Faculty of Psychology,Universitas Indonesia,Depok,Indonesia.
Clinical Psychology and Psychotherapy,Institute of Psychology,University of Hamburg,Hamburg,Germany.
Psychol Med. 2018 Jun;48(8):1299-1307. doi: 10.1017/S003329171700277X. Epub 2017 Sep 28.
Cognitive models postulate that negative-self-schemas (NSS) cause and maintain positive symptoms and that negative affect mediates this link. However, only few studies have tested the temporal mediation claim systematically using an appropriate design.
A longitudinal cohort design in an online community sample (N = 962) from Germany, Indonesia, and the USA was used. NSS, negative affect and positive symptoms were measured at four time-points (T0-T3) over a 1-year period. Cross-lagged panel and longitudinal mediation analyses with structural equation modeling were used to test the temporal mediation.
Independent cross-lagged panel models showed a significant unidirectional longitudinal path from NSS to positive symptoms (T2-T3, β = 0.18, p < 0.01) and bidirectional longitudinal associations from NSS to negative affect (T0-T1, γ = 0.14, p < 0.01) and vice versa (T0-T1, γ = 0.19, p < 0.01). There was also a significant indirect pathway from NSS at baseline via negative affect at T1 and T2 to positive symptoms at T3 (unstandardized indirect effect coefficient = 0.020, p < 0.05, BCa CI 0.004-0.035), indicating mediation.
Our findings support the postulated affective pathway from NSS to positive symptoms via negative affect. Specifically, our data indicate that NSS and negative affect influence each other and build up over the course of several months before leading on to positive symptoms. We conclude that interrupting this process by targeting NSS and negative affect early in the process could be a promising strategy to prevent the exacerbation of positive symptoms.
认知模型假设消极自我图式（NSS）导致并维持阳性症状，而消极情绪则介导这种联系。然而，只有少数研究使用适当的设计系统地测试了时间中介的主张。
使用来自德国、印度尼西亚和美国的在线社区样本的纵向队列设计（N=962）。在一年的时间里，通过四个时间点（T0-T3）测量 NSS、消极情绪和阳性症状。使用结构方程模型进行交叉滞后面板和纵向中介分析，以测试时间中介。
独立的交叉滞后面板模型显示，从 NSS 到阳性症状存在显著的单向纵向路径（T2-T3，β=0.18，p<0.01），从 NSS 到消极情绪存在双向的纵向关联（T0-T1，γ=0.14，p<0.01），反之亦然（T0-T1，γ=0.19，p<0.01）。基线时的 NSS 通过 T1 和 T2 时的消极情绪对 T3 时的阳性症状有显著的间接途径（未标准化间接效应系数=0.020，p<0.05，BCa CI 0.004-0.035），表明存在中介作用。
我们的发现支持从 NSS 到阳性症状的假设的情感途径，通过消极情绪。具体来说，我们的数据表明，NSS 和消极情绪相互影响，并在导致阳性症状之前在几个月的时间里逐渐积累。我们得出结论，通过在早期阶段针对 NSS 和消极情绪来打断这个过程，可能是预防阳性症状恶化的一种有前途的策略。
