元认知视角下的强迫症的特征、模型及干预

强迫症的元认知模型认为, 元认知是理解强迫症病理的关键。强迫症患者存在错误的元认知知识信念、消极的元认知体验及不恰当使用元认知策略等问题。强迫症的元认知疗法强调思维过程(如自我聚焦注意、对担忧不变的思维风格和威胁调节的注意策略等)的重要性, 而非思维的具体内容, 并在个体心理干预、团体心理干预等研究中显示出较好的疗效。未来研究应从认知神经科学等视角考查强迫症的记忆等元认知特征, 并进一步验证和修正强迫症的元认知模型。     

强迫症的元认知研究:进展与趋势

该文分析了强迫症患者在现实监控、知道感、元认知信念和责任控制等方面的研究,发现缺乏对不同类型强迫症元认知差异的研究、被试选取的典型性和代表型有待提高,现实监控障碍的身心原因尚不明确、责任-控制障碍形成的机制研究不足.指出元认知干预的强迫症治疗范式、强迫症与其他精神症元认知障碍的比较、强迫症元认知的认知神经科学探索和强迫性网络使用的元认知机制等是未来研究的趋势.     

认知操作背景下在线元认知调节能力的特征

利用认知任务为载体,对在线元认知调节特征进行研究,探讨了在线元认知调节的跨任务一致性和规则特异性。实验采用字母记忆与跟踪击键两种任务作为在线元认知调节的载体,通过逐步增加“提示线索”,观测个体在任务作业上的“成绩”（字母作业任务）或“成绩提高量”（跟踪击键任务）,以此作为评价在线元认知调节能力的指标。结果发现,随着认知任务中潜在规律线索数量的增加,被试能够通过在线元认知调节过程提高其认知作业水平;被试通过认知任务与追述报告分别反映的在线元认知调节水平具有一致性;在线元认知调节一方面具有跨任务情境的一致性,另一方面具有规则发现的差异性。因此,基于认知操作为背景的元认知评价方法能够较好地评估在线元认知调节能力     

元认知在线监控和离线监控与一般元认知能力的关系

该研究探索元认知在线监控和离线监控与一般元认知能力之间的关系,采用跟踪击键任务、学习判断任务和大学生元认知能力量表,对40名大学生进行研究。结果表明:(1)元认知离线监控对一般元认知能力各个子成分的预测作用受元认知在线监控的影响;(2)元认知在线、离线监控对一般元认知能力的预测作用是彼此独立的。     

元认知的性质、结构与评定方法

对元认知的性质、结构及评定方法等一系列问题进行了探讨。首先介绍了“元”概念产生的哲学根源及其哲学涵义,以及元认知模型的基本特点;重点分析了元认知与认知的区别;在前人研究的基础上提出元认知有三个成分：元认知知识、元认知体验和认知调节;并总结了元认知评定的主要方法;最后对元认知研究中存在的主要问题及其研究前景作了分析。     

离线元认知调节的结构探索与验证

离线元认知调节指脱离具体任务情境后,个体在整体层面对自身活动的规划、管理、归纳反省并重新评价的过程。与在线元认知调节相结合,可以使元认知对行为的调节作用得到更加完整有力地发挥。本研究探索了离线元认知调节的测量学结构,开发出相应的测量工具,并且在职业测评领域通过实践检验。研究一编制离线调节量表,对离线元认知调节结构进行探索,得到全局规划、洞察力和整合概化三个维度;研究二对工具的效度进行实证检验,通过层次Logistic回归分析,发现公司中层领导与普通员工在离线调节水平上存在差异,验证了该工具的实证效度。研究结果证明离线调节量表具有较好的心理测量学品质,可以应用于相关的实践领域。     

儿童、青年与老年人在知觉和高阶元认知监控上的年龄差异

元认知是以监测和控制为核心的动态调节活动。本研究以9岁儿童、年轻人和老年人为研究对象，分别采用选点任务和词对学习任务，在知觉元认知和高阶元认知层次考察元认知监测和控制及其关系随年龄变化的特点。结果显示：(1)儿童的知觉元认知和高阶元认知监控能力大都低于年轻人；(2)老年人的知觉元认知能力与年轻人相似，但高阶元认知能力则低于年轻人；(3)老年人和年轻人一样能够在记忆监测中利用控制线索，而9岁儿童尚未表现出这种能力。本研究从发展的角度，支持了知觉元认知与高阶元认知能力具有领域特殊性的理论假设，并对监测和控制的关系发展进行了讨论。     

元认知的调节过程及其领域一般性问题的分析

元认知是个体对自身认知的动态的调节活动.该文界定了元认知调节的六个基本过程,总结了常见的研究范式,并着重探讨了元认知调节领域一般性的研究结果.大多数结果支持元认知调节的领域一般性;但随着认知任务带来的心理负荷程度不同,元认知调节活动也会表现出一定的领域特殊性.研究者提出,通过比较元认知调节过程在不同领域的变化或发展趋势,可以从另一个角度来探讨元认知调节的领域一般性问题.     

