Bröcker Anna-Lena, Bayer Samuel, Stuke Frauke, Giemsa Patrick, Heinz Andreas, Bermpohl Felix, Lysaker Paul H, Montag Christiane
Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany.
International Psychoanalytic University Berlin (IPU), Berlin, Germany.
Psychol Psychother. 2017 Sep;90(3):401-418. doi: 10.1111/papt.12122. Epub 2017 Mar 23.
Metacognition, the capacity 'to think about thinking' and thus to reflect and to master interpersonal problems on a mentalistic basis, is often impaired among patients with schizophrenia spectrum disorders and has been suggested as a potential treatment target. However, little is known about the reliability of its measurement and links with related phenomena. The aim of this study was to validate a German translation of the Metacognition Assessment Scale (MAS-A) as a measure to assess metacognition from free narratives of patients' personally relevant episodes and relationships.
MAS-A was applied to narratives of 22 individuals with schizophrenia spectrum disorders together with self-ratings and behavioural tests of metacognitive and related functions such as mentalizing and emotional awareness. Multi-level modelling allowed to calculate inter-rater reliability (IRR) and inter-rater agreement (IRA) and to include test results as level-2 predictors of the aggregated scorings on the MAS-A subscales in order to explore convergent validity. After considering neurocognition and symptom scores as further predictors, aggregated scorings were correlated with psychosocial functioning.
There were high IRRs and IRAs all over the ratings. None of the related measures accounted for variance in MAS-A scorings, indicating the existence of separable, non-overlapping constructs. Verbal memory and positive symptoms were significant predictors for MAS-A subscales. MAS-A, but no other measure, displayed significant associations with psychosocial functioning.
MAS-A is a reliable expert rating to assess metacognition from patients' free narratives. Considering the link to psychosocial functioning, MAS-A appears to be a promising tool for the evaluation of metacognition.
MAS-A is a reliable tool to evaluate metacognitive function from narratives about emotionally relevant topics and meaningful relationships. Metacognition appears separate from neighbouring constructs such as mentalizing, ToM, or emotional awareness. MAS-A scales are significantly predicted by verbal memory and positive symptoms. Only MAS-A scales display significant associations with psychosocial functioning, and it thus is a promising tool to evaluate metacognition in psychotherapy research.
元认知，即“思考思维”的能力，从而在心理层面上反思并解决人际问题，在精神分裂症谱系障碍患者中常常受损，并被认为是一个潜在的治疗靶点。然而，关于其测量的可靠性以及与相关现象的联系，我们所知甚少。本研究的目的是验证元认知评估量表（MAS-A）的德语翻译版本，该量表用于从患者个人相关事件和人际关系的自由叙述中评估元认知。
将MAS-A应用于22名精神分裂症谱系障碍患者的叙述中，同时结合元认知及相关功能（如心理化和情绪意识）的自评和行为测试。多层次建模允许计算评分者间信度（IRR）和评分者间一致性（IRA），并将测试结果作为MAS-A子量表汇总评分的二级预测指标，以探索聚合效度。在将神经认知和症状评分作为进一步的预测指标后，汇总评分与心理社会功能进行相关分析。
所有评分的IRR和IRA都很高。没有一项相关测量能够解释MAS-A评分的方差，这表明存在可分离的、不重叠的结构。言语记忆和阳性症状是MAS-A子量表的显著预测指标。MAS-A，但不是其他测量指标，与心理社会功能显示出显著关联。
MAS-A是一种可靠的专家评分工具，用于从患者的自由叙述中评估元认知。考虑到与心理社会功能的联系，MAS-A似乎是评估元认知的一个有前景的工具。
MAS-A是一种可靠的工具，用于从关于情感相关主题和有意义关系的叙述中评估元认知功能。元认知似乎与心理化、心理理论或情绪意识等相邻结构是分开的。言语记忆和阳性症状显著预测MAS-A量表。只有MAS-A量表与心理社会功能显示出显著关联，因此它是心理治疗研究中评估元认知的一个有前景的工具。
