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元认知能力作为非临床人群中类似精神病性体验发生的保护因素

Metacognitive Abilities as a Protective Factor for the Occurrence of Psychotic-Like Experiences in a Non-clinical Population.

作者信息

Giugliano Marco, Contrada Claudio, Foglia Ludovica, Francese Francesca, Romano Roberta, Dello Iacono Marilena, Di Fausto Eleonora, Esposito Mariateresa, Azzara Carla, Bilotta Elena, Carcione Antonino, Nicolò Giuseppe

机构信息

Società Italiana di Cognitivismo Clinico, Rome, Italy.

Terzo Centro di Psicoterapia, Rome, Italy.

出版信息

Front Psychol. 2022 Feb 24;13:805435. doi: 10.3389/fpsyg.2022.805435. eCollection 2022.

Abstract

Psychotic-like experiences (PLEs) are a phenomenon that occurs in the general population experiencing delusional thoughts and hallucinations without being in a clinical condition. PLEs involve erroneous attributions of inner cognitive events to the external environment and the presence of intrusive thoughts influenced by dysfunctional beliefs; for these reasons, the role played by metacognition has been largely studied. This study investigates PLEs in a non-clinical population and discriminating factors involved in this kind of experience, among which metacognition, as well as psychopathological features, seems to have a crucial role. The aim of this study was to extend the knowledge about the relationship between metacognition, psychopathology, and PLEs, orienting the focus on metacognitive functioning. The sample consisted of 207 Italian participants (men = 32% and women = 68%) voluntarily recruited online, who gave consent to participate in the study. The average age of the sample was 32.69 years (SD: 9.63; range: 18-71). Subjects affected by psychosis, neurological disease, and drug addiction were excluded from the analyses. The following scales were used to investigate PLEs: Peters et al. Delusions Inventory (PDI), Launay-Slade Hallucinations Scale-Extended Revised (LSHSE), Prodromal Questionnaire-Brief (PQ-B), and Revised Hallucination Scale (RHS). To assess general psychopathological features, the Behavior and Symptom Identification Scale (BASIS-32) was administrated. The Metacognition Self-Assessment Scale (MSAS) was chosen to evaluate metacognitive functioning. From hierarchical regression analyses, it emerged that the presence of anxiety, depression, and impulsive/addictive symptoms constitute a remarkable vulnerability factor for PLEs, in line with previous evidence regarding the relationship between general psychopathology and PLEs. Metacognition negatively predicts PLEs, and its presence does not affect the significance of psychopathological variables, suggesting that metacognitive abilities seem to play a protective role for the occurrence of PLEs among non-clinical individuals, and such ability operates as an independent predictor along with other variables. These results are explained by the role of metacognitive functions, which allow individuals to operate many mental processes such as interpreting sensorial events as real or illusory, understanding behaviors, thoughts, and drives of others, and questioning the subjective interpretation of facts.

摘要

类精神病体验(PLEs)是一种在普通人群中出现的现象,这些人会经历妄想思维和幻觉,但并未处于临床疾病状态。PLEs涉及将内心认知事件错误归因于外部环境,以及存在受功能失调信念影响的侵入性思维;基于这些原因,元认知所起的作用已得到大量研究。本研究调查了非临床人群中的PLEs以及这类体验所涉及的鉴别因素,其中元认知以及精神病理学特征似乎起着关键作用。本研究的目的是扩展关于元认知、精神病理学和PLEs之间关系的知识,将重点放在元认知功能上。样本由207名意大利参与者组成(男性占32%,女性占68%),他们通过网络自愿招募,并同意参与研究。样本的平均年龄为32.69岁(标准差:9.63;范围:18 - 71岁)。患有精神病、神经疾病和药物成瘾的受试者被排除在分析之外。使用以下量表来调查PLEs:彼得斯等人的妄想量表(PDI)、劳内 - 斯莱德幻觉量表扩展修订版(LSHSE)、前驱症状问卷简版(PQ - B)和修订后的幻觉量表(RHS)。为了评估一般精神病理学特征,使用了行为和症状识别量表(BASIS - 32)。选择元认知自我评估量表(MSAS)来评估元认知功能。从分层回归分析中可以看出,焦虑、抑郁和冲动/成瘾症状的存在构成了PLEs的一个显著脆弱因素,这与先前关于一般精神病理学与PLEs之间关系的证据一致。元认知对PLEs具有负向预测作用,其存在并不影响精神病理学变量的显著性,这表明元认知能力似乎对非临床个体中PLEs的发生起到保护作用,并且这种能力与其他变量一起作为一个独立的预测因素发挥作用。这些结果可以通过元认知功能的作用来解释,元认知功能使个体能够进行许多心理过程,如将感官事件解释为真实或虚幻、理解他人的行为、思想和动机,以及质疑对事实的主观解释。

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