UCL Institute of Mental Health, Division of Psychiatry, University College London, London, UK.
First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Zografou, Greece.
Psychopathology. 2024;57(5):434-443. doi: 10.1159/000538096. Epub 2024 Mar 27.
The exploration of metacognition in relation to anxiety has received considerable attention in recent decades. Research indicates that it plays a role in the development and maintenance of anxiety disorders while also providing benefits, including the ability to assess situations, modify behaviors, and make informed decisions.
We propose that having an awareness of a disorder, also known as insight, is related to metacognition in anxiety. This relationship stems from the ability it provides individuals to recognize their mental state through reflection on personal experiences. We discuss the impact of insight and metacognition on decision-making, treatment-seeking behaviors, and coping strategy selection.
Understanding the concept of insight in anxiety disorders, as compared to other mental disorders like psychosis, requires exploring its complexities while carefully considering the balance of harms and benefits. While the medicalization of symptoms in psychosis is widely regarded as clearly beneficial, evaluating the role of insight in anxiety disorders demands a more nuanced understanding. Gaining a fuller perspective on patients' beliefs can impact their behaviors and decision-making. Clinicians can achieve this by encouraging active self-reflection to increase awareness, which includes evaluating both severity and impact on daily functioning. This also involves expressing experiences and exploring attributions of anxiety. This practical approach enables clinicians to understand engagement and treatment-seeking behaviors, allowing them to tailor treatment plans and develop effective coping and management strategies. Ultimately, this knowledge promotes a deeper comprehension of insight into anxiety disorders.
近年来,元认知与焦虑之间的关系备受关注。研究表明,元认知在焦虑障碍的发展和维持中起着重要作用,同时也带来益处,包括评估情况、改变行为和做出明智决策的能力。
我们提出,对障碍的意识,也称为洞察力,与焦虑中的元认知有关。这种关系源于个体通过反思个人经历来识别自己心理状态的能力。我们讨论了洞察力和元认知对决策、寻求治疗行为和应对策略选择的影响。
理解焦虑障碍中洞察力的概念,与精神病等其他精神障碍不同,需要探索其复杂性,同时仔细考虑权衡利弊。虽然精神病中症状的医学化被广泛认为是明显有益的,但评估焦虑障碍中洞察力的作用需要更细致的理解。更全面地了解患者的信念可以影响他们的行为和决策。临床医生可以通过鼓励积极的自我反思来增加意识来实现这一点,这包括评估严重程度和对日常功能的影响。这还包括表达体验和探索焦虑的归因。这种实用方法使临床医生能够了解参与和寻求治疗的行为,从而使他们能够制定治疗计划并开发有效的应对和管理策略。最终,这一知识促进了对焦虑障碍中洞察力的更深入理解。