目的:进行了两项研究来验证认知洞察力的简要测量,并将其与经验模型-认知意识模型(CAM)进行比较。
方法:一项初步研究包括31名(52%为男性;Mage=69.42)来自门诊神经心理学评估诊所的患者。7名患者被诊断为可能患有老年痴呆症(AD),15轻度认知障碍(MCI),和9没有诊断(即,认知正常;CN)。实施了认知编码表格(CCF)和其他几项措施。研究2涉及240例患者的档案数据提取(80CN,80MCI和80AD;53.3%为女性;Mage=72.8),以检查CCF是否可以预测记忆(韦克斯勒记忆量表-IV)和执行功能(跟踪测试B)。
结果:初步研究发现了8项CCF的收敛和判别效度的初步证据。研究2证实,患者报告的认知问题(F(2,237)=10.40,p<.001,ω2=.07,功率=.99)和,更强烈,CCF信息-患者差异评分(F(2,237)=24.52,p<.001,ω2=.16,功率=.99)可以将CNs与MCI和AD区分开。回归表明抑郁(5.5%;β=-.38,p<.001)和TMT-B(13%;β=-.43,p<.001),合计占洞察力方差的18.5%(R2=.19,F(2,219)=26.10,p<.001),支持CAM。
结论:这些研究建立了一种有效的洞察力测量方法,具有很高的临床实用性,并为文献提供了有关洞察力在预测阿尔茨海默病病理表现中的作用的文献。
OBJECTIVE: Two studies were performed to validate a brief measure of cognitive insight and compare it to an empirical model - the Cognitive Awareness Model (CAM).
METHODS: A pilot study included 31 (52% male; Mage = 69.42) patients from an outpatient neuropsychological assessment clinic. Seven patients were diagnosed with likely Alzheimer\'s dementia (AD), 15 mild cognitive impairment (MCI), and 9 no diagnosis (i.e., cognitively normal; CN). The Cognitive Coding Form (CCF) and several other measures were administered. Study 2 entailed archival data extraction of 240 patients (80 CN, 80 MCI, and 80 AD; 53.3% female; Mage = 72.8) to examine whether the CCF predicts memory (Wechsler Memory Scale - IV) and executive functioning (Trail-Making Test B).
RESULTS: The pilot study found preliminary evidence of convergent and discriminant validity for the 8-item CCF. Study 2 confirmed that both patient-reported cognitive concerns (F(2,237) = 10.40, p < .001, ω2 = .07, power = .99) and, more strongly, CCF informant-patient discrepancy scores (F(2,237) = 24.52, p < .001, ω2 = .16, power = .99) can distinguish CNs from those with MCI and AD. A regression indicated that depression (5.5%; β = -.38, p < .001) and TMT-B (13%; β = -.43, p < .001), together accounted for 18.5% of the variance in insight (R2 = .19, F(2,219) = 26.10, p < .001), supporting the CAM.
CONCLUSIONS: These studies establish an efficient measure of insight with high clinical utility and inform the literature on the role of insight in predicting performance in those with Alzheimer\'s pathology.