Metacognition and schizophrenia: The capacity for self-reflectivity as a predictor for prospective assessments of work performance over six months
Metacognition and schizophrenia: The capacity for self-reflectivity as a predictor for prospective assessments of work performance over six months
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DOI：
10.1016/j.schres.2009.04.024
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发表时间：
2010-09-01
影响因子：
4.5
通讯作者：
Nicolo, Giuseppe
中科院分区：
文献类型：
--
作者：
Lysaker, Paul H.;Dimaggio, Giancarlo;Nicolo, Giuseppe
研究表明，许多精神分裂症患者在元认知能力方面存在缺陷，元认知能力的定义是思考能力的障碍。这些困难与症状有关，但不能归因于症状，并被假设为心理社会功能的独立障碍。为了探讨自我反思性这一元认知领域的缺陷是否会成为有效工作功能的障碍，56名精神分裂症患者根据接受工作安置前的一次访谈，根据他们的自我反省能力被分为三组。然后对这三组人在接下来的六个月里的工作表现进行盲法评分。重复测量方差分析的结果显示，被评为具有最高元认知水平的组，即能够看到他们的结论是主观的和容易出错的，随着时间的推移，他们对工作表现的评分高于自我反省水平中等和低水平的组。这些发现被发现即使在对执行功能测试的损害进行统计学控制的情况下也是如此。结果被解释为与新兴模型一致，即元认知缺陷可能是严重精神疾病的关键特征，影响功能。文中还讨论了其临床和理论意义。爱思唯尔出版公司(Elsevier B.V.)
Research has indicated that many with schizophrenia experience deficits in metacognitive capacity, defined as impairments in the ability to think about thinking. These difficulties are related to, but not reducible to symptoms and have been hypothesized to function as an independent impediment to psychosocial function. To explore the possibility that deficits in one domain of metacognition, self-reflectivity, are a barrier to effective work function, 56 participants with schizophrenia were categorized into three groups according to their capacity for self reflection based on an interview conducted prior to accepting a job placement. Blind ratings of work performance of these three groups over the next six months were then compared. Results of repeated measures ANOVA revealed that the group rated as having the highest level of metacognition, that is, able to see that their conclusions are subjective and fallible, had higher ratings of work performance over time than groups with medium and low levels of self reflectivity. These findings were found to persist even when impairment on a test of executive function was controlled for statistically. Results are interpreted as consistent with emerging models that deficits in metacognition may be key features of severe mental illness which affect function. Clinical and theoretic implications are discussed. Published by Elsevier B.V.