元认知的本质与要素

该文就元认知的本质和要素进行了探讨。文章首先对已有的相关观点进行了分析,在此基础上,将元认知的内涵界定为“个体对当前认知活动的认知调节”,并确定了元认知活动的三要素,即元认知技能、元认知知识、元认知体验,论述了每一要素在元认知活动中的作用,并以元认知三要素关系示意图描述了三者之间的关系。     

元认知的神经机制:元认知功能、脑区与脑网络

元认知是指个体对当前进行的认知活动的监测和调节。通过对元认知神经机制研究的梳理,归纳出两条研究主线:一条主线以具体元认知加工的脑区激活研究为主,主要考察元认知与认知过程的分离及典型元认知加工的共享性和特异性。研究发现元认知加工主要与前额叶有关,还涉及脑岛、顶叶、颞叶和楔前叶等部分脑区。另一条主线探讨广泛的元认知功能与广泛大脑网络的相关。研究提出了大脑的“元认知网络”的概念,发现脑损伤或病变造成的元认知功能损伤与脑功能网络有关,而非固定在某一特定脑区。建议未来的研究应重视四个方面的研究:元认知加工的具体脑区和脑功能网络,元认知神经机制的分离,元认知脑功能的损伤和元认知训练的改善作用,以及基于神经机制研究的元认知模型的建构与修正。     

Anxiety and selective attention in obsessive-compulsive disorder

Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive-compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.     

Implicit learning, thought-focused attention and obsessive-compulsive disorder: a replication and extension

Although significant empirical support exists for both cognitive and neurobiological models of obsessive-compulsive disorder (OCD), there have been few efforts to integrate findings. In this investigation, we attempted to link models by examining relationships between performance on information processing tasks posited to be markers of OCD-related neuropathology and a self-report measure of excessive thought-focused attention (cognitive self-consciousness; CSC). Congruent with predictions and prior research, OCD patients' performance was impaired in comparison to an anxious control group on the Serial Reaction Time (SRT) Task, a measure of implicit procedural learning. Following completion of the SRT, participants' awareness of the embedded stimulus pattern was assessed. As predicted, participants with OCD demonstrated superior performance on this task. Scoring on a measure of CSC correlated with performance on both tasks, although the amount of variance accounted for was modest. Evaluation of OCD symptom subgroups revealed greater procedural learning impairment in a hoarding subgroup. Implications for theory and treatment are discussed.     

No evidence for object alternation impairment in obsessive-compulsive disorder (OCD)

Recent neuroimaging studies have consistently ascribed the orbito-frontal cortex (OFC) a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). Cognitive tests presumed sensitive to this region, such as the Object Alternation Task (OAT), are considered important tools to verify this assumption and to investigate the impact of cortical dysfunction on behavior. The aim of the present study was to assess if patients with OCD show enhanced perseveration errors on the OAT relative to healthy controls taking into account several potential moderators, especially comorbid depression and OCD subtype. Thirty-five OCD patients and 18 healthy controls underwent the OAT as well as the Trail-Making Tests (TMT) A and B. In line with prior studies, OCD patients were slowed on both TMT tasks. In contrast, samples performed similarly on the OAT. While the latter finding does not invalidate the assumption that the OFC is affected in OCD, dysfunctions involving this region may be more subtle than often claimed and likely encompass only a small subset of functional domains hosted in the OFC.     

