Metacognitive deficits in schizophrenia: Presence and associations with psychosocial outcomes

Journal of Nervous and Mental Disease

Volumn 203, Issue 7, 2015, Pages 530-536

  Lysaker, Paul H ^a,b   Vohs, Jenifer ^b,c,d   Minor, Kyle S ^e   Irarrázaval, Leonor ^f,g   Leonhardt, Bethany ^b   Hamm, Jay A ^h   Kukla, Marina ^a   Popolo, Raffaele ⁱ   Luther, Lauren ^e   Buck, Kelly D ^a   Wasmuth, Sara ^a   Dimaggio, Giancarlo ^i,j  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b INDIANA UNIVERSITY   (United States)

^c Prevention and Recovery Center for Early Psychosis Midtown Community Mental Health Centers Wishard Hospital   (United States)

^d Larue D Carter Memorial Hospital   (United States)

^e INDIANA UNIVERSITY   (United States)

^f UNIVERSIDAD DIEGO PORTALES   (Chile)

^g UNIVERSITY HOSPITAL HEIDELBERG   (Germany)

^h ESKENAZI HEALTH   (United States)

ⁱ From Center for Metacognitive Interpersonal Therapy   (Italy)

^j SAPIENZA UNIVERSITY OF ROME   (Italy)

more..

Author keywords

Metacognition; Negative symptoms; Recovery; Schizophrenia; Social cognition

Indexed keywords

ARTICLE; COGNITIVE DEFECT; MENTAL FUNCTION; METACOGNITIVE DEFECT; OUTCOME ASSESSMENT; PSYCHOLOGICAL ASPECT; PSYCHOSOCIAL DISORDER; SCHIZOPHRENIA; SOCIAL ASPECT; SOCIAL PSYCHOLOGY; COGNITION DISORDERS; HUMAN; HUMAN RELATION; MOTIVATION; PERCEPTION; PROGNOSIS; PSYCHOLOGY; SELF CONCEPT; SOCIAL ADAPTATION; TREATMENT OUTCOME;

COGNITION DISORDERS; GOALS; HUMANS; INTERPERSONAL RELATIONS; PROGNOSIS; SCHIZOPHRENIA; SCHIZOPHRENIC PSYCHOLOGY; SELF CONCEPT; SOCIAL ADJUSTMENT; SOCIAL PERCEPTION; SOCIAL SKILLS; TREATMENT OUTCOME;

EID: 84941027484     PISSN: 00223018     EISSN: 1539736X     Source Type: Journal    
DOI: 10.1097/NMD.0000000000000323     Document Type: Article

References (74)

1. Abu-Akel A, Bo S (2013) Superior mentalizing abilities of female patients with schizophrenia. Psychiatr Res. 210:794-799.
2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Publishing.
3. Bacon E, Izaute M (2009) Metacognition in schizophrenia: Processes underlying patients' reflections on their own episodic memory. Biol Psychiatry. 66:1031-1037.
4. Bargenquast R, Schweitzer RD (2014) Enhancing sense of recovery and selfreflectivity in people with schizophrenia: A pilot study of Metacognitive Narrative Psychotherapy. Psychol Psychother. 87:338-356.
5. Bennouna-Greene M, Berna F, Conway MA, Rathbone CJ, Vidailhet P, Danion JM (2012) Self-images and related autobiographical memories in schizophrenia. Conscious Cogn. 21:247-257.
6. Bleuler E (1950) Dementia praecox or the group of schizophrenias. New York: International Universities Press.
7. Bo S, Abu-Akel A, Bertelsen P, Kongerslev M, Haahr UH (2013) Attachment, mentalizing and personality pathology severity in premeditated and impulsive aggression in schizophrenia. Int J Forensic Ment Health. 12:126-138.
8. Bo S, Abu-Akel A, Kongerslev M, Haahr UH, Bateman A (2014) Mentalizing mediates the relationship between psychopathy and type of aggression in schizophrenia. J Nerv Ment Dis. 202:55-63.
9. Brent BK, Fonagy P (2014) A mentalization-based treatment approach to disturbances of social understanding. In Lysaker PH, Diamaggio G, Brüne M (Eds), Social cognition and metacognition in schizophrenia: Psychopathology and treatment approaches (1st ed, pp 245-259). Waltham, MA: Academic Press.
10. Brent BK, Seidman LJ, Thermenos HW, Holt DJ, Keshavan MS (2014) Selfdisturbances as a possible premorbid indicator of schizophrenia risk: A neurodevelopmental perspective. Schizophr Res. 152:73-80.
11. Brüne M, Dimaggio G, Lysaker PH (2011) Metacognition and social functioning in schizophrenia: Evidence, mechanisms of influence and treatment implications. Curr Psychiatr Rev. 7:239-247.
12. Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L (2004) Examining the factor structure of the Recovery Assessment Scale. Schizophr Bull. 30:1035.
13. Davis LW, Eicher AC, Lysaker PH (2011) Metacognition as a predictor of therapeutic alliance over 26 weeks of psychotherapy in schizophrenia. Schizophr Res. 129: 85-90.
14. de Jong S, Renard SB, van Donkersgoed RJM, van der Gaag M, Wunderink L, Pijnenborg GHM, Lysaker PH (2014) The influence of adjunctive treatment and metacognitive deficits in schizophrenia on the experience of work. Schizophr Res. 157:107-111.
15. Dimaggio G, Carcione A, Nicolò G, Conti L, Fiore D, Pedone R, Popolo R, Procacci M, Semerari A (2009) Impaired decentration in personality disorder: A series of single cases analysed with the metacognition assessment scale. Clin Psychol Psychother. 16:450-462.
16. Dinsmore DL, Alexander PA, Loughlin SM (2008) Focusing the conceptual lens on metacognition, self-regulation, and self-regulated learning. Educ Psychol Rev. 20:391-409.
17. Flavell JH (1979) Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. Am Psychol. 34:906-911.
18. Fonagy P, Gergely G, Jurist EL (2004) Affect regulation, mentalization and the development of the self. London: Karnac Books.
19. Fridberg DJ, Brenner A, Lysaker PH (2010) Verbal memory intrusions in schizophrenia: Associations with self-reflectivity, symptomatology, and neurocognition. Psychiatry Res. 179:6-11.
20. Grant PM, Reisweber J, Luther L, Brinen AP, Beck AT (2014) Successfully breaking a 20-year cycle of hospitalizations with recovery-oriented cognitive therapy for schizophrenia. Psychol Serv. 11:125-133.
21. Green MF, Leitman DI (2008) Social cognition in schizophrenia. Schizophr Bull. 34: 670-672.
22. Hamm JA, Renard SB, Fogley RL, Leonhardt BL, Dimaggio G, Buck KD, Lysaker PH (2012) Metacognition and social cognition in schizophrenia: Stability and relationship to concurrent and prospective symptom assessments. J Clin Psychol. 68: 1303-1312.
23. Hasson-Ohayon I (2012) Integrating cognitive behavioral-based therapy with an intersubjective approach: Addressing metacognitive deficits among people with schizophrenia. J Psychother Integr. 22:356-374.
24. Hasson-Ohayon I, Avidan-Msika M, Mashiach-Eizenberg M, Kravetz S, Rozencwaig S, Shalev H, Lysaker PH (2015) Metacognitive and social cognition approaches to understanding the impact of schizophrenia on social quality of life. Schizophr Res. 161:386-391.
25. Hillis JD, Leonhardt BL, Vohs JL, Buck KD, Salvatore G, Popolo R, Dimaggio G, Lysaker PH (2015) Metacognitive reