Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Campus Universitario, Carretera Madrid-Barcelona Km. 33,600, 28871, Alcalá de Henares, Madrid, Spain.
Moncayo Mental Health Centre, Tarazona, Aragón, Spain.
Psychiatr Q. 2021 Sep;92(3):947-959. doi: 10.1007/s11126-020-09863-x. Epub 2021 Jan 6.
The main objective of this study was to evaluate the mentalizing performance of patients with schizophrenia who received daily psychosocial rehabilitation treatment compared with healthy controls. Differences in mentalizing performance between men and women, and the relationship between mentalizing deficits, cognitive impairment, symptoms, and global functioning of patients were also examined. A case-control study design was utilized (N = 95). Adults with schizophrenia were recruited from psychosocial rehabilitation clinics (n = 53) and healthy controls were recruited from the community (n = 42). Mentalizing was evaluated with the Movie for the Assessment of Social Cognition, an audiovisual measure with good ecological validity. Measures of cognitive functioning, symptoms, and global functioning were also administered. Patients exhibited significant mentalizing deficits. Specifically, patients made more undermentalizing errors and more no mentalizing errors compared with healthy controls. In patients and healthy controls, no differences were found between men and women in mentalizing abilities. In patients with schizophrenia, lower cognitive functioning (i.e., immediate and delayed verbal learning, verbal fluency, and processing speed) were associated with poorer mentalizing. In patients, processing speed explained 31% of the variance in total mentalizing errors and mentalizing deterioration was associated with poorer overall functioning. Psychosocial rehabilitation interventions in people with schizophrenia should consider mentalizing deficits (especially undermentalizing and no mentalizing difficulties) and their relationship with reduced processing speed in treatment delivery (e.g., direct and organized communication). Integration of treatments targeting mentalizing deficits in a psychosocial rehabilitation setting is recommended to improve functioning in schizophrenia.
本研究的主要目的是评估接受日常心理社会康复治疗的精神分裂症患者的心理化表现，并与健康对照组进行比较。还检查了男性和女性之间的心理化表现差异，以及心理化缺陷与认知障碍、症状和患者的整体功能之间的关系。采用病例对照研究设计（N=95）。从心理社会康复诊所招募精神分裂症成年人（n=53），从社区招募健康对照者（n=42）。使用具有良好生态有效性的视听测量法电影评估社会认知来评估心理化。还进行了认知功能、症状和整体功能的测量。患者表现出明显的心理化缺陷。具体来说，与健康对照组相比，患者做出了更多的下心理化错误和更多的无心理化错误。在精神分裂症患者和健康对照组中，心理化能力在男女之间没有差异。在精神分裂症患者中，较低的认知功能（即即时和延迟言语学习、言语流畅性和加工速度）与较差的心理化相关。在患者中，加工速度解释了总心理化错误的 31%，心理化恶化与整体功能较差相关。精神分裂症患者的心理社会康复干预应考虑心理化缺陷（尤其是下心理化和无心理化困难）及其与治疗提供中降低的加工速度的关系（例如，直接和有组织的沟通）。建议在心理社会康复环境中整合针对心理化缺陷的治疗方法，以改善精神分裂症的功能。