The role of the orbitofrontal cortex in normally developing compulsive-like behaviors and obsessive-compulsive disorder

Mounting evidence concerning obsessive-compulsive disorders points to abnormal functioning of the orbitofrontal cortices. First, patients with obsessive-compulsive disorder (OCD) perform poorly on tasks that rely on response suppression/motor inhibition functions mediated by the orbitofrontal cortex relative to both normal and clinical controls. Second, patients with OCD exhibit functional hyperactivity in lateral orbitofrontal and related structures corresponding with symptom severity. In this article, we compare these neurocognitive correlates of OCD with the executive and neural underpinnings of "compulsive-like" behaviors that are common in normal childhood. We discuss the phenomenology and natural history of normative compulsive-like behaviors as well as the behavioral, emotional, and cognitive continuities between typical and pathological obsessive-compulsive behaviors. We then examine associations between children's executive performance deficits and their observed compulsive-like characteristics. We relate these patterns to executive deficits shown by adults with OCD. Finally, we speculate on the developmental neurobiology of children's compulsive-like behaviors, with particular attention to orbitofrontal functions including behavioral and emotional regulation, and we suggest similarities and differences with the neurobiology of OCD. In making these comparisons, we hope to open a dialogue between researchers who study underlying brain pathologies associated with OCD and those who explore the neurocognitive bases of normal development.     

强迫症患者反应抑制缺陷及注意的调节作用

使用内外源线索结合不同冲突水平的侧抑制任务,考察强迫症患者对分心刺激的抑制有无缺陷、注意定向对分心刺激的干扰效应有无调节作用及在何水平上发挥作用。结果表明:强迫症患者不同冲突水平的侧抑制任务均无明显反应抑制缺陷,可能与其注意威胁性信息等有关;集中注意在知觉冲突水平上对强迫症患者和正常人的反应冲突进行调节且无显著性差异,可能与强迫症患者关注内容非空间定向有关。     

Auditory, visual, tactile, olfactory, and bodily hallucinations in patients with obsessive-compulsive disorder

Although much attention has been paid to patients who lack insight into their obsessional beliefs, less importance has been given to individuals with obsessive-compulsive disorder (OCD) who display perceptual disturbances typically found in psychotic disorders, including schizophrenia, schizoaffective disorders, or mood disorders with psychotic features. We would like to call the attention to a phenomenon that has been neglected in the psychiatric literature: the occurrence of hallucinations and related phenomena in patients with OCD. In this case report, we describe five clinical vignettes of patients with OCD with hallucinations in several different sensory modalities, including the auditory, the visual, the tactile, the olfactory, and the cenesthetic ones. Further psychopathological research should clarify the clinical significance of hallucinations among patients with OCD.     

Subtypes of obsessive-compulsive disorder: Implications for specialized cognitive behavior therapy

Although obsessive-compulsive disorder (OCD) is a heterogeneous condition, OCD subtypes have received limited attention in trials of cognitive behavior therapy (CBT). Because many patients with OCD do not respond optimally to CBT, it is important for clinicians to consider whether variability in treatment response is related to symptom presentation. Treatment modifications for patients without overt compulsions or with hoarding symptoms show promise. In this article we discuss the available research addressing the treatment of OCD subtypes, review the clinical characteristics and treatment recommendations for prominent OCD subtypes, raise the prospect of using dysfunctional beliefs as a potentially helpful conceptual approach to subtyping OCD and matching treatment to subtypes, and consider future directions in the treatment of OCD subtypes.     

负荷越大，转换更难-来自数字大小交替比较的证据

工作记忆与认知灵活性是执行功能的两个核心成分,但两者之间的关系并不清晰。本研究在一个数字大小交替比较任务中操纵工作记忆负荷,考察转换代价在不同记忆负荷下的差异。结果显示与非转换条件相比,转换条件下的反应时更长,正确率更低。另外,高记忆负荷下的转换代价显著高于低记忆负荷下的转换代价。这些结果表明工作记忆负荷越大,转换越难,代价越大。     

Cognitive confidence in obsessive-compulsive disorder: distrusting perception, attention and memory

Previous studies have established that obsessive-compulsive disorder (OCD) is characterised by significant levels of distrust in memory (e.g. for actions). Ironically, this lowered confidence is at least in part due to repeated checking, which is assumed to lower perceptual processing and thereby reduces vividness and detail of the recollections. In a previous study, Hermans, D., Martens, K., De Cort, K., Pieters, G., and Eelen, P. [(2003). Reality monitoring and metacognitive beliefs related to cognitive confidence in OCD. Behaviour Research and Therapy, 41, 383-401] observed that OCD is not only characterised by reduced confidence in memory, but also by a similar distrust in attention (Hermans et al., 2003). The present study aimed at replicating and extending this finding. It was observed (a) that patients suffering from OCD showed less confidence in attention and memory than a clinical and a nonclinical control group; (b) that confidence in attention was uniquely related to checking behaviour, and (c) that repeated checking caused increased levels of distrust in attention. In addition, it was observed that cognitive distrust while performing OCD-related actions not only extends to attention, but also to perception. It is argued that research on metacognition in OCD should move beyond the study of memory.