METHODS: The study recruited 229 individuals given a diagnosis of schizophrenia and schizoaffective disorders from outpatient clinics and the day ward of a mental health hospital. After informed consent was obtained, the participants underwent assessments using the backward digit span, the digit symbol, and measures of self-defeatist beliefs, experiential negative symptoms, and social functioning. A structural equation model was applied to assess the fitness of the hypothesized model, with indices such as the goodness-of-fit index, comparative fit index, root mean square error of approximation, and standardized root mean square residual being used for model evaluation.
RESULTS: The hypothesized model had an adequate fit. The study findings indicated that neurocognition might indirectly influence self-defeatist beliefs through its effect on experiential negative symptoms. Contrary to expectations, the study did not observe a direct influence of neurocognition, self-defeatist beliefs, or negative symptoms on social functioning. The revised model revealed the role of experiential negative symptoms in mediating the association between neurocognition and social functioning. However, self-defeatist beliefs did not significantly affect social functioning.
CONCLUSIONS: Before modifying negative thoughts, enhancement of self-awareness ability can help improve negative symptoms and thereby improve the performance of social functions. Future research should develop a hierarchical program of negative symptoms, from cognition rehabilitation to enhancement of self-awareness, and end with modifying maladaptive beliefs.
方法:这项研究招募了229名被诊断为精神分裂症和分裂情感障碍的人,他们来自精神健康医院的门诊和日间病房。在获得知情同意后,参与者使用向后数字跨度进行评估,数字符号,以及自欺欺人的信念的衡量标准,经验阴性症状,和社会功能。应用结构方程模型来评估假设模型的适合度,利用拟合优度指数等指数,比较拟合指数,逼近的均方根误差,标准化均方根残差用于模型评估。
结果:假设模型具有足够的拟合度。研究结果表明,神经认知可能通过对经验阴性症状的影响间接影响自欺欺人的信念。与预期相反,这项研究没有观察到神经认知的直接影响,自欺欺人的信念,或社会功能的负面症状。修订后的模型揭示了经验阴性症状在介导神经认知与社会功能之间的关系中的作用。然而,自欺欺人的信念并没有显着影响社会功能。
结论:在改变消极思想之前,增强自我意识能力有助于改善阴性症状,从而提高社会功能的表现。未来的研究应该制定一个阴性症状的分层程序,从认知康复到自我意识的增强,并以修改适应不良的信念结束。