Metacognition strengthens the association between neurocognition and attenuated psychosis syndrome: Preliminary evidence from a pilot study among treatment-seeking versus healthy adolescents

Koren, Danny; Scheyer, Ravit; Stern, Yonatan; Adres, Merav; Reznik, Noa; Apter, Alan; Seidman, Larry J.

doi:10.1016/j.schres.2018.12.036

Cited by 13 publications

(13 citation statements)

References 46 publications

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“…This study shows that individuals with schizophrenia evaluated their functioning to be worse than control participants, which is in accordance with previous studies reporting poor functioning in schizophrenia with self-reported measures. 43,44 Our results also confirm the previous reports of impaired monitoring 45 and regulation 46,47 of metacognitive strategies in schizophrenia. In our study, individuals with schizophrenia reported seeking significantly less help than individuals without schizophrenia.…”

Section: Discussionsupporting

confidence: 91%

Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

et al. 2019

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Objectives: The aim of this study is to design a questionnaire, the Versailles Metacognitive Strategies Evaluation Questionnaire, for assessing the use of metacognitive and help-seeking strategies in three key-domains of impaired daily functioning in schizophrenia. To evaluate its psychometric properties (internal consistency, factor structure, convergent and divergent validity, and stability). Design: Development of a questionnaire and psychometric validation procedure in patients with schizophrenia compared with healthy controls. Stability over one year was assessed in the patient group. Setting: Schizophrenia Centers of Expertise (French FondaMental Network). Subjects: A total of 141 patients with schizophrenia, among whom 77 participated in the second evaluation; 97 healthy subjects. Main measures: The Versailles Metacognitive Strategies Evaluation Questionnaire, Positive and Negative Symptoms Scale, Personal and Social Performance Scale, Evaluation of Cognitive Processes involved in Disability in Schizophrenia Scale, Schizophrenia Quality of Life Questionnaire, and Stages of Recovery Instrument. Results: From the 36-items version, stepwise exploratory factor analysis (oblimin) produced a 25-items scale which had a 3-factors structure (hygiene concern, social relationships, and hygiene help-seeking). Cronbach’s were respectively equal to 0.91, 0.82, and 0.78. One-year stability was good (intra-class correlation coefficient = 0.7). The three factors showed good convergent validity with measures of quality of life (rho = 0.34, P ⩽ 0.001). The first two factors correlated with recovery ( N = 34, rho = 0.53, P ⩽ 0.001). On the contrary, the factors exhibited divergent validity, with no significant correlation, with symptoms and cognitive and psychosocial functioning ( P > 0.05). Factor structure in healthy controls did not match with that of patients, all items but one were found significantly different among groups. Conclusion: The Versailles Metacognitive Strategies Evaluation Questionnaire provides a simple and valid means to assess metacognitive strategies in individuals with schizophrenia.

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Section: Discussionsupporting

confidence: 91%

Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

et al. 2019

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“…Altogether, 72 studies employed the SIPS/SOPS, 19 the CAARMS, 6 the BSABS, 3 the SPI‐CY and 4 the PANSS (10 studies used more than one instrument). The proportion of individuals meeting CHR‐P criteria was 16%–36% in mental health settings (Koren et al, 2019, Lo Cascio et al, 2017), including 23.6% in adolescent inpatient settings (Gerstenberg et al, 2015) and 13% in nonhelp‐seeking adolescents with disruptive behaviours (Manninen et al, 2014). From a psychometric perspective, four studies focused on the validation of CHR‐P assessment scales in adolescents across different languages (Fux, Walger, Schimmelmann, & Schultze‐Lutter, 2013; Kline et al, 2012; Pelizza, Azzali, et al, 2019; Thompson, Kline, Reeves, Pitts, & Schiffman, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Systematic review: Eight studies investigated cognition. The CHP-P state in adolescents was related to impairments in neurocognitive performance compared with HC (D'Angelo et al, 2019;Koren et al, 2019;Woodberry et al, 2010), including poor visual form perception (Ilonen, Heinimaa, Korkeila, Svirskis, & Salokangas, 2010), mild-to-moderate executive impairments (Ilonen et al, 2010) in working memory (Smith, Park, & Cornblatt, 2006), labelling of facial expressions (van Rijn et al, 2011a), and ability to recognise facial identity (van Rijn et al, 2011a). CHR-P adolescents experienced more maladaptive beliefs (Welsh, Cartwright-Hatton, Wells, Snow, & Tiffin, 2014) and difficulties in verbalising their own emotions (van Rijn, Schothorst, Wout, Sprong, Ziermans, et al, 2011).…”

Section: Meta-analysismentioning

confidence: 99%

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Catalán

Pablo

Serrano

et al. 2020

Child Psychology Psychiatry

118

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Background: The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. Methods: We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I 2 test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. Results: Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 AE 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. Prognosis: Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95% CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ≥36 months. Interventions: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. Conclusions: It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required.

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“…Interestingly, a recent study using VR to manipulate other aspects of the embodied Self (i.e., making the participant bigger or smaller) also showed a correlation between sensitivity to this alteration and APS [ 107 ]. Our correlation between self-reported psychotic symptoms and metacognition points to the potential role metacognition may play in attenuating and translating experimentally measured impairments into real-world functioning [ 108 , 109 , 110 ]. Second, the precariousness of the correlations highlights the wide range of symptoms endorsed in the general population, which especially affects small sample sizes.…”

Section: Discussionmentioning

confidence: 98%

Assessing the Relationship between Sense of Agency, the Bodily-Self and Stress: Four Virtual-Reality Experiments in Healthy Individuals

Stern

Koren

Moebus

et al. 2020

JCM

Self Cite

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The bodily-self, our experience of being a body, arises from the interaction of several processes. For example, embodied Sense of Agency (SoA), the feeling of controlling our body’s actions, is a fundamental facet of the bodily-self. SoA is disturbed in psychosis, with stress promoting its inception. However, there is little knowledge regarding the relationship between SoA, stress, and other facets of the bodily-self. In four experiments manipulating embodied SoA using a virtual hand (VH), we examined (1) How is embodied SoA related to other facets of the bodily-self?; and (2) How is SoA impacted by stress? We found that increased alteration of the VH significantly decreased subjective ratings of SoA and body ownership (Exp. 1), supporting the close relation between SoA and body ownership. Interoceptive accuracy and SoA were positively correlated (Exp. 3), connecting awareness to one’s actions and cardiac signals. Contrary to our expectations, SoA was not related to trait anxiety (Exp. 3), nor did induced stress impair SoA (Exp. 4). Finally, we found a negative correlation between self-reported prodromal symptoms and SoA. These results strongly support the connection between SoA and the bodily-self. Whereas, SoA was not impaired by stress, and weakly related to psychotic symptoms.

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Metacognition strengthens the association between neurocognition and attenuated psychosis syndrome: Preliminary evidence from a pilot study among treatment-seeking versus healthy adolescents

Cited by 13 publications

References 46 publications

Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Assessing the Relationship between Sense of Agency, the Bodily-Self and Stress: Four Virtual-Reality Experiments in Healthy Individuals

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