Defeatist performance beliefs in individuals at clinicalhigh-riskfor psychosis and outpatients with chronic schizophrenia
Defeatist performance beliefs in individuals at clinicalhigh-riskfor psychosis and outpatients with chronic schizophrenia
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DOI：
10.1111/eip.13024
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发表时间：
2020-08-02
影响因子：
2
通讯作者：
Strauss, Gregory P.
中科院分区：
文献类型：
--
作者：
Clay, Kendall B.;Raugh, Ian M.;Strauss, Gregory P.
目的 先前的研究表明，精神分裂症慢性期 (SZ) 患者的失败主义表现信念 (DPB) 升高，并与阴性症状、功能结果和神经认知障碍相关。然而，尚不清楚这些相同的结果模式是否适用于精神病临床高风险（CHR）的参与者。方法 进行了两项研究以确定 SZ 的先前结果是否可以复制并扩展到 CHR。研究 1 的参与者包括 184 名健康对照者 (CN) 和 186 名患有慢性 SZ 的门诊患者，研究 2 的参与者包括 30 名 CN 和 35 名 CHR。在这两项研究中，参与者完成了 DPB 量表以及阴性症状、心理社会功能和神经认知的测量。结果 与 CN 相比，慢性 SZ 和 CHR 参与者的 DPB 均升高（p < .01）。在深圳，较高的 DPB 与较大的阴性症状 (r's = .31-.37，p's < .01)、较差的社会功能和受损的社会认知 (r = -.40，P < .001) 相关。在 CHR 中，较大的 DPB 与较差的社会功能 (r = -.52，P < .05) 以及推理神经认知领域的损伤 (r = -.48，P < .05) 和处理速度 (r = -.41，P < .05) 相关。测试 DPB 是否介导阴性症状与功能、阴性症状与认知以及认知与功能之间的联系的模型在 SZ 和 CHR 样本中不显着。结论 研究结果通常为阴性症状和功能的认知模型提供支持，并表明 DPB 是精神疾病各个阶段的重要临床目标。
Aim Prior studies indicate that defeatist performance beliefs (DPBs) are elevated in those in the chronic phase of schizophrenia (SZ) and associated with negative symptoms, functional outcome and neurocognitive impairment. However, it is unclear whether these same patterns of results hold in participants at clinical high-risk (CHR) for psychosis. Methods Two studies were conducted to determine whether prior results in SZ could be replicated and extended to CHR. Participants included 184 healthy controls (CN) and 186 outpatients with chronic SZ for Study 1, and 30 CN and 35 CHR in Study 2. In both studies, participants completed the DPB scale and measures of negative symptoms, psychosocial functioning and neurocognition. Results Both chronic SZ and CHR participants had elevated DPBs compared to CN (p's < .01). In SZ, higher DPBs were associated with greater negative symptoms (r's = .31-.37,p's < .01), poorer social functioning and impaired social cognition (r = -.40,P < .001). In CHR, greater DPBs were associated with poorer social functioning (r = -.52,P < .05) and impairments in the neurocognitive domains of reasoning (r = -.48,P < .05) and processing speed (r = -.41,P < .05). Models testing whether DPBs mediated links between negative symptoms and functioning, negative symptoms and cognition and cognition and functioning were nonsignificant in SZ and CHR samples. Conclusions Findings generally provide support for the cognitive model of negative symptoms and functioning and suggest that DPBs are an important clinical target across phases of psychotic illness.