Boston Attention and Learning Lab, VA Boston Health Care System.
Posit Science Corporation.
Neuropsychology. 2024 Oct;38(7):622-636. doi: 10.1037/neu0000967. Epub 2024 Aug 29.
Metacognition is disrupted in several clinical populations. One aspect of metacognition, global metacognitive bias (difference between objective and self-reported abilities), has shown to be particularly relevant to clinical functioning. However, previous studies of global metacognitive biases in populations with elevated depressive/posttraumatic stress disorder (PTSD) symptoms have not measured objective and self-reported abilities relative to normative samples, limiting the quantification of biases. Additionally, few studies have examined whether cognitive interventions can improve metacognitive biases or how this relates to depressive/PTSD symptom severity.
A total of 84 participants with mild traumatic brain injury (77% veterans) performed PTSD and depression assessments along with self-reported and objective measures of global cognition. Age-adjusted norm-based z scores were used for self-reported and objective cognition, and bias was calculated by subtracting objective minus self-report scores. Participants then received 13 weeks of targeted cognitive training or entertainment games training (both providing performance feedback). Participants were assessed at baseline, immediately posttraining, and 3 months posttraining.
We found large negative metacognitive biases in those with clinically significant severity of depressive symptoms (z score difference = -1.77), PTSD symptoms (-1.47), and depressive + PTSD symptoms (-2.29). Metacognitive biases improved after both targeted and entertainment training and was associated with reductions in depressive/PTSD symptom severity ( = -.41/-.42, respectively), led by the entertainment training group ( = -.54/-.46, respectively).
These findings show that clinically significant severity of depressive/PTSD symptoms is associated with substantial negative global metacognitive biases and preliminarily suggests that cognitive training may improve these biases and depressive/PTSD symptom severity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
元认知在多个临床群体中受到干扰。元认知的一个方面，即全局元认知偏差（客观能力与自我报告能力之间的差异），与临床功能特别相关。然而，以前对抑郁/创伤后应激障碍（PTSD）症状升高的人群中全局元认知偏差的研究没有相对于标准样本测量客观和自我报告的能力，限制了偏差的量化。此外，很少有研究探讨认知干预是否可以改善元认知偏差，以及这与抑郁/PTSD 症状严重程度的关系如何。
共有 84 名轻度创伤性脑损伤患者（77%为退伍军人）进行了 PTSD 和抑郁评估，以及自我报告和客观的全局认知测量。自我报告和客观认知采用年龄调整后的基于标准的 z 分数，偏差通过减去客观分数减去自我报告分数计算。然后，参与者接受了 13 周的有针对性的认知训练或娱乐游戏训练（均提供绩效反馈）。参与者在基线、训练后立即和 3 个月后进行评估。
我们发现，具有临床显著严重程度的抑郁症状（z 分数差异=-1.77）、PTSD 症状（-1.47）和抑郁+PTSD 症状（-2.29）的个体存在较大的负性元认知偏差。在有针对性和娱乐训练后，元认知偏差都得到了改善，并且与抑郁/PTSD 症状严重程度的降低相关（分别为-0.41/-0.42），由娱乐训练组引领（分别为-0.54/-0.46）。
这些发现表明，临床显著的抑郁/PTSD 症状严重程度与显著的负性全局元认知偏差相关，并初步表明认知训练可能改善这些偏差和抑郁/PTSD 症状严重程度。
