Arnon-Ribenfeld Nitzan, Atzil-Slonim Dana, Bar-Kalifa Eran, Silber Yosef, Fisher Hadar, Peri Tuvia, Lysaker Paul H, Hasson-Ohayon Ilanit
Department of Psychology, Bar-Ilan University, Ramat Gan.
Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel.
J Nerv Ment Dis. 2019 Nov;207(11):936-943. doi: 10.1097/NMD.0000000000001051.
Deficits in metacognition have often been identified as a central feature in various forms of psychopathology. The current study explores changes in metacognition and symptoms during the process of psychodynamic-oriented psychotherapy conducted in a community setting among people with diverse psychological challenges. We examined the associations between metacognition and symptoms at both the within-client and the between-clients level. Nine good-outcome and nine poor-outcome cases of psychodynamic treatment were analyzed. In terms of metacognitive abilities, results showed that clients who were part of the good-outcome group had higher levels of decentration than did clients who were part of the poor-outcome group. In addition, clients' ability to understand the other's mind improved significantly only for clients in the good-outcome group. Furthermore, sessions in which clients' self-reflectivity was higher were followed by increased symptom levels (in the next session) beyond group (poor or good outcome group). Clinical implications regarding the improvement of metacognitive abilities and their associations with outcome measures are discussed.
元认知缺陷常常被视为各种心理病理学形式的核心特征。本研究探讨了在社区环境中对面临各种心理挑战的人群进行心理动力取向心理治疗过程中元认知和症状的变化。我们在个体内部和个体之间两个层面考察了元认知与症状之间的关联。分析了9例心理动力治疗效果良好的案例和9例效果不佳的案例。在元认知能力方面，结果显示，治疗效果良好组的来访者比治疗效果不佳组的来访者具有更高水平的去中心化能力。此外，只有治疗效果良好组的来访者理解他人心理的能力有显著提高。而且，来访者自我反思性较高的治疗阶段之后（在下一阶段），超出分组（效果不佳或良好组）的症状水平会有所增加。文中讨论了关于提高元认知能力及其与治疗效果指标之间关联的临床意义。
