The association between metacognitive abilities and outcome measures among people with schizophrenia: a meta-analysis.
Abstract
Abstract Background: Deficits in metacognition are one of the major causes of the difficulties experienced by individuals with schizophrenia. Studies have linked these deficits to symptom exacerbation and deterioration in psychosocial functioning. The aim of the present meta-analysis was to examine the extensive existing literature regarding metacognitive deficits among persons with schizophrenia; a further aim was to assess the extent to which metacognitive abilities are linked to outcome measures of symptoms and psychosocial functioning. Method: We conducted a systematic literature search of studies examining the relationship between metacognitive abilities and outcome measures among people with schizophrenia. We then analyzed the data using a random-effects meta-analytic model with Cohen's d standardized mean effect size. Results: Heterogeneity analyses (k = 32, Cohen's d = −.12, 95% CI.−1.92 to 1.7) produced a significant Q-statistic (Q = 456.89) and a high amount of heterogeneity, as indicated by the I2 statistic (93.04%), suggesting that moderator analyses were appropriate. As hypothesized, measure type moderated the metacognitive deficit with homogenous effect for psychosocial functioning measures (Q = 9.81, I2 = 19.47%, d = .94. 95% CI .58 to 1.2) and symptoms (Q = 19.87, I2 = 0%, d = −1.07, 95% CI −1.18 to −.75). Further analysis found homogenous effects for MAS-A subscales as well as PANSS factors of symptoms. Conclusion: Our meta-analysis results illustrated a significant association between metacognitive deficits and both symptomatic and psychosocial functioning measures. These links suggest that the associations between metacognitive abilities and symptomatic outcomes are different from those between metacognitive abilities and psychosocial functioning measures. Intriguing hypotheses are raised regarding the role that metacognitive abilities play in both symptoms and psychosocial functioning measures of people diagnosed with schizophrenia spectrum disorders.
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Patients with psychotic symptoms seem to show deficits in all four components of metacognition (knowledge, awareness, goal, strategy).
“Patients with psychotic symptoms thereby seem to show deficits in all four components (94).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [94]
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Art Therapy as a Nursing Intervention for Individuals With Schizophrenia
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de Jong, S., Hasson‐Ohayon, I., van Donkersgoed, R. J. M., Timmerman, M. E., van der Gaag, M., Aleman, A., Pijnenborg, G. H. M., & Lysaker, P. H. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2388 · Cited by 10 · see citing works
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Bröcker, A., Zimmermann, J., Stuke, F., Just, S. A., Bayer, S., Mielau, J., Bertram, G., Funcke, J., Maaßen, E., Hadzibegovic, J., et al. (2022) · Journal of Personality Assessment · doi:10.1080/00223891.2022.2048843 · Cited by 9 · see citing works
Relationship between cognition and suicidal behavior in recent-onset psychosis
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Metacognição no transtorno bipolar: uma revisão sistemática
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“Patients with psychotic symptoms thereby seem to show deficits in all four components (94).”
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Tracing Metacognition in Psychotherapy
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Enhancing Metacognition Through Group-Based Metacognitive Reflection and Insight Therapy (MERITg)
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Disturbances in the dialogical self in psychosis
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Self-citationMetacognition as a pathway to the study and treatment of fragmentation in schizophrenia
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Self-citationAdolescent Social Skills Intervention: Theory, Design, and Implementation
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- Authors
- Arnon-Ribenfeld, N., Hasson-Ohayon, I., Lavidor, M., Atzil-Slonim, D., & Lysaker, P. H.
- Affiliations
- Bar-Ilan University (IL)
- Richard L. Roudebush VA Medical Center (US)
- ORCID
- Lysaker, P.H.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-10
- Volume
- 46
- Pages
- 33-41
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2753692511
- Cited by
- 84
- References
- 73
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 10 · 2023: 14 · 2022: 11 · 2021: 11 · 2020: 6 · 2019: 15 · 2018: 9
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bar-Ilan University
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- metacognition, metacognitive deficits, schizophrenia, schizophrenia spectrum disorders, symptom severity, psychosocial functioning, outcome measures, PANSS
- MeSH terms
- Metacognition, Humans, Schizophrenia, Schizophrenic Psychology, Treatment Outcome, Outcome Assessment, Health Care
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