Department of Psychology, University of Georgia, Athens, Georgia, USA.
Early Interv Psychiatry. 2021 Aug;15(4):865-873. doi: 10.1111/eip.13024. Epub 2020 Aug 2.
Prior studies indicate that defeatist performance beliefs (DPBs) are elevated in those in the chronic phase of schizophrenia (SZ) and associated with negative symptoms, functional outcome and neurocognitive impairment. However, it is unclear whether these same patterns of results hold in participants at clinical high-risk (CHR) for psychosis.
Two studies were conducted to determine whether prior results in SZ could be replicated and extended to CHR. Participants included 184 healthy controls (CN) and 186 outpatients with chronic SZ for Study 1, and 30 CN and 35 CHR in Study 2. In both studies, participants completed the DPB scale and measures of negative symptoms, psychosocial functioning and neurocognition.
Both chronic SZ and CHR participants had elevated DPBs compared to CN (p's < .01). In SZ, higher DPBs were associated with greater negative symptoms (r's = .31-.37, p's < .01), poorer social functioning and impaired social cognition (r = -.40, P < .001). In CHR, greater DPBs were associated with poorer social functioning (r = -.52, P < .05) and impairments in the neurocognitive domains of reasoning (r = -.48, P < .05) and processing speed (r = -.41, P < .05). Models testing whether DPBs mediated links between negative symptoms and functioning, negative symptoms and cognition and cognition and functioning were nonsignificant in SZ and CHR samples.
Findings generally provide support for the cognitive model of negative symptoms and functioning and suggest that DPBs are an important clinical target across phases of psychotic illness.
先前的研究表明，在慢性精神分裂症（SZ）患者中，挫败表现信念（DPB）升高，并与阴性症状、功能结果和神经认知损伤相关。然而，目前尚不清楚这些相同的结果模式是否适用于精神病高危（CHR）人群。
进行了两项研究，以确定在 SZ 中是否可以复制先前的结果并将其扩展到 CHR。参与者包括研究 1 中的 184 名健康对照者（CN）和 186 名慢性 SZ 门诊患者，以及研究 2 中的 30 名 CN 和 35 名 CHR。在两项研究中，参与者都完成了 DPB 量表以及阴性症状、心理社会功能和神经认知的测量。
与 CN 相比，慢性 SZ 和 CHR 患者的 DPB 都升高（p<0.01）。在 SZ 中，较高的 DPB 与更严重的阴性症状相关（r=0.31-0.37，p<0.01），较差的社会功能和受损的社会认知（r=-0.40，P<0.001）。在 CHR 中，更大的 DPB 与较差的社会功能相关（r=-0.52，P<0.05）以及推理（r=-0.48，P<0.05）和加工速度（r=-0.41，P<0.05）神经认知领域的损伤相关。在 SZ 和 CHR 样本中，测试 DPB 是否介导阴性症状与功能、阴性症状与认知以及认知与功能之间的关系的模型均无统计学意义。
研究结果普遍支持阴性症状和功能的认知模型，并表明 DPB 是精神病各阶段的重要临床目标。
