Exploring the effects of cognitive remediation on metacognition in people with schizophrenia
Open accessAbstract
Background: Interventions targeting cognition in people with schizophrenia have shown moderate effects on improving functioning. Recent cognitive remediation (CR) approaches have begun to target metacognition to improve functioning outcomes. This study aims to develop a novel measure of metacognition and assess whether metacognitive-based CR (mCR) can improve metacognition. Method: We use data from a single-blinded randomized controlled trial comparing mCR plus treatment as usual (TAU) to TAU alone in people with schizophrenia. Participants were assessed with measures of cognition, functioning, and a new measure of metacognition at three time points: Week 0 (baseline), Week 12, and Week 24. Results: The evaluation of the novel metacognition assessment suggests that it is a reliable and valid measure. The measure positively correlates with cognitive measures, in particular with executive function and IQ but also with a measure of functioning. We found that a course of mCR was able to increase metacognition compared to TAU by Week 24. Conclusions: Metacognition may be an important mechanism to explain how CR affects functioning outcomes in people with psychosis. The systematic assessment of metacognition as part of CR studies may help to evaluate more clearly its role and relevance to functioning.
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The interventions included staff training about activity engagement, Individual Placement and Support (IPS), cognitive remediation, Social Recovery Therapy (SRT), a befriending program, lifestyle modification and occupational therapy group programs.
“These interventions included staff training about activity engagement, its importance for addressing mental illness and approaches to encourage engagement (49); Individual Placement and Support (IPS) (45, 48); cognitive remediation (50); Social Recovery Therapy (SRT) (based on cognitive behavioral strategies) (52–54); a befriending program (56); lifestyle modification (51) and occupational therapy”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [50]
The TUS has been used to measure time spent in structured activities (excluding resting and sleep) as an indicator of overall functioning.
“To date, the TUS has been variously used to measure time spent in structured activities (excluding resting and sleep) as an indicator of overall functioning (50, 52, 53); economic and structured activity participation (55); social participation (e.g. places visited and people with whom activities were completed) (56); and time use as an indicator of social recovery (54).”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [50]
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“…the TUS has been variously used to measure time spent in structured activities (excluding resting and sleep) as an indicator of overall functioning (50, 52, 53); economic and structured activity participation (55); social participation (e.g. places visited and people with whom activities were…”
BackgroundMethod
- Authors
- Cella, M., Edwards, C., Swan, S., Elliot, K., Reeder, C., & Wykes, T.
- Affiliations
- King's College London (GB)
- Bethlem Royal Hospital (GB)
- King’s College London, UK
- Corresponding author
- Cella, Matteo
- Venue
- Journal of Experimental Psychopathology
- Publisher
- SAGE Publications
- Published
- 2019-04-01
- Volume
- 10
- Issue
- 2
- ISSN
- 2043-8087 (ISSN-L)
- OpenAlex
- W2944026743
- Cited by
- 19
- References
- 35
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 7 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 3
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Experimental Psychopathology (publishedVersion, cc-by-nc)
- Research Portal (King's College London) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- cognitive remediation, metacognition, schizophrenia, metacognition assessment, executive function, functional outcome, psychosis, cognitive rehabilitation, psychometric validation
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