Investigation of metamemory functioning in the at-risk mental state for psychosis
Investigation of metamemory functioning in the at-risk mental state for psychosis
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DOI：
10.1017/s0033291715001373
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发表时间：
2015-11-01
影响因子：
6.9
通讯作者：
Zink, M.
中科院分区：
文献类型：
--
作者：
Eisenacher, S.;Rausch, F.;Zink, M.
背景。元记忆描述了对一个人的记忆能力的监控和了解。在以前的研究中，精神分裂症患者被要求提供回顾性的信心评级时，发现他们区分正确和错误答案的能力较差（信心差距较小）。此外，在该患者组中发现了更高比例的非常高自信但错误的反应（高知识腐败）。这些偏见是否以及如何促成精神病的早期发病机制尚不清楚。本研究旨在探讨精神病早期的元记忆功能。在言语识别任务结合回顾性置信度评分的情况下，对处于精神病高危精神状态的患者（ARMS, n = 34）、首次精神病发作的患者（FEP, n = 21）和健康对照（hc, n = 38）进行比较。FEP患者的置信差最小，ARMS患者次之，hc患者次之。各组之间存在显著差异。在知识腐败方面，FEP患者与hc患者存在显著差异，而ARMS组与FEP组之间存在统计学差异。元记忆、阳性症状测量和工作记忆表现之间存在相关性。这些数据强调了在ARMS患者中存在的元记忆偏倚，而在FEP患者中更为明显。这种偏差可能代表了早期精神病状态的认知标志。需要纵向研究来揭示元认知缺陷是否预示着向精神病的转变，并评估治疗干预措施。
Background. Metamemory describes the monitoring and knowledge about one's memory capabilities. Patients with schizophrenia have been found to be less able in differentiating between correct and false answers (smaller confidence gap) when asked to provide retrospective confidence ratings in previous studies. Furthermore, higher proportions of very-high-confident but false responses have been found in this patient group (high knowledge corruption). Whether and how these biases contribute to the early pathogenesis of psychosis is yet unclear. This study thus aimed at investigating metamemory function in the early course of psychosis.Method. Patients in an at-risk mental state for psychosis (ARMS, n = 34), patients with a first episode of psychosis (FEP, n = 21) and healthy controls (HCs, n = 38) were compared on a verbal recognition task combined with retrospective confidence-level ratings.Results. FEP patients showed the smallest confidence gap, followed by ARMS patients, followed by HCs. All groups differed significantly from each other. Regarding knowledge corruption, FEP patients differed significantly from HCs, whereas a statistical trend was revealed in comparison of ARMS and FEP groups. Correlations were revealed between metamemory, measures of positive symptoms and working memory performance.Conclusions. These data underline the presence of a metamemory bias in ARMS patients which is even more pronounced in FEP patients. The bias might represent an early cognitive marker of the beginning psychotic state. Longitudinal studies are needed to unravel whether metacognitive deficits predict the transition to psychosis and to evaluate therapeutic interventions.