Associations of Metacognition With Symptoms, Insight, and Neurocognition in Clinically Stable Outpatients With Schizophrenia

Abstract

Research indicates that many with schizophrenia experience deficits in metacognitive capacity or the ability to form complex representations of themselves and others. Previous work has found that metacognitive capacity in schizophrenia is correlated with symptoms, insight, and neurocognitive deficits. We sought to replicate these results in a sample of Italian participants treated in a community setting. Metacognition was assessed with the abbreviated Metacognition Assessment Scale and correlated with concurrent assessment of symptoms, insight, and neurocognitive abilities, including verbal and visual memory, premorbid intelligence, processing speed, and executive function. Correlations revealed that, consistent with previous work, lesser capacity for self-reflectivity was related to greater levels of negative symptoms, poorer insight, neurocognitive impairment (particularly impairments in verbal and visual memory) premorbid intelligence, and processing speed. Other metacognitive domains were also linked to poorer neurocognition. Results support contentions that deficits in metacognition are linked with negative symptoms, insight, and neurocognitive deficits.

Metacognition in Relation to Cognitive and Social Functioning in Schizophrenia

“…This is in line with many earlier findings (Nicolò et al, 2012). Only the relationship between negative symptoms and understanding others is significant in this study, which is consistent with former studies in both chronic and firstepisode psychosis samples MacBeth et al, 2013).…”

“…A disturbed sense of agency over thoughts can also be explained by lowered metacognitive control. The most consistent finding, however, is that low metacognition is related to more negative symptoms (MacBeth et al, 2013;Nicolò et al, 2012).…”

Meta-cognition is associated with cortical thickness in youth at clinical high risk of psychosis

“…Associations were seen between multiple metacognitive domains and cortical thickness in right rostral middle frontal gyrus and right pars triangularis, providing partial support for our second hypothesis. Inspection of MAS scores indicated that our CHR participants were more Self-Reflective, scored higher on Understanding Others, showed greater Mastery as well as higher Decentration as compared to means reported in people with schizophrenia (Lysaker et al, 2008(Lysaker et al, , 2010Nicolo et al, 2012;Macbeth et al, 2014).…”

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

“…Social cognition includes a number of components such as Theory of Mind (ToM), Affect Recognition, and Attributional Style [53]. The second process which may be related to insight is metacognition [77][78][79][80]. Metacognition refers to activities which allow persons to be aware of and form integrated and complex ideas about the self and others.…”