Abstract：
OBJECTIVE: The Cognitive Model of Negative Symptoms is a prominent model that posits that defeatist performance beliefs (DPB) are a key psychological mechanism underlying negative symptoms in those with schizophrenia (SZ). However, the ecological validity of the model has not been established, and temporally specific evaluations of the model\'s hypotheses have not been conducted. This study tested the model\'s key hypotheses in real-world environments using ecological momentary assessment (EMA).
METHODS: Fifty-two outpatients with SZ and 55 healthy controls (CN) completed 6 days of EMA. Multilevel models examined concurrent and time-lagged associations between DPB and negative symptoms in daily life.
RESULTS: SZ displayed greater DPB in daily life than CN. Furthermore, greater DPB were associated with greater concurrently assessed negative symptoms (anhedonia, avolition, and asociality) in daily life. Time-lagged analyses indicated that in both groups, greater DPB at time t led to elevations in negative symptoms (anhedonia, avolition, or asociality) at t + 1 above and beyond the effects of negative symptoms at time t.
CONCLUSIONS: Results support the ecological validity of the Cognitive Model of Negative Symptoms and identify a temporally specific association between DPB and subsequent negative symptoms that is consistent with the model\'s hypotheses and a putative mechanistic pathway in Cognitive Behavioral Therapy for negative symptoms. Findings suggest that DPB are a psychological factor contributing to negative symptoms in real-world environments. Implications for measuring DPB in daily life and providing just-in-time mobile health-based interventions to target this mechanism are discussed.
METHODS: Fifty-two outpatients with SZ and 55 healthy controls (CN) completed 6 days of EMA. Multilevel models examined concurrent and time-lagged associations between DPB and negative symptoms in daily life.
RESULTS: SZ displayed greater DPB in daily life than CN. Furthermore, greater DPB were associated with greater concurrently assessed negative symptoms (anhedonia, avolition, and asociality) in daily life. Time-lagged analyses indicated that in both groups, greater DPB at time t led to elevations in negative symptoms (anhedonia, avolition, or asociality) at t + 1 above and beyond the effects of negative symptoms at time t.
CONCLUSIONS: Results support the ecological validity of the Cognitive Model of Negative Symptoms and identify a temporally specific association between DPB and subsequent negative symptoms that is consistent with the model\'s hypotheses and a putative mechanistic pathway in Cognitive Behavioral Therapy for negative symptoms. Findings suggest that DPB are a psychological factor contributing to negative symptoms in real-world environments. Implications for measuring DPB in daily life and providing just-in-time mobile health-based interventions to target this mechanism are discussed.
摘要：
目的：阴性症状的认知模型是一个突出的模型，它认为失败表现信念（DPB）是精神分裂症患者阴性症状的关键心理机制。然而,模型的生态有效性尚未建立，并且尚未对模型的假设进行具体的评估。本研究使用生态瞬时评估（EMA）在现实环境中测试了模型的关键假设。
方法：52名SZ门诊患者和55名健康对照（CN）完成了6天的EMA治疗。多水平模型检查了DPB与日常生活中阴性症状之间的并发和时滞关联。
结果：SZ在日常生活中显示出比CN更高的DPB。此外，更高的DPB与更高的同时评估的阴性症状相关(快感缺失，废除,和可用性)在日常生活中。时滞分析表明，在两组中，在时间t增加DPB导致阴性症状升高(快感缺失，废除,在t1时高于或超出时间t时阴性症状的影响。
结论：结果支持阴性症状认知模型的生态有效性，并确定了DPB与随后的阴性症状之间的时间特异性关联，这与模型的假设和阴性症状认知行为治疗中假定的机制途径一致。研究结果表明，DPB是导致现实环境中负面症状的心理因素。讨论了在日常生活中测量DPB并提供基于实时移动健康的干预措施以针对该机制的含义。
方法：52名SZ门诊患者和55名健康对照（CN）完成了6天的EMA治疗。多水平模型检查了DPB与日常生活中阴性症状之间的并发和时滞关联。
结果：SZ在日常生活中显示出比CN更高的DPB。此外，更高的DPB与更高的同时评估的阴性症状相关(快感缺失，废除,和可用性)在日常生活中。时滞分析表明，在两组中，在时间t增加DPB导致阴性症状升高(快感缺失，废除,在t1时高于或超出时间t时阴性症状的影响。
结论：结果支持阴性症状认知模型的生态有效性，并确定了DPB与随后的阴性症状之间的时间特异性关联，这与模型的假设和阴性症状认知行为治疗中假定的机制途径一致。研究结果表明，DPB是导致现实环境中负面症状的心理因素。讨论了在日常生活中测量DPB并提供基于实时移动健康的干预措施以针对该机制的含义。
