A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances.
Por:
García-Mieres H, Lundin NB, Minor KS, Dimaggio G, Popolo R, Cheli S and Lysaker PH
Publicada:
1 dic 2020
Ahead of Print:
14 sep 2020
Resumen:
The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive symptoms interact and thus interfere with persons' ability to understand and express emotions in ways others can recognize. Individuals with schizophrenia-spectrum disorders (N = 201) provided personal narratives detailing their life story and reflections about their mental illness. Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants' personal narratives via Coh-Metrix 3.0, an automated program that calculates language indices. Diminished expression and cognitive symptoms were measured with the Positive and Negative Syndrome Scale. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive symptoms and situation models on diminished expression. Results of the SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (ß = -.073, p = .008, ±95% CI [-0.126, -0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (ß = 0.099, p = .001, ±95% CI [0.038, 0.160]). In conclusion, results suggest that self-reflectivity, linguistic cohesion, and cognitive symptoms may be useful targets for intervention in efforts to treat diminished expression in psychosis.
Filiaciones:
García-Mieres H:
Research and Development Unit. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
Lundin NB:
Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, 1101 E. 10th Street, Bloomington, IN, 47405, United States. Electronic address:
Minor KS:
Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford Street, Indianapolis, IN, 46202, United States
Dimaggio G:
Centro di Terapia Metacognitiva Interpersonale, Piazza dei Martiri di Belfiore 4, 00151, Rome, Italy
Popolo R:
Centro di Terapia Metacognitiva Interpersonale, Piazza dei Martiri di Belfiore 4, 00151, Rome, Italy
Cheli S:
The Center for Psychology and Health, Tages Onlus, via della Torretta 14, 50137, Florence, Italy
Lysaker PH:
Department of Psychiatry, Richard L. Roudebush VA Medical Center, 116A, 1481 W. 10th Street, Indianapolis, IN, 46202, United States
Indiana Univeristy School of Medicine, Department of Psychiatry, 541 Clinical Drive, Indianapolis, IN, 46202, USA
Green Accepted, Green Submitted, Bronze
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