Necessary, but not sufficient: Links between neurocognition, social cognition, and metacognition in schizophrenia are moderated by disorganized symptoms

Minor, Kyle S.; Lysaker, Paul H.

doi:10.1016/j.schres.2014.08.005

Cited by 70 publications

(62 citation statements)

References 56 publications

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“…Surprisingly, we found that no single disorganized symptom helped explain this relationship, which runs counter to previous findings that disorganized symptoms moderate relationships between neurocognition and social cognition (Minor and Lysaker, 2014). The current finding could indicate that the moderating effect of disorganized symptoms is driven by a type of disorganization that was not assessed in this study.…”

Section: Discussioncontrasting

confidence: 99%

“…Adequate neurocognition provides a necessary building block for the more complex process of metacognition (Lysaker et al, 2010); strong links between these processes indicate that neurocognition can be utilized for metacognitive tasks, whereas weak links suggest that neurocognitive abilities essential for metacognition cannot be engaged. A previous study from our group showed that links between neurocognition and metacognition break down when people with schizophrenia experience disorganized symptoms (Minor and Lysaker, 2014) and the current study found that conceptual disorganization drives this moderating effect. Thus, conceptual disorganization appears to disrupt metacognition in schizophrenia, in part, by weakening its relationship with neurocognition.…”

Section: Discussionsupporting

confidence: 66%

“…Although findings from Minor and Lysaker (2014) support previous models, no one has yet examined how specific types of disorganized symptoms affect the limiting relationship of neurocognition on social cognition and metacognition. Conceptual disorganization is a disorganized symptom that is assessed using descriptors (e.g., loose associations, disrupted goaldirected sequencing, illogicality) that are similar to Bleuler's "loosening of associations" paradigm; thus, it is likely to play a prominent role.…”

Section: Introductionmentioning

confidence: 66%

“…Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV-TR Disorders-Patient Edition (SCID-I/P; First et al, 2002). All participants were recruited from a Midwestern VA Medical Center and were part of the sample reported in a previous paper (Minor and Lysaker, 2014). Exclusion criteria consisted of: a) any change in medication, housing, or outpatient status (e.g., hospitalizations) within the past 30 days; b) active substance dependence; and c) a documented intellectual disability at any time point (based on medical record review).…”

Section: Participantsmentioning

confidence: 99%

“…They are more strongly related to cognitive processes than reality distortion or negative symptoms (Hamm et al, 2012;Ventura et al, 2010;Ventura et al, 2013) and are inversely associated with longterm functioning (Evans et al, 2004;Shenton et al, 1992;Smith et al, 2002). A recent study from our group demonstrated that disorganized symptoms are an integral link in cognitive pathways, with connections between cognitive processes weakening as disorganized symptoms increase (Minor and Lysaker, 2014). This finding suggests that when disorganized symptoms are present, people with schizophrenia are no longer able to effectively utilize the neurocognitive abilities necessary for performing social cognitive or metacognitive tasks.…”

Section: Introductionmentioning

confidence: 99%

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Conceptual disorganization weakens links in cognitive pathways: Disentangling neurocognition, social cognition, and metacognition in schizophrenia

Minor

Marggraf

Davis

et al. 2015

Schizophrenia Research

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Disentangling links between neurocognition, social cognition, and metacognition offers the potential to improve interventions for these cognitive processes. Disorganized symptoms have shown promise for explaining the limiting relationship that neurocognition holds with both social cognition and metacognition. In this study, primary aims included: 1) testing whether conceptual disorganization, a specific disorganized symptom, moderated relationships between cognitive processes, and 2) examining the level of conceptual disorganization necessary for links between cognitive processes to break down. To accomplish these aims, comprehensive assessments of conceptual disorganization, neurocognition, social cognition, and metacognition were administered to 67 people with schizophrenia-spectrum disorders. We found that conceptual disorganization significantly moderated the relationship between neurocognition and metacognition, with links between cognitive processes weakening when conceptual disorganization is present even at minimal levels of severity. There was no evidence that conceptual disorganization-or any other specific disorganized symptom-drove the limiting relationship of neurocognition on social cognition. Based on our findings, conceptual disorganization appears to be a critical piece of the puzzle when disentangling the relationship between neurocognition and metacognition. Roles of specific disorganized symptoms in the neurocognition -social cognition relationship were less clear. Findings from this study suggest that disorganized symptoms are an important treatment consideration when aiming to improve cognitive impairments.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 66%

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Conceptual disorganization weakens links in cognitive pathways: Disentangling neurocognition, social cognition, and metacognition in schizophrenia

Minor

Marggraf

Davis

et al. 2015

Schizophrenia Research

Self Cite

View full text Add to dashboard Cite

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Dynamic relationships between emotional distress, persecutory ideation, and metacognition in schizophrenia

et al. 2019

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Objective Determine whether metacognitive capacity (i.e., a range of abilities that involve recognition, reflection, and integration of mental states) influences the relationships between emotional distress and persecutory ideation (PI). Methods The present study examined emotional distress, metacognition and PI in a sample (n = 337) of individuals with schizophrenia or schizoaffective disorder and clinician‐rated PI. Pearson and partial correlations were used to examine relationships between variables, as well as between‐subjects analysis of variances to compare groups characterized based on emotional distress and persecutory ideation scores. Results While emotional distress and PI are associated with one another, metacognition is negatively associated with PI and positively associated with emotional distress. Subgroup comparisons demonstrated that individuals with high emotional distress and low PI had significantly higher metacognitive capacity than those elevated in PI or reduced in both emotional distress and PI. Conclusions Findings suggest metacognitive capacity may relate to improved awareness of distress and reduced PI.

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The clinical characterization of the patient with primary psychosis aimed at personalization of management

et al. 2021

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The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medication is prescribed, with second‐generation antipsychotics usually preferred to first‐generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence‐based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves “recovery‐oriented”, it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient’s needs in terms of employment, housing, self‐care, social relationships and education, and offers a focus on identity, meaning and resilience.

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Necessary, but not sufficient: Links between neurocognition, social cognition, and metacognition in schizophrenia are moderated by disorganized symptoms

Cited by 70 publications

References 56 publications

Conceptual disorganization weakens links in cognitive pathways: Disentangling neurocognition, social cognition, and metacognition in schizophrenia

Conceptual disorganization weakens links in cognitive pathways: Disentangling neurocognition, social cognition, and metacognition in schizophrenia

Dynamic relationships between emotional distress, persecutory ideation, and metacognition in schizophrenia

The clinical characterization of the patient with primary psychosis aimed at personalization of management

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