Asensio-Aguerri Leonor, Beato-Fernández Luis, Stavraki Maria, Rodríguez-Cano Teresa, Bajo Miriam, Díaz Darío
Mental Health Unit, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Ciudad Real Medical School, Universidad de Castilla - La Mancha, Ciudad Real, Spain.
Front Psychol. 2019 Sep 12;10:2099. doi: 10.3389/fpsyg.2019.02099. eCollection 2019.
Pathological confidence in one's thoughts is a key mechanism of chronic paranoid thinking. For this reason, many of the current therapies focus on trying to reduce it. In fact, the way some antipsychotics (e.g., haloperidol) work seems to be through the induction of doubt. Because of the impact of these pathological thoughts on positive health, studying the well-being of people who experience paranoid thoughts is fundamental. The first objective of this research is to apply the Complete State Model of Health (CSMH) to a sample of patients characterized by the presence of paranoid thinking. Our second objective is to evaluate the impact of therapies based on reducing pathological confidence on patients' well-being.
Sixty participants with SCID-5 confirmed DSM-5 diagnosis related with paranoid thinking and without mood symptoms were recruited. In order to test the existence of a two continua model of mental health (CSMH), we conducted a parallel analysis and an exploratory factor analysis. To test our hypothesis regarding the partially mediating role of doubt between paranoid thinking and patients' well-being, we conducted a biased corrected bootstrapping procedure.
As expected, two different unipolar dimensions emerged from the measures used to assess paranoid thinking and positive health (two continua model of mental health). When patients received metacognitive and pharmacological treatment, more paranoid thinking led to more doubt in all thoughts, which in turn affected well-being. The analyses carried out confirmed the partial mediating role of doubt.
Despite the efficacy shown by both metacognitive therapies and antipsychotics, it seems that they not only reduce pathological confidence, but can also affect other thoughts not linked to delirium. This effect of generalization of doubt in all thoughts negatively affected patients' well-being and quality of life.
对自身想法的病理性确信是慢性偏执思维的关键机制。因此，当前许多疗法都致力于尝试降低这种确信。事实上，一些抗精神病药物（如氟哌啶醇）的作用方式似乎是通过引发怀疑。鉴于这些病理性思维对健康的影响，研究有偏执思维者的幸福感至关重要。本研究的首要目标是将健康全状态模型（CSMH）应用于以存在偏执思维为特征的患者样本。我们的第二个目标是评估基于降低病理性确信的疗法对患者幸福感的影响。
招募了60名经SCID - 5确诊患有与偏执思维相关的DSM - 5诊断且无情绪症状的参与者。为了检验心理健康的双连续体模型（CSMH）的存在，我们进行了平行分析和探索性因素分析。为了检验我们关于怀疑在偏执思维与患者幸福感之间的部分中介作用的假设，我们进行了偏差校正的自助法程序。
正如预期的那样，从用于评估偏执思维和积极健康的测量中出现了两个不同的单极维度（心理健康的双连续体模型）。当患者接受元认知和药物治疗时，更多的偏执思维会导致对所有想法产生更多怀疑，进而影响幸福感。所进行的分析证实了怀疑的部分中介作用。
尽管元认知疗法和抗精神病药物都显示出了疗效，但似乎它们不仅降低了病理性确信，还可能影响与妄想无关的其他想法。这种怀疑在所有想法中的泛化效应会对患者的幸福感和生活质量产生负面影响。
