Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, Indiana, USA,
Center for Metacognitive Interpersonal Therapy, Rome, Italy.
Psychopathology. 2019;52(2):135-142. doi: 10.1159/000495297. Epub 2018 Dec 11.
BACKGROUND/AIMS: Disturbances in first person experience is a broadly noted feature of schizophrenia, which cannot be reduced to the expression of psychopathology. Yet, though categorically linked with profound suffering, these disturbances are often ignored by most contemporary treatment models.
In this paper, we present a model, which suggests that deficits in metacognition and their later resolution parsimoniously explain the development of self-disturbance and clarify how persons can later recover. We define "metacognition" as processes integral to the availability of a sense of self and others within the flow of life and report research suggesting its contribution to schizophrenia and link to self-disturbance.
We describe a newly emerging integrative form of psychotherapy, Metacognitive Reflection and Insight Therapy (MERIT), designed to target metacognition and enhance the recovery of healthy self-experience. We describe eight measurable core elements that allow MERIT to be operationalized and discuss about how to address disturbances in self-experience.
We detail research that provides evidence of the feasibility, acceptability, and effectiveness of MERIT across a broad range of patients, including those who might not otherwise be offered psychotherapy. MERIT represents one form of psychotherapy that may address self-disorders among adults with schizophrenia.
背景/目的：第一人称体验的障碍是精神分裂症的一个广泛注意到的特征，它不能简化为精神病理学的表达。然而，尽管这些障碍与深刻的痛苦有明确的联系，但它们常常被大多数当代治疗模式所忽视。
在本文中，我们提出了一个模型，该模型表明元认知缺陷及其随后的解决可以简洁地解释自我障碍的发展，并阐明人们如何能够恢复。我们将“元认知”定义为生活流程中自我和他人意识的基本过程，并报告研究表明其对精神分裂症的贡献及其与自我障碍的联系。
我们描述了一种新出现的整合心理治疗形式，元认知反思和洞察治疗（MERIT），旨在针对元认知并增强健康自我体验的恢复。我们描述了八项可衡量的核心要素，使 MERIT 能够实现操作，并讨论了如何解决自我体验的障碍。
我们详细介绍了研究结果，该研究提供了证据证明 MERIT 在广泛的患者中具有可行性、可接受性和有效性，包括那些否则可能不接受心理治疗的患者。MERIT 代表了一种心理治疗形式，可能会解决精神分裂症成人的自我障碍。
