Orygen, Parkville, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia.
Clin Psychol Rev. 2020 Jul;79:101871. doi: 10.1016/j.cpr.2020.101871. Epub 2020 Jun 1.
People who have experienced psychosis describe functional and personal recovery as a key goal of treatment. To date, the early, pervasive and influential role of cognitive impairments in functional recovery in psychosis has been predominantly addressed using approaches aiming to remediate clinically-defined cognitive deficits. Despite acceptance of the recovery and strengths-based model of care for first-episode psychosis (FEP), there has been minimal attention paid to the potential for strengths-based approaches to be extended to cognitive function. The purpose of this review is to present the case for supplementary strengths-based approaches to addressing cognition and functioning in FEP. In this review we appraise current approaches to addressing cognition in FEP that have primarily focused on remediating cognitive impairment, showing evidence for inconsistent engagement and generally small treatment effects. We describe the important role of psychological factors such as motivation and self-efficacy in mediating the relationship between cognitive performance and functional outcome, and draw on positive psychology and self-determination theory as models for potential application in relation to a cognitive-strengths paradigm. Our review supports the argument for complementing approaches for remediating cognitive deficits by applying strengths-based or positive psychology approaches to the domain of cognition as a promising avenue for further enhancing personal and functional recovery from FEP.
经历过精神病的人将功能和个人康复描述为治疗的关键目标。迄今为止，认知障碍在精神病的功能康复中早期、普遍和具有深远影响的作用，主要是通过旨在纠正临床定义的认知缺陷的方法来解决。尽管接受了针对首发精神病 (FEP) 的康复和优势为本的护理模式，但很少关注将优势为本的方法扩展到认知功能的潜力。本综述的目的是提出补充优势为本的方法来解决 FEP 中的认知和功能问题。在本综述中，我们评估了目前主要集中在纠正认知障碍的 FEP 认知处理方法，这些方法显示出参与度不一致且治疗效果通常较小的证据。我们描述了心理因素（如动机和自我效能感）在调节认知表现和功能结果之间关系的重要作用，并借鉴积极心理学和自我决定理论作为可能应用于认知优势范式的模型。我们的综述支持这样的观点，即通过将基于优势或积极心理学的方法应用于认知领域来补充纠正认知缺陷的方法，这是进一步增强从 FEP 中获得个人和功能康复的有前途的途径。
