Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

Trauelsen, Anne Marie; Gumley, Andrew; Jansen, Jens Einar; Pedersen, Marlene Buch; Nielsen, Hanne-Grethe Lyse; Trier, Christopher Høier; Haahr, Ulrik; Simonsen, Erik

doi:10.1016/j.psychres.2016.02.003

Cited by 51 publications

(47 citation statements)

References 64 publications

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“…People with psychosis are highly likely to have experienced childhood trauma (Trauelsen et al, 2015;Varese et al, 2012) and they exhibit lower metacognitive abilities than non-clinical controls (Healey et al, 2016;Trauelsen et al, 2016b). As childhood trauma has been found to affect metacognition in population studies (Cicchetti et al, 2003;Edwards et al, 2005;Ensink et al, 2015;Pears and Fisher, 2005;Shipman and Zeman, 1999), it seems important to address the possible association in people with psychosis.…”

Section: Introductionmentioning

confidence: 99%

Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

Trauelsen

Gumley

Jansen³

et al. 2019

Psychiatry Research

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Research suggests that people with first-episode psychosis (FEP) report more childhood traumas and have lower metacognitive abilities than non-clinical controls. Metacognition refers to the identification of thoughts and feelings and the formation of complex ideas about oneself and others.Childhood trauma negatively affects metacognitive development in population studies, while the association remains largely unexplored in FEP populations. This study hypothesized that childhood trauma would be associated with lower metacognitive abilities in people with FEP. In a representative sample of 92 persons with non-affective FEP, we assessed childhood trauma, metacognitive abilities and symptoms of non-affective psychosis. We used the Childhood Trauma Questionnaire (CTQ) and the Metacognitive Assessment Scale -Abbreviated which includes Selfreflectivity, Awareness of the Mind of the Other, Decentration and Mastery. Hierarchical regression analyses were performed with metacognitive domains as outcome variables and childhood traumas as independent variables, while controlling for age, gender, first-degree psychiatric illness and negative symptoms. We found few significant associations between the different types of childhood trauma and metacognitive domains, and they suggested childhood trauma are associated with better metacognitive abilities. Study limitations included the cross-sectional design and use of self-report measures. Future studies could preferably be prospective and include different measures of psychopathology and neuropsychology.

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Section: Introductionmentioning

confidence: 99%

Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

Trauelsen

Gumley

Jansen³

et al. 2019

Psychiatry Research

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“…The unimpaired performance by patients on the familiarity portion of the task suggests that memory deficits are not the result of a failure of attention, or of a lack of motivation to try to do the task. However, other known areas of difficulty in CHR and FE, including cognitive control (Hou et al 2016) and meta-cognition (Trauelsen et al 2016, Cotter et al 2016) cannot be ruled out as a source of memory deficits, and could be mediating the relationship between memory and negative symptoms. Familiarity was unimpaired in both FE and CHR relative to TD groups.…”

Section: Discussionmentioning

confidence: 99%

Episodic memory functions in first episode psychosis and clinical high risk individuals

Greenland-White

Ragland

Niendam

et al. 2017

Schizophrenia Research

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Objective Individuals with schizophrenia have disproportionate memory impairments when encoding relational versus item-specific information, and when using recollection versus familiarity during retrieval. It is unclear whether this pattern is unique to people with chronic schizophrenia, or if it occurs in individuals after a first episode of psychosis (FE), or when at clinical high-risk for psychosis (CHR). Methods We administered the Relational and Item-Specific Memory task (RiSE) to 22 CHR, 101 FE, and 58 typically developing (TD) participants. We examined group differences in item and relational encoding, and familiarity-based and recollection-based retrieval using parametric analysis and structural equation modeling (SEM). Longitudinal data allowed us to examine relations between baseline RiSE performance and change in clinical symptoms at 1-year follow-up in the FE group. Results Groups did not differ on familiarity. FE and CHR groups were equally impaired on overall recognition accuracy. Although recollection was impaired in both FE and CHR groups following relational encoding, only the FE group had impaired recollection following item encoding. SEM showed atypical relationships between familiarity and recollection, as well as familiarity and item recognition for both the FE and CHR groups. For FE individuals, better baseline recognition accuracy predicted less severe negative symptoms at 1-year follow-up. Conclusions Impaired relational and recollective memory may reflect neurodevelopmental abnormalities predating conversion to psychosis. These memory deficits appear related to negative symptom changes. In contrast, item specific recollection deficits appear to occur after the development of full psychosis. Familiarity appears to be a relatively preserved memory function across the psychosis spectrum.

