Background and Hypothesis: The Cognitive Model of Negative Symptoms is a prominent model that posits that defeatist performance beliefs (DPB) are a key psychological mechanism underlying negative symptoms in those with schizophrenia (SZ). However, the ecological validity of the model has not been established, and temporally specific evaluations of the model’s hypotheses have not been conducted. This study tested the model’s key hypotheses in real-world environments using ecological momentary assessment (EMA). Study Design: Fifty-two outpatients with SZ and 55 healthy controls (CN) completed 6 days of EMA. Multilevel models examined concurrent and time-lagged associations between DPB and negative symptoms in daily life. Study Results: SZ displayed greater DPB in daily life than CN. Furthermore, greater DPB were associated with greater concurrently assessed negative symptoms (anhedonia, avolition, and asociality) in daily life. Time-lagged analyses indicated that in both groups, greater DPB at time t led to elevations in negative symptoms (anhedonia, avolition, or asociality) at t + 1 above and beyond the effects of negative symptoms at time t. Conclusions: Results support the ecological validity of the Cognitive Model of Negative Symptoms and identify a temporally specific association between DPB and subsequent negative symptoms that is consistent with the model’s hypotheses and a putative mechanistic pathway in Cognitive Behavioral Therapy for negative symptoms. Findings suggest that DPB are a psychological factor contributing to negative symptoms in real-world environments. Implications for measuring DPB in daily life and providing just-in-time mobile health-based interventions to target this mechanism are discussed.

中文翻译：

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通过生态瞬时评估测量的失败主义绩效信念在精神分裂症阴性症状状态波动中的作用


背景和假设： 阴性症状的认知模型是一个突出的模型，它假设失败主义表现信念 （DPB） 是精神分裂症 （SZ） 患者负面症状的关键心理机制。然而，该模型的生态有效性尚未建立，并且尚未对模型的假设进行时间上的具体评估。本研究使用生态瞬时评估 （EMA） 在真实环境中测试了该模型的关键假设。研究设计： 52 名 SZ 门诊患者和 55 名健康对照 （CN） 完成了 6 天的 EMA。多级模型检查 DPB 与日常生活中阴性症状之间的并发和时间滞后关联。研究结果： SZ 在日常生活中表现出比 CN 更高的 DPB。此外，较大的 DPB 与日常生活中同时评估的阴性症状 （快感缺乏、 avolition 和无社交性） 的增加相关。时间滞后分析表明，在两组中，时间 t 较大的 DPB 导致 t + 1 时阴性症状（快感缺乏、爱欲或社交性）的升高高于时间 t 阴性症状的影响。结论：结果支持阴性症状认知模型的生态有效性，并确定了 DPB 与随后的阴性症状之间的时间特异性关联，这与模型的假设和推定的机制途径一致针对阴性症状的认知行为疗法。研究结果表明，DPB 是导致现实世界环境中阴性症状的心理因素。讨论了在日常生活中测量 DPB 和提供基于即时移动健康的干预措施以针对该机制的意义。