Hillis Jaclyn D, Bidlack Nathan, Macobin Brian
Department of Psychology, Chillicothe VA Medical Center, Chillicothe, Ohio (Hillis, Bidlack); Department of Psychology, Louisville VA Medical Center, Louisville (Macobin).
Am J Psychother. 2018 Dec 1;71(4):186-195. doi: 10.1176/appi.psychotherapy.20180031. Epub 2018 Nov 21.
Schizophrenia often involves a loss of metacognitive capacity, the ability to form complex and integrated representations of self and others. Independent of symptoms and neurocognition, deficits in synthetic metacognition are related to difficulties engaging in goal-directed activities in social and vocational settings. Against this backdrop, the authors provide a case report of the effects of metacognitive reflection and insight therapy (MERIT) provided over the course of seven months to assist a client with persistent schizophrenia. Eight elements of MERIT that stimulate and promote metacognitive capacity are presented. As illustrated in this article, these elements helped the client to move from a state in which he had virtually no complex ideas about himself or others to one in which he had developed integrated and realistic ideas about his own identity and that of others. He then could use these representations to understand and effectively respond to life challenges.
精神分裂症常常涉及元认知能力的丧失，即形成关于自我和他人的复杂且整合的表征的能力。与症状和神经认知无关，综合性元认知缺陷与在社交和职业环境中参与目标导向活动的困难有关。在此背景下，作者提供了一份病例报告，介绍了在七个月的时间里提供的元认知反思与洞察疗法（MERIT）对一名患有持续性精神分裂症的患者的治疗效果。文中介绍了MERIT中刺激和促进元认知能力的八个要素。如本文所示，这些要素帮助该患者从几乎对自己或他人没有复杂想法的状态，转变为对自己和他人的身份形成了整合且现实的想法的状态。然后，他能够利用这些表征来理解并有效应对生活中的挑战。
