A meta-analysis of metacognitive beliefs as implicated in the self-regulatory executive function model in clinical psychosis

Sellers, Rachel; Varese, Filippo; Wells, Adrian; Morrison, Anthony P.

doi:10.1016/j.schres.2016.09.032

Cited by 52 publications

(39 citation statements)

References 59 publications

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“…Symptom correlates of the CAS observed in stress and emotional disorder generalize to psychosis confirming the universality of these relationships. In their systematic review, Sellers et al (2017) identified 51 eligible studies among which findings confirmed specific positive relationships between central elements of the CAS and experiences of psychosis and psychological distress.…”

Section: The Cognitive Attentional Syndromementioning

confidence: 98%

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

Wells

2019

Front. Psychol.

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The self-regulatory executive function (S-REF) model explains the role of strategic processes and metacognition in psychological disorder and was a major influence on the development of metacognitive therapy. The model identifies a universal style of perseverative negative processing termed the cognitive attentional syndrome (CAS), comprised of worry, rumination, and threat monitoring in the development of disorder. The CAS is linked to dysfunctional metacognitions that include beliefs and plans for regulating cognition. In this paper, I extend the theoretical foundations necessary to support further research on mechanisms linking metacognition to cognitive regulation and effective treatment. I propose a metacognitive control system (MCS) of the S-REF that can be usefully distinguished from cognition and is comprised of multiple structures, information, and processes. The MCS monitors and controls activity of the cognitive system and regulates the behavior of neural networks whose activities bias the way cognition is experienced. Metacognitive information involved in the regulation of on-line processing includes metacognitive beliefs, metacognitive procedural commands, and more transient cybernetic code. Separation of the cognitive and metacognitive systems and modeling their relationship presents major implications concerning what should be done in therapy and how it should be done. The paper concludes with an in-depth consideration of methods that strengthen the psychological basis of psychotherapy and aid in understanding and applying metacognitive therapy in particular. Finally, limitations of the model and implications for future research on self-awareness, self-regulation, and metacognition are discussed.

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Section: The Cognitive Attentional Syndromementioning

confidence: 98%

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

Wells

2019

Front. Psychol.

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“…Dozens of studies now document impairments in metacognition in individuals with, or at risk for, schizophrenia using discrete (based primarily on self‐report questionnaires) or expansive (based primarily on clinical ratings of narratives) definitions. Further, indexes of metacognitive impairment show associations with a wide array of clinical features, including positive, negative and disorganized symptoms, social and nonsocial cognition, motivation, self‐agency, insight, and functional outcomes.…”

Section: Recent Developments and Future Directions For Research On Comentioning

confidence: 99%

Nonsocial and social cognition in schizophrenia: current evidence and future directions

2019

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Cognitive impairment in schizophrenia involves a broad array of nonsocial and social cognitive domains. It is a core feature of the illness, and one with substantial implications for treatment and prognosis. Our understanding of the causes, consequences and interventions for cognitive impairment in schizophrenia has grown substantially in recent years. Here we review a range of topics, including: a) the types of nonsocial cognitive, social cognitive, and perceptual deficits in schizophrenia; b) how deficits in schizophrenia are similar or different from those in other disorders; c) cognitive impairments in the prodromal period and over the lifespan in schizophrenia; d) neuroimaging of the neural substrates of nonsocial and social cognition, and e) relationships of nonsocial and social cognition to functional outcome. The paper also reviews the considerable efforts that have been directed to improve cognitive impairments in schizophrenia through novel psychopharmacology, cognitive remediation, social cognitive training, and alternative approaches. In the final section, we consider areas that are emerging and have the potential to provide future insights, including the interface of motivation and cognition, the influence of childhood adversity, metacognition, the role of neuroinflammation, computational modelling, the application of remote digital technology, and novel methods to evaluate brain network organization. The study of cognitive impairment has provided a way to approach, examine and comprehend a wide range of features of schizophrenia, and it may ultimately affect how we define and diagnose this complex disorder.

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“…From another perspective (Wells, 2000), dysfunctional metacognitive beliefs have also been reported in schizophrenia. These include negative appraisals about the benefit of becoming involved in cognitive activities and heightened anticipation of the uncontrollability, and danger of thoughts (Sellers et al, 2016) and have been associated with positive symptoms (Baker and Morrison, 1998;Morrison et al, 2011), especially hallucinations Hill et al, 2012;Austin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Metacognitive profiles in schizophrenia and bipolar disorder: Comparisons with healthy controls and correlations with negative symptoms

Popolo

Smith

Lysaker

et al. 2017

Psychiatry Research

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While deficits in metacognition, or the ability to notice and reflect upon mental states has been observed in schizophrenia and linked with poorer concurrent and future function, it is unknown whether these deficits are unique to schizophrenia. Accordingly, this study assessed metacognition using the Metacognitive Assessment Scale-Abbreviated (MAS-A) and the Metacognitions Questionnaire- 30 (MCQ-30) among 26 adults with schizophrenia, 23 with bipolar disorder and 23 healthy controls. Symptom levels of the psychiatric groups were assessed with the Brief Psychiatric Rating Scale. ANCOVA controlling for age and education revealed that the schizophrenia group had lower scores on the MAS-A total and its subscales compared to the bipolar group and healthy controls. The bipolar disorder group also had lower MAS-A scores than the healthy control group. No group differences were found for the MCQ-30. Examination of symptom correlates revealed MAS-A scores were most commonly related to negative symptoms in both clinical groups. The total score and need for control subscale of MCQ-30 was related to total symptomatology and positive symptoms in patients with bipolar disorder. Correlations between the two measures of metacognition revealed that higher MAS-A scores were significantly related to lower scores on the Need to Control Thoughts MCQ-30 subscale.

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A meta-analysis of metacognitive beliefs as implicated in the self-regulatory executive function model in clinical psychosis

Cited by 52 publications

References 59 publications

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

Nonsocial and social cognition in schizophrenia: current evidence and future directions

Metacognitive profiles in schizophrenia and bipolar disorder: Comparisons with healthy controls and correlations with negative symptoms

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