analysis of Associations with Symptoms and Engagement.

作者信息

MacBeth Angus, Gumley Andrew, Schwannauer Matthias, Carcione Antonino, McLeod Hamish J, Dimaggio Giancarlo

机构信息

The University of Edinburgh, Scotland, UK.

University of Glasgow, Scotland, UK.

出版信息

Clin Psychol Psychother. 2016 Jul;23(4):329-39. doi: 10.1002/cpp.1959. Epub 2015 May 12.

Abstract

UNLABELLED

Significant metacognitive impairments are observed in first episode psychosis (FEP) and chronic psychosis samples. There is evidence of associations between metacognition and presentation in FEP, but the relative contribution of metacognitive understanding of the self and the other is as yet unclear. The current study is a secondary analysis of date on metacognition, symptoms and engagement with treatment (help-seeking) in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology and help-seeking within treatment (clinician-rated service engagement) were also measured. An item level analysis of the MAS-R was conducted exploring associations between symptoms and cognitive, emotional, differentiation, integration and decentration aspects of metacognition. We report that associations between negative symptoms and deficits in the understanding of other's mental states extend across cognitive, emotional, integrative and decentration aspects of metacognition. We also report associations between negative symptoms and understanding one's own mind. We also note that cognitive and decentration aspects of metacognition were significantly associated with help-seeking once in treatment. Our findings suggest that an appreciation of metacognitive processes may inform treatment frameworks for FEP. Copyright © 2015 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGES

Individual components of metacognition including the capacity to relate cognitive and emotional variables are important in first episode phychosis. Impaired metacognitive understanding of both one's own and others' mental states is associated with increased negative symptoms. Metacognitive variables may be important in understanding how different individuals seek help or engage with services after the initiation of treatment.

摘要

未标注

在首发精神病(FEP)和慢性精神病样本中观察到显著的元认知障碍。有证据表明元认知与FEP的表现之间存在关联,但对自我和他人的元认知理解的相对贡献尚不清楚。本研究是对FEP样本中关于元认知、症状及治疗参与度(寻求帮助)数据的二次分析。在一项横断面队列研究中,使用修订版元认知评估量表(MAS-R)对治疗前12个月的个体进行元认知评估。还测量了精神病症状及治疗中的寻求帮助情况(临床医生评定的服务参与度)。对MAS-R进行了项目层面分析,以探究症状与元认知的认知、情感、分化、整合和去中心化方面之间的关联。我们报告,阴性症状与他人心理状态理解缺陷之间的关联在元认知的认知、情感、整合和去中心化方面均存在。我们还报告了阴性症状与自我心理理解之间的关联。我们还注意到,元认知的认知和去中心化方面与治疗期间的寻求帮助显著相关。我们的研究结果表明,对元认知过程的认识可能为FEP的治疗框架提供参考。版权所有© 2015约翰·威利父子有限公司。

关键从业者信息

元认知的各个组成部分,包括关联认知和情感变量的能力,在首发精神病中很重要。对自己和他人心理状态的元认知理解受损与阴性症状增加有关。元认知变量可能在理解不同个体在治疗开始后如何寻求帮助或参与服务方面很重要。

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