Negative symptoms can be linked to Bleuler’s concept of splitting or fragmentation of thought, affect, and will. Research has shown a link between disturbances in metacognition and negative symptoms, although relatively few studies have examined this relationship longitudinally. The aim of this article is to examine whether metacognitive capacity among patients with first episode psychosis (FEP) predicted negative symptoms after a follow-up period of 3 years. Metacognition was assessed using the Metacognition Assessment Scale abbreviated and symptoms were assessed using Positive and Negative Syndrome Scale among 59 adults with FEP. Symptoms were then reassessed at a 3-year follow-up. Significant correlations were found between baseline metacognitive scores and the expressive component of negative symptoms as well as for individual negative symptoms such as blunted affect, poor rapport, and alogia at 3-year follow-up after controlling for baseline negative symptoms. Self-reflectivity was significantly correlated with the expressive component of negative symptoms at 3-year follow-up. The results are partly consistent with a Bleulerian model which understands the emergence of negative symptoms as a response in part to the experience of fragmentation, particularly in terms of sense of self and others. Future research should clarify the likely role of metacognition in the development and maintenance of negative symptoms.

中文翻译：

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初发精神病的元认知能力和阴性症状：三年随访中前瞻性关系的证据

负面症状可以与布莱勒的思想，情感和意志分裂或支离破碎的概念联系在一起。研究表明元认知障碍和负面症状之间存在联系，尽管相对较少的研究从纵向上检查了这种关系。本文的目的是研究首发精神病（FEP）患者的3年随访后，其元认知能力是否预测为阴性症状。在59名FEP成人中，使用缩写的元认知评估量表评估元认知，并使用阳性和阴性综合征量表评估症状。然后在3年的随访中重新评估症状。在控制基线阴性症状后的3年随访中，发现基线元认知评分与阴性症状的表达成分以及个体阴性症状（如钝痛，融洽关系和失语）之间存在显着相关性。在三年的随访中，自反性与阴性症状的表达成分显着相关。结果部分与布鲁利安模型一致，该模型理解负面症状的出现，部分原因是对分裂经历的反应，特别是在自我意识和他人方面。未来的研究应阐明元认知在负面症状发展和维持中的可能作用。在控制基线阴性症状后的3年随访中出现失语。在三年的随访中，自反性与阴性症状的表达成分显着相关。结果部分与布鲁利安模型一致，该模型理解负面症状的出现，部分原因是对分裂经历的反应，特别是在自我意识和他人方面。未来的研究应阐明元认知在负面症状发展和维持中的可能作用。在控制基线阴性症状后的3年随访中出现失语。在三年的随访中，自反性与阴性症状的表达成分显着相关。结果部分与布鲁利安模型一致，该模型理解负面症状的出现，部分原因是对分裂经历的反应，特别是在自我意识和他人方面。未来的研究应阐明元认知在负面症状发展和维持中的可能作用。特别是在自我意识和他人方面。未来的研究应阐明元认知在负面症状发展和维持中的可能作用。特别是在自我意识和他人方面。未来的研究应阐明元认知在负面症状发展和维持中的可能作用。