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A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances
- Source :
- J Psychiatr Res
- Publication Year :
- 2020
-
Abstract
- 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 (β = −.073, p = .008, ±95% CI [-0.126, −0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (β = 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.
- Subjects :
- Cognitive model
Psychosis
Positive and Negative Syndrome Scale
Metacognition
medicine.disease
Mental illness
Structural equation modeling
Article
030227 psychiatry
03 medical and health sciences
Psychiatry and Mental health
0302 clinical medicine
Expression (architecture)
Psychotic Disorders
Schizophrenia
medicine
Humans
Schizophrenic Psychology
Psychology
030217 neurology & neurosurgery
Biological Psychiatry
Clinical psychology
Language
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Psychiatr Res
- Accession number :
- edsair.doi.dedup.....77e303a60d49d4ca7361d714960289e2