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“…Among 32 studies, 21 studies 32,37,65,66,79-96 reported clusters in patients and one study 66 in unaffected siblings based on neurocognitive and/or social cognitive function. In addition, two studies were conducted on negative symptoms 29,97 , one study on positive symptom 98 , three studies on positive and negative symptoms 35,99,100 , and three studies on positive and negative schizotypy. 67,101,102 The reported clustering methods were K-means or non-hierarchical clustering analysis 35 32,85,86,91,93 reported four clusters and one study 94 discovered five clusters of patients.…”

Section: Symptomatic Clustersmentioning

confidence: 99%

“…One study 104 found three clusters of patients by combining social cognition and negative symptom whereas another study 103 found four clusters of patients based on neurocognition and negative symptom. In addition, two studies 35,99 reported three clusters while another study 100 profiles. Details has been presented in Table 2.…”

Section: Symptomatic Clustersmentioning

confidence: 99%

“…As illustrated in Figure 4, severe positive and/or negative symptoms cluster(s) were predicted by male gender, ethnic minority, low educational status, early age onset of illness, low IQ, severe general psychopathology, , and poor cognition, premorbid adjustment and global functioning. 29,35,97,99,100 Severe positive and/or negative schizotypy cluster(s) in unaffected first degree relatives of patients with schizophrenia were predicted by poor experience of pleasure and emotional expression, and low neurocognitive performance. 67 In the non-clinical population, severe positive and/or negative schizotypy cluster(s) were predicted by male gender, severe paranoid and schizoid symptoms, major depressive episode, substance abuse, medication use, poor social adjustment, severe somatic and anxiety symptoms, and poor neurocognitive and social functioning.…”

Section: Predictors Of Symptomatic Clustersmentioning

confidence: 99%

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Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

Rodijk

Liemburg

Sidorenkov

et al. 2019

Preprint

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= 244 words Text body = 4,558 words Abstract Introduction: To tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its (sub)clinical symptoms though there is no systematic review. Aims: To summarize the evidence from cluster-and trajectory-based studies of positive, negative and cognitive symptoms in patients with schizophrenia spectrum disorders, their siblings and healthy people. Additionally, we aimed to highlight knowledge gaps and point out future directions to optimize the translatability of cluster-and trajectory-based studies. Methods: A systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE, and Web of Science electronic databases. Both cross-sectional and longitudinal studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data.Results: Of 2,285 studies retrieved, 50 studies (17 longitudinal and 33 cross-sectional) conducted in 30 countries were selected for review. Longitudinal studies discovered two to five trajectories of positive and negative symptoms in patient, and four to five trajectories of cognitive deficits in patient and sibling. In cross-sectional studies, three clusters of positive and negative symptoms in patient, four clusters of positive and negative schizotypy in sibling, and three to five clusters of cognitive deficits in patient and sibling were identified. These studies also reported multidimensional predictors of clusters and trajectories. Conclusions:Our findings indicate that (sub)clinical symptoms of schizophrenia are more heterogeneous than currently recognized. Identified clusters and trajectories can be used as a basis for personalized psychiatry.

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Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

Cited by 51 publications

References 64 publications

Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

Episodic memory functions in first episode psychosis and clinical high risk individuals

Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

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