Cognitive insight refers to awareness of one's own thinking. Research has found deficits in cognitive insight in schizophrenia but studies of its links with positive symptoms and delusions have been equivocal. One possibility is that the association of cognitive insight with positive symptoms and delusions is moderated by other factors. To explore this issue this study examined whether level of socially naive self-appraisal moderated the relationship of two forms of cognitive insight, self-reflectivity and self-certainty with delusions and positive symptoms. Participants were 92 adults, with diagnoses of schizophrenia or schizoaffective disorder, who were administered the Positive and Negative Syndrome Scale, self-deceptive subscale from the Marlowe-Crowne Social Desirability Scale and the Beck Cognitive Insight Scale. Stepwise multiple regressions with the interaction term of the predictive and moderator variables suggested that social naiveté moderates the relationship between self-reflectivity and self-certainty with positive symptoms in general. Moreover, association between self-certainty and delusions was also moderated by social naiveté self-appraisal. All models were significant after controlling for willful impression management as well as a measure of executive function. Results suggest that higher levels of self-certainty are a risk factor for having greater positive symptoms including more severe levels of delusions, when one has a view of oneself that is not tempered by the perceptions of others. Concerning lower levels of self-reflectivity it may be that this combined with a socially naïve view of oneself leaves persons less inhibited when they are tempted to accept unusual thoughts and perceptions as accurate. Implications for treatment are discussed.

译文

:认知洞察力是指对自己的思想的认识。研究发现精神分裂症的认知洞察力不足,但对其与阳性症状和妄想的联系的研究却模棱两可。一种可能性是认知洞察力与积极症状和妄想之间的关联受到其他因素的调节。为了探讨这个问题,本研究探讨了社交天真的自我评价水平是否调节了两种形式的认知洞察力,自我反思性和自我确定性与妄想和积极症状之间的关系。参加者为92位诊断为精神分裂症或精神分裂症的成年人,他们接受了阳性和阴性综合征量表,Marlowe-Crowne社会期望量表的自我欺骗性子量表和Beck认知洞察量表。预测变量和调节变量的交互项的逐步多元回归表明,天真的社交关系调节了自我反映和自我确定之间总体上带有积极症状的关系。此外,社会天真的自我评价也调节了自我确定性与妄想之间的联系。在控制了故意的印象管理以及执行功能的度量之后,所有模型都是有意义的。结果表明,当一个人对自己的看法没有被他人的看法所抑制时,较高的自我确定性是具有较高积极症状(包括较严重的妄想)的危险因素。关于较低的自我反省度,这可能是因为当人们试图接受不正确的思想和观念时,人们的社交天真观感会受到较少的抑制。讨论了对治疗的意义。

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