Metacognitive Deficits in Schizophrenia: Presence and Associations With Psychosocial Outcomes
Abstract
Early formulations of schizophrenia suggested that the disorder involves a loss of ability to form integrated ideas about oneself, others, and the world, resulting in reductions in complex goal-directed behaviors. Exploring this position, the current review describes evidence that persons with schizophrenia experience decrements in their ability to form complex ideas about themselves and to ultimately use that knowledge to respond to psychological and social challenges. Studies are detailed that find greater levels of these impairments, defined as metacognitive deficits, in persons with schizophrenia in both early and later phases of illness as compared with other clinical and community groups. Furthermore, studies linking metacognitive deficits with poorer psychosocial functioning and other variables closely linked to outcomes are summarized. Clinical implications are also discussed.
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Greater metacognitive capacity is related to higher levels of both clinical and cognitive insight, independent of symptom severity and neurocognitive function.
“Consistent with this, a recent review 145 suggested that greater metacognitive capacity is related to higher levels of both clinical and cognitive insight, and that its contribution to both forms of insight is independent of symptom severity and neurocognitive function and may also protect against the emergence of depression in the wake of the development of insight.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [145]
Poor insight may arise from metacognitive deficits.
“A fifth potential barrier to insight is metacognition, or the processes which allow persons to be aware of and form integrated and complex ideas about the self and others.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [145]
Metacognition may protect against the emergence of depression in the wake of the development of insight.
“Consistent with this, a recent review 145 suggested that greater metacognitive capacity is related to higher levels of both clinical and cognitive insight, and that its contribution to both forms of insight is independent of symptom severity and neurocognitive function and may also protect against the emergence of depression in the wake of the development of insight.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [145]
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- Authors
- Lysaker, P. H., Vohs, J., Minor, K. S., Irarrázaval, L., Leonhardt, B., Hamm, J. A., Kukla, M., Popolo, R., Luther, L., Buck, K. D., Wasmuth, S., & Dimaggio, G.
- Affiliations
- Heidelberg University (DE)
- Sidney & Lois Eskenazi Hospital (US)
- Indiana University – Purdue University Indianapolis (US)
- University Hospital Heidelberg (DE)
- Indiana University School of Medicine (US)
- Richard L. Roudebush VA Medical Center (US)
- Eskenazi Health (US)
- Sapienza University of Rome (IT)
- Corresponding author
- Lysaker, Paul H.
- Hamm, Jay A.
- Kukla, Marina
- Buck, Kelly D.
- Wasmuth, Sara
- ORCID
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2015-07
- Volume
- 203
- Issue
- 7
- Pages
- 530-536
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2405024193
- Cited by
- 94
- References
- 63
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 7 · 2020: 8 · 2019: 24 · 2018: 10 · 2017: 9 · 2016: 15 · 2015: 2
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (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
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- schizophrenia, metacognition, metacognitive deficits, self-knowledge, social cognition, psychosocial functioning, clinical course, cognitive impairment
- MeSH terms
- Cognition Disorders, Goals, Humans, Interpersonal Relations, Prognosis, Schizophrenia, Schizophrenic Psychology, Self Concept, Social Adjustment, Social Perception, Treatment Outcome, Social Skills
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