Metacognition Is Necessary for the Emergence of Motivation in People With Schizophrenia Spectrum Disorders

Luther, Lauren; Bonfils, Kelsey A.; Firmin, Ruth L.; Buck, Kelly D.; Choi, Julie; Dimaggio, Giancarlo; Popolo, Raffaele; Minor, Kyle S.; Lysaker, Paul H.

doi:10.1097/nmd.0000000000000753

Cited by 31 publications

(23 citation statements)

References 44 publications

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“…Consequently, the motivation to persist and not withdraw from work or relationships may be reduced heightened the possibility of a gradual withdrawal from functioning in the community. This is consistent with finding suggesting that a certain level of metacognitive function is needed for the experience of intrinsic motivation (Luther et al, 2017).…”

Section: Disturbances In Metacognitive Capacity and Intersubjectivitysupporting

confidence: 92%

Metacognition and Intersubjectivity: Reconsidering Their Relationship Following Advances From the Study of Persons With Psychosis

et al. 2020

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As research on metacognition has progressed a significant array of definitions, methodologies and therapeutic applications have emerged. Some of this work has primarily framed metacognition as an activity carried out by one person in order to know, monitor, and adjust their beliefs, memories, and behaviors. Accordingly, problems with metacognition have often been characterized as issues related to cognition. This, however, risks neglecting how metacognition is also a fundamentally intersubjective act, one in which human beings know and reflect upon themselves and others primarily with and through connections with other people. In this paper, we review research on metacognition in schizophrenia using the integrative model of metacognition and a research paradigm in which metacognition is assessed within personal narratives. Stimulated by this work, we discuss how disturbances in intersubjective experience and metacognitive capacity mutually influence one another, with disruptions in metacognition perhaps more deeply understood as disruptions in relatedness with others. We then discuss how metacognition and intersubjectivity each affect mental health. We finally focus on the implications of this for treatments that target metacognition as well as future directions for research.

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Section: Disturbances In Metacognitive Capacity and Intersubjectivitysupporting

confidence: 92%

Metacognition and Intersubjectivity: Reconsidering Their Relationship Following Advances From the Study of Persons With Psychosis

et al. 2020

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“…We also only included persons with schizophrenia spectrum disorders. It is consequently unknown if the relationships found here are specific to schizophrenia or whether they may also apply to other disorders where metacognitive deficits have been observed to be linked to social functioning, including Posttraumatic Stress Disorder (Davis et al, 2016; Leonhardt, Lysaker, Vohs, James, & Davis, 2018), affective disorders (Ladegaard, Lysaker, Larsen, & Videbach, 2014; Lysaker, Hamm, et al, 2018), substance abuse (Inchausti, Ortuño-Sierra, García-Poveda, & Ballesteros-Prados, 2017b), and borderline personality disorder (Lysaker et al, 2017). Assessment of social functioning was completed by a trained rater, and metacognition was assessed using a single paradigm.…”

Section: Discussionmentioning

confidence: 93%

Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis

Gagen

Zalzala

Hochheiser

et al. 2019

Journal of Experimental Psychopathology

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Functional deficits are a hallmark of schizophrenia spectrum disorders, but much debate still exists over why and how they originate. One model suggests that disturbances in social functioning are a result of metacognitive deficits or a failure to integrate information to form more complex ideas of themselves and others. It is unclear if this social dysfunction is present across different symptom presentations. We examined the relationship of metacognition, symptoms, and social functioning among a sample of adults with schizophrenia spectrum disorders (N ¼ 334). A latent class analysis produced a four-class model. Groups were classified as follows: diffuse symptoms/moderately impaired social functioning (Class 1), positive and hostility symptoms/mildly impaired social functioning (Class 2), minimal symptoms/good social functioning (Class 3), and negative and cognitive symptoms/severely impaired social functioning (Class 4). Class 3 demonstrated better overall metacognitive capacity than both Classes 1 and 4 but did not differ significantly from Class 2. Classes 2 and 3 both demonstrated better interpersonal functioning than Classes 1 and 4. Together, these findings provide support for models of poor functioning that stem from fragmentation of an individual's experience, leading to diminished abilities to form meaningful connections with others. Additional interpretations, limitations, and research implications are discussed.

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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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Metacognition Is Necessary for the Emergence of Motivation in People With Schizophrenia Spectrum Disorders

Cited by 31 publications

References 44 publications

Metacognition and Intersubjectivity: Reconsidering Their Relationship Following Advances From the Study of Persons With Psychosis

Metacognition and Intersubjectivity: Reconsidering Their Relationship Following Advances From the Study of Persons With Psychosis

Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis

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

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