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思维的认识。研究发现精神分裂症的认知能力不足,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的关联受到其他因素的调节。为了探讨这个问题,本研究检查了社交天真的自我评估水平是否调节了两种认知洞察力,自我反射和自我确定性与妄想和积极症状之间的关系。参与者为92名诊断为精神分裂症或分裂情感障碍的成年人,他们接受了阳性和阴性综合征量表,Marlowe-Crowne社会期望量表和Beck认知洞察力量表的自我欺骗性量表。具有预测变量和调节变量相互作用项的逐步多元回归表明,社会天真通常会缓和自我反射性和自我确定性与积极症状之间的关系。此外,社会天真的自我评估也减轻了自我确定性和妄想之间的联系。在控制了故意的印象管理以及执行功能的度量之后,所有模型都很重要。结果表明,当一个人对自己的看法不受他人的看法影响时,较高的自我确定性水平是出现更大积极症状 (包括更严重的妄想) 的危险因素。关于较低的自我反射率,这可能与对自己的社会天真的看法相结合,使人们在试图接受不寻常的想法和看法准确时受到的抑制较小。讨论了对治疗的影响。

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