Metacognition in schizophrenia: correlates and stability of deficits in theory of mind and self-reflectivity.
Abstract
Research suggests that many with schizophrenia experience a range of deficits in metacognition including difficulties recognizing the emotions and intentions of others as well as reflecting upon and questioning their own thinking. Unclear, however, is the extent to which these deficits are stable over time, how closely related they are to one another and whether their associations with core aspects of the disorder such as disorganization symptoms are stable over time. To explore this issue, we administered three assessments of Theory of Mind (ToM), the Beck Cognitive Insight Scale (BCIS), and the Positive and Negative Syndrome Scale at baseline and 6 months to 36 participants with schizophrenia. Correlations revealed the ToM and BCIS scores were stable across the two test administrations and that the ToM tests were closely linked to each other but not to the BCIS. Poorer baseline performance on the ToM tests and the Self-Certainty scale of the BCIS were linked to greater cognitive symptoms at baseline and follow-up, while greater Self-Reflectivity on the BCIS was linked to greater levels of emotional distress at both baseline and 6-month follow-up. Results are consistent with assertions that deficits in metacognition are a stable feature of schizophrenia.
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Our ecological assessment identified metacognitive deficits as the main determinant for pathogenetic cognitive processes associated with positive symptoms.
“Furthermore, our ecological assessment (see Supplementary Table 2) identified metacognitive deficits (90) to be the main determinant for pathogenetic cognitive processes associated with positive symptoms (first health problem).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [90]
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- Authors
- Lysaker, P. H., Olesek, K. L., Warman, D. M., Martin, J. M., Salzman, A. K., Nicolò, G., Salvatore, G., & Dimaggio, G.
- Affiliations
- Richard L. Roudebush VA Medical Center (US)
- University of Indianapolis (US)
- Butler University (US)
- Corresponding author
- Lysaker, Paul H.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 190
- Issue
- 1
- Pages
- 18-22
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2078062326
- Cited by
- 114
- References
- 55
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 7 · 2018: 5 · 2017: 10 · 2016: 12 · 2015: 9 · 2014: 11 · 2013: 16 · 2012: 14
- FWCI
- 8.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- metacognition, schizophrenia, theory of mind, self-reflectivity, cognitive insight, Beck Cognitive Insight Scale, emotional distress, cognitive symptoms, disorganization symptoms, test-retest stability, self-certainty
- MeSH terms
- Adult, Awareness, Cognition Disorders, Emotions, Eye, Female, Hospitals, Veterans, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Theory of Mind
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