https://doi.org/10.4081/mw.2023.6

The double-strand bond between metacognition and schizophrenia: actual impact and future directions

Vol. 1 No. 1 (2023)
Submitted: 2023 November 1
Accepted: 2023 November 22
Published: 2023 November 30
Metacognition, schizophrenia, psychotherapy, metacognition abilities, psychosis
Abstract Views: 8288
PDF: 73
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Controlling, monitoring, and modulating cognitive processes is what is known as metacognition: it guides behavior through several types of mental activities that range in complexity from discrete activities, such as recognizing others' judgment, to more integrated ones, such as recognizing oneself and others' cognitive processes. There is an increasing body of research examining the impact of schizophrenia on metacognition, underlining their double-strand link, especially on a wide range of mental processes, including reasoning, autobiographical memory, cognitive beliefs, and clinical insight. Metacognition is intimately linked to the severity of symptoms as well as specific symptomatic sub-domains, such as positive symptoms, negative symptoms, or disorganization. Recently, cognitive-derived psychotherapies have been developed to treat metacognitive deficits in schizophrenia. While all these treatments share a metacognitive component, each one targets different aspects. In metacognitive therapy, false or unhelpful beliefs are treated; in metacognitive training, cognitive biases are the main focus; in cognitive-behavioral therapy for psychoses, the core is represented by schematic dysfunctional beliefs; in metacognitive reflection insight therapy, metacognitive knowledge and self-identity are addressed; and in metacognitive interpersonal therapy for psychosis, interpersonal ideas or events may trigger delusional thinking. Future directions should address the need for more refined knowledge of metacognition processes and the need for growing mental health professionals’ expertise in the field. Moreover, the evaluation of metacognition-based intervention effectiveness in real-world populations and in high-risk psychosis and their enforceability in mental health facilities should become a critical issue.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Pinkham AE. Metacognition in psychosis. J Exp Psychopathol 2019;10:1-4. DOI: https://doi.org/10.1177/2043808719841146
Wells A, Matthews G. Modelling cognition in emotional disorder: the S-REF model. Behav Res Ther 1996;34:881-8. DOI: https://doi.org/10.1016/S0005-7967(96)00050-2
Wells A. Metacognitive therapy: cognition applied to regulating cognition. Behav Cogn Psychother 2008;36:651-8. DOI: https://doi.org/10.1017/S1352465808004803
Lysaker PH, Hamm JA, Hasson-Ohayon I, et al. Promoting recovery from severe mental illness: implications from research on metacognition and metacognitive reflection and insight therapy. World J Psychiatry 2018;8:1-11. DOI: https://doi.org/10.5498/wjp.v8.i1.1
Lysaker PH, Cheli S, Dimaggio G, et al. Metacognition, social cognition, and mentalizing in psychosis: are these distinct constructs when it comes to subjective experience or are we just splitting hairs? BMC Psychiatry 2021;21:329. DOI: https://doi.org/10.1186/s12888-021-03338-4
Davies G, Greenwood K. A meta-analytic review of the relationship between neurocognition, metacognition and functional outcome in schizophrenia. J Ment Health 2020;29:496-505. DOI: https://doi.org/10.1080/09638237.2018.1521930
Rouy M, Saliou P, Nalborczyk L, et al. Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders. Neurosci Biobehav Rev 2021;126:329-37. DOI: https://doi.org/10.1016/j.neubiorev.2021.03.017
Lysaker PH, Vohs J, Hamm JA, et al. Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity. J Psychiatr Res 2014;55:126-32. DOI: https://doi.org/10.1016/j.jpsychires.2014.04.011
Martiadis V, Pessina E, Raffone F, et al. Metacognition in schizophrenia: a practical overview of psychometric metacognition assessment tools for researchers and clinicians. Front Psychiatry 2023;14:1155321. DOI: https://doi.org/10.3389/fpsyt.2023.1155321
Vohs JL, Lysaker PH, Francis MM, et al. Metacognition, social cognition, and symptoms in patients with first episode and prolonged psychoses. Schizophr Res 2014;153:54-9. DOI: https://doi.org/10.1016/j.schres.2014.01.012
Arnon-Ribenfeld N, Hasson-Ohayon I, Lavidor M, et al. The association between metacognitive abilities and outcome measures among people with schizophrenia: a meta-analysis. Eur Psychiatry 2017;46:33-41. DOI: https://doi.org/10.1016/j.eurpsy.2017.08.002
Fowler DR, Garety PA, Kuipers L. Cognitive behaviour therapy for psychosis: theory and practice. Hoboken: John Wiley & Sons; 1995.
Fisher P, Wells A. Metacognitive therapy. New York: Routledge; 2009. DOI: https://doi.org/10.4324/9780203881477
Moritz S, Andreou C, Schneider BC, et al. Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia. Clin Psychol Rev 2014;34:358-66. DOI: https://doi.org/10.1016/j.cpr.2014.04.004
Hillis JD, Leonhardt BL, Vohs JL, et al. Metacognitive reflective and insight therapy for people in early phase of a schizophrenia spectrum disorder. J Clin Psychol 2014;71:125-35. DOI: https://doi.org/10.1002/jclp.22148
Salvatore G, Russo B, Russo M, et al. Metacognition-oriented therapy for psychosis: the case of a woman with delusional disorder and paranoid personality disorder. J Psychother Integr 2012;22:314-29. DOI: https://doi.org/10.1037/a0029577
van der Gaag M, Valmaggia LR, Smit F. The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: a meta-analysis. Schizophr Res 2014;156:30-7. DOI: https://doi.org/10.1016/j.schres.2014.03.016
Moritz S, Menon M, Balzan R, et al. Metacognitive training for psychosis (MCT): past, present, and future. Eur Arch Psychiatry Clin Neurosci 2023;273:811-7. DOI: https://doi.org/10.1007/s00406-022-01394-9
Hasson-Ohayon I, Igra L, Lavi-Rotenberg A, et al. Findings from a randomized controlled trial of Metacognitive Reflection and Insight Therapy for people with schizophrenia: effects on metacognition and symptoms. Psychol Psychother 2023;31. DOI: https://doi.org/10.1111/papt.12485
Dimaggio G, Montano A, Popolo R, Salvatore G. Metacognitive interpersonal therapy for personality disorders: a treatment manual. New York: Routledge; 2015. DOI: https://doi.org/10.4324/9781315744124
Lysaker PH, Gagen E, Moritz S, Schweitzer RD. Metacognitive approaches to the treatment of psychosis: a comparison of four approaches. Psychol Res Behav Manag 2018;11:341-51. DOI: https://doi.org/10.2147/PRBM.S146446

How to Cite

1.
Martiadis V, Raffone F, Pessina E, Scognamiglio P. The double-strand bond between metacognition and schizophrenia: actual impact and future directions. Mental Wellness [Internet]. 2023 Nov. 30 [cited 2024 Jun. 28];1(1). Available from: https://www.mental-wellness-journal.net/mw/article/view/6
Copyright (c) 2023 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.