Metacognition, symptoms and premorbid functioning in a First Episode Psychosis sample

Abstract

Significant metacognitive impairments are observed in chronic psychosis samples but metacognition is less understood in first episode psychosis (FEP). The current study explored correlations between metacognition, symptoms and premorbid functioning in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology, premorbid adjustment, and clinician rated service engagement were also measured. Lower scores for metacognitive understanding of other's minds were significantly correlated with greater negative symptoms, poorer early adolescent social adjustment and poorer clinician rated help-seeking. Our findings suggest that FEP individuals with difficulties in understanding other's minds have more social deficits and may be less able to make effective use of treatment.

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). Understanding of one's own mind has been found to be associated with metacognition in chronic samples, but not in first-episode samples.…”

“…If the association between understanding of one's own mind and negative symptoms becomes stronger over time, the diversity in time since onset of the disorder in the current study may be able to explain the non-significance of this association. The results of the current study combined with these earlier findings suggest that understanding of others might be more specific to the early stages of the disorder (MacBeth et al, 2013). The lack of association between metacognition and positive symptoms is consistent with a meta-analysis of Varese and Bentall (2011), who found that after controlling for emotional distress and other comorbid symptoms, hallucination-proneness is no longer significantly related to metacognition.…”

“…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).…”

“…This was the same for self-reflectivity, understanding of others, decentration, and mastery separately, which is in contrast to Lysaker, Shea et al (2010), who found that the variance in mastery was significantly predicted by cognitive functioning. Lysaker et al (2005), Lysaker, Bob et al (2013), andMacBeth et al (2013) found that poor metacognition leads to social functioning deficits in schizophrenia and that metacognitive training results in better social functioning. The variability in time since onset of the disorder may influence this relationship.…”

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).…”