فراشناخت در روایات اسکیزوفرنی: ارتباط با حوزه های مختلف شناخت عصبی

Research has suggested many with schizophrenia experience impairments in metacognition, or difficulties apprehending their own thoughts and the thoughts of others, and that those deficits are not reducible to a single symptom or cognitive impairment. While links between metacognition and more severe levels of symptoms have emerged, less clear is whether there are consistent associations between metacognition and other neurocognitive capacities. Accordingly the current study sought to examine whether different patterns of metacognition deficits have different neurocognitive correlates. Narratives were gathered from 69 adults with schizophrenia spectrum disorder using the Indiana Psychiatric Illness Interview along with a symptom interview and neurocognitive battery including subtests of the Wechsler Adult Intelligence Scale III, Wechsler Memory Scale III and the Wisconsin Card Sorting Test. Metacognitive capacity within the narrative interview was assessed using the Metacognition Assessment Scale and participants were divided based on those scores into three groups: minimal self-reflectivity/not decentered (n = 25); basic self-reflectivity/not decentered (n = 33); and basic self-reflectivity/decentered (n = 11). Basic self-reflectivity refers to the ability to distinguish one's own thoughts and feelings while decentered refers to the ability to see others as having independent perspectives and relationships with one another. MANOVA and ANOVA comparing groups revealed that the participants lacking basic self-reflectivity had significantly poorer working memory and more symptoms of disorganization, while participants able to see others as having independent perspectives and relationships demonstrated better visual memory. Results suggest different deficits in metacognition may be linked to different neurocognitive capacities.

Terms such as “Metacognition,” “Theory of Mind,” and “Mentalizing” refer to a person's general capacity to think about thinking, both their own thinking and the thinking of others. These terms, while often used interchangeably to refer to a general aptitude, involve a wide range of semi independent faculties which allow persons to represent their own mental states and the mental states of others, to form, revise and reform ideas of what is believed, felt, dreamt of, feared, feigned or pretended (Frith, 1992). These capacities consequently allow humans to make meaning of their dilemmas, to understand one another's intentions, and to ultimately adapt to a changing environment. In this paper we have selected to use the term metacognition to refer to this general set of phenomenon because of its potential to describe a wide range of internal and socially driven cognitive acts which contain primarily reflexive qualities (e.g. Semerari et al., 2003). Admittedly there is much in common between this term and theory of mind, which has been defined, for instance, as the “capacity to represent one's own and other persons' mental states” (Brune, 2005, p 21).