Metacognitive capacity and negative symptoms in first episode psychosis: Evidence of a prospective relationship over a 3-year follow-up
Metacognitive capacity and negative symptoms in first episode psychosis: Evidence of a prospective relationship over a 3-year follow-up
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DOI：
10.1177/2043808718821572
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发表时间：
2019-01-06
影响因子：
1.4
通讯作者：
Simonsen, Erik
中科院分区：
文献类型：
--
作者：
Austin, Stephen Fitzgerald;Lysaker, Paul H.;Simonsen, Erik
阴性症状可能与布莱德利的思想、情感和意志分裂或碎片化的概念有关。研究表明，元认知障碍和阴性症状之间存在联系，尽管相对较少的研究纵向研究这种关系。本文的目的是检查是否元认知能力的首次发作精神病（FEP）患者的阴性症状的随访期后3年。采用简化的元认知评定量表评定59例成人FEP患者的元认知，采用阳性和阴性症状量表评定症状。然后在3年随访时重新评估症状。在控制基线阴性症状后的3年随访中，发现基线元认知评分与阴性症状的表达成分以及个体阴性症状（如情感迟钝、关系不佳和失语症）之间存在显著相关性。在3年的随访中，自我反射与阴性症状的表达成分显著相关。这些结果与布勒勒的模型部分一致，该模型将负面症状的出现理解为部分对碎片化体验的反应，特别是在自我和他人感方面。未来的研究应该阐明元认知在阴性症状的发展和维持中可能发挥的作用。
Negative symptoms can be linked to Bleuler's concept of splitting or fragmentation of thought, affect, and will. Research has shown a link between disturbances in metacognition and negative symptoms, although relatively few studies have examined this relationship longitudinally. The aim of this article is to examine whether metacognitive capacity among patients with first episode psychosis (FEP) predicted negative symptoms after a follow-up period of 3 years. Metacognition was assessed using the Metacognition Assessment Scale abbreviated and symptoms were assessed using Positive and Negative Syndrome Scale among 59 adults with FEP. Symptoms were then reassessed at a 3-year follow-up. Significant correlations were found between baseline metacognitive scores and the expressive component of negative symptoms as well as for individual negative symptoms such as blunted affect, poor rapport, and alogia at 3-year follow-up after controlling for baseline negative symptoms. Self-reflectivity was significantly correlated with the expressive component of negative symptoms at 3-year follow-up. The results are partly consistent with a Bleulerian model which understands the emergence of negative symptoms as a response in part to the experience of fragmentation, particularly in terms of sense of self and others. Future research should clarify the likely role of metacognition in the development and maintenance of negative symptoms.