Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia
Open accessAbstract
The present article provides a narrative review of empirical studies on metacognitive training in psychosis (MCT). MCT represents an amalgam of cognitive-behavioral therapy (CBT), cognitive remediation (CRT) and psychoeducation. The intervention is available in either a group (MCT) or an individualized (MCT+) format. By sowing the seeds of doubt in a playful and entertaining fashion, the program targets positive symptoms, particularly delusions. It aims to raise patients' awareness for common cognitive traps or biases (e.g., jumping to conclusions, overconfidence in errors, bias against disconfirmatory evidence) that are implicated in the formation and maintenance of psychosis. The majority of studies confirm that MCT meets its core aim, the reduction of delusions. Problems (e.g., potential allegiance effects) and knowledge gaps (i.e., outcome predictors) are highlighted. The preliminary data suggest that the individual MCT format is especially effective in addressing symptoms, cognitive biases and insight. We conclude that MCT appears to be a worthwhile complement to pharmacotherapy.
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Subjective versus objective cognition: Evidence for poor metacognitive monitoring in schizophrenia
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Self-citationDimensions of Delusions and Attribution Biases along the Continuum of Psychosis
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Delusional evidence-responsiveness
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Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia
Moritz, S., Göritz, A. S., Gallinat, J., Schafschetzy, M., Quaquebeke, N. V., Peters, M. J. V., & Andreou, C. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.02.011 · Cited by 47 · see citing works
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Self-citationStress is a bad advisor. Stress primes poor decision making in deluded psychotic patients
Moritz, S., Köther, U., Hartmann, M. M., & Lincoln, T. M. (2015) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-015-0585-1 · Cited by 44 · see citing works
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Self-citationThe Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy
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Individualized metacognitive therapy for delusions: A randomized controlled rater-blind study
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Willingness to vaccinate against SARS-CoV-2: The role of reasoning biases and conspiracist ideation
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Lüdtke, T., Kriston, L., Schröder, J., Lincoln, T. M., & Moritz, S. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.08.014 · Cited by 39 · see citing works
Self-citationGawęda, Ł., & Prochwicz, K. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2015.08.003 · Cited by 38 · see citing works
Hauschildt, M., Schröder, J., & Moritz, S. (2016) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2016.04.010 · Cited by 37 · see citing works
Self-citationThree Dangers: Phenomenological Reflections on the Psychotherapy of Psychosis
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Neuropsychological functioning and jumping to conclusions in recent onset psychosis patients.
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Towards a common conceptual space for metacognition in perception and memory
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Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training
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Self-citationByrne, G., & Ní Ghráda, Á. (2019) · Aggression and Violent Behavior · doi:10.1016/j.avb.2019.01.001 · Cited by 32 · see citing works
Monocausal attribution and its relationship with reasoning biases in schizophrenia
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Self-citationGoing meta on metacognitive interventions
Moritz, S., Lysaker, P. H., Hofmann, S. G., & Hautzinger, M. (2018) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2018.1520636 · Cited by 28 · see citing works
Self-citationDopamine effects on evidence gathering and integration.
Andreou, C., Schneider, B. C., Braun, V., Kolbeck, K., Gallinat, J., & Moritz, S. (2015) · Journal of Psychiatry & Neuroscience · doi:10.1503/jpn.140306 · Cited by 31 · see citing works
Self-citationThe efficacy of extended metacognitive training for psychosis: A randomized controlled trial
Ishikawa, R., Ishigaki, T., Shimada, T., Tanoue, H., Yoshinaga, N., Oribe, N., Morimoto, T., Matsumoto, T., & Hosono, M. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.08.006 · Cited by 29 · see citing works
Interpretation Biases in Clinical Paranoia
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Cognitive Bias Modification for paranoia (CBM-pa): study protocol for a randomised controlled trial
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The Benefits of Doubt: Cognitive Bias Correction Reduces Hasty Decision-Making in Schizophrenia
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Self-citationDistorted learning from local metacognition supports transdiagnostic underconfidence
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Running acceptance and commitment therapy groups for psychosis in community settings
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Cost Evaluation During Decision-Making in Patients at Early Stages of Psychosis
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How culture shapes social cognition deficits in mental disorders: A review
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Do metacognitive therapies for schizophrenia-spectrum disorders work? A meta-analytic investigation
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Clinical and therapeutic role of mentalization in schizophrenia—a review
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Patient involvement in a systematic review: Development and pilot evaluation of a patient workshop
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Self-citation
- Authors
- Moritz, S., Andreou, C., Schneider, B. C., Wittekind, C. E., Menon, M., Balzan, R. P., & Woodward, T. S.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- University of British Columbia (CA)
- Flinders University (AU)
- Corresponding author
- Moritz, Steffen
- ORCID
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 34
- Issue
- 4
- Pages
- 358-366
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2125152710
- Cited by
- 325
- References
- 68
- Citations by year
- 2026: 20 · 2025: 17 · 2024: 17 · 2023: 19 · 2022: 27 · 2021: 20 · 2020: 32 · 2019: 45 · 2018: 35 · 2017: 31 · 2016: 27 · 2015: 28 · 2014: 6
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Psychology Review (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc-sa)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- Deutsche Forschungsgemeinschaft
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- metacognitive training, schizophrenia, psychosis, delusions, cognitive biases, jumping to conclusions, cognitive remediation, cognitive behavioral therapy, psychoeducation, insight, positive symptoms
- MeSH terms
- Emotions, Humans, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Self Concept, Cognitive Behavioral Therapy
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