Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, 08035, Barcelona, Spain; The Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
Department of Psychological and Brain Sciences, Indiana University Bloomington, 47405, IN, United States.
Schizophr Res. 2020 Aug;222:297-303. doi: 10.1016/j.schres.2020.05.027. Epub 2020 Jun 6.
People with psychosis experience significant emotional burden and distress associated with the symptomatic consequences of their mental disorder, thus difficulting their recovery. Several studies have found self-reflectivity, a dimension of cognitive insight, to be associated with effects which taken together may seem paradoxical, by predicting less psychotic symptom severity but more depression. To elucidate this issue, we examined the influence of psychotic symptoms, depressive symptoms, and self-reflectivity, on psychological distress. Further, we tested whether self-reflectivity moderated the relationship between depressive symptoms and psychological distress.
Seventy-six outpatients with psychotic-spectrum disorders were assessed using measures of psychotic symptoms, depressive symptoms, cognitive insight (i.e., self-reflectivity, self-certainty) and psychological distress.
A regression model revealed that depressive, positive symptoms and the interaction between depressive symptoms and self-reflectivity had a significant effect on psychological distress. The moderation analysis showed that higher levels of self-reflectivity were related to less psychological distress associated with depressive mood.
The role of self-reflectivity on depression and distress may be more complex than a direct effect. Interventions targeted to improve metacognition by enhancing self-reflectivity might be important for lowering the psychological distress associated with depressive symptoms in people with psychosis.
精神病患者会经历与精神障碍症状后果相关的巨大情绪负担和痛苦，从而阻碍他们的康复。一些研究发现，认知洞察力的一个维度——自我反省，与看似矛盾的效果有关，它可以预测较少的精神病症状严重程度，但更多的抑郁。为了阐明这个问题，我们研究了精神病症状、抑郁症状和自我反省对心理困扰的影响。此外，我们还测试了自我反省是否调节了抑郁症状和心理困扰之间的关系。
76 名精神病谱系障碍患者接受了精神病症状、抑郁症状、认知洞察力（即自我反省、自我确信）和心理困扰的评估。
回归模型显示，抑郁症状、阳性症状以及抑郁症状和自我反省之间的相互作用对心理困扰有显著影响。调节分析表明，较高的自我反省水平与与抑郁情绪相关的较少的心理困扰有关。
自我反省对抑郁和困扰的作用可能比直接影响更为复杂。通过增强自我反省来改善元认知的干预措施可能对降低精神病患者与抑郁症状相关的心理困扰很重要。
