Mental Health Centre, University Hospital Marqués de Valdecilla, Santander, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
Parc Sanitari Sant Joan de Déu, Barcelona, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Universitat de Barcelona (UB), Barcelona, Spain.
J Psychiatr Res. 2021 Sep;141:104-110. doi: 10.1016/j.jpsychires.2021.06.040. Epub 2021 Jun 22.
Metacognitive training (MCT) is a promising treatment for improving cognitive insight associated with delusional beliefs in individuals with psychotic disorders. The aim of this study was to examine potential moderators of cognitive insight in individuals with first-episode psychosis (FEP) who received either MCT or psychoeducation. The present study was based on data from a randomized control trial comparing MCT to psychoeducation. Baseline sociodemographic and clinical characteristics in a sample of 122 patients with FEP were examined as potential moderators of the self-reflectiveness and self-certainty dimensions of cognitive insight using the SPSS PROCESS macro. The only variable that moderated self-reflectiveness at the post-treatment evaluation was age of onset (b = -0.27, p = .025). The effect of MCT in reducing self-certainty was stronger in women (b = -3.26, p = .018) and in individuals with average or above average baseline self-esteem (b = -0.30, p = .007). Overall, our findings support the generalization of MCT to a variety of sociodemographic and clinical profiles. While some patient profiles may require targeted interventions such as MCT to improve cognitive insight, others may do equally as well with less demanding interventions such as a psychoeducational group.
元认知训练（MCT）是一种很有前途的治疗方法，可以改善精神障碍患者的妄想相关认知洞察力。本研究的目的是检验接受 MCT 或心理教育的首发精神病患者（FEP）认知洞察力的潜在调节因素。本研究基于一项比较 MCT 与心理教育的随机对照试验的数据。使用 SPSS PROCESS 宏，以 122 名 FEP 患者的样本为基础，检查基线人口统计学和临床特征是否为认知洞察力的自我反思和自我确信维度的潜在调节因素。在治疗后评估中，只有发病年龄（b = -0.27，p =.025）调节自我反思。MCT 降低自我确信的效果在女性（b = -3.26，p =.018）和基线自尊处于平均或以上水平的个体中更强（b = -0.30，p =.007）。总的来说，我们的研究结果支持 MCT 推广到各种社会人口学和临床特征。虽然一些患者特征可能需要 MCT 等针对性干预来改善认知洞察力，但其他患者通过要求不那么高的干预，如心理教育小组，也可以同样有效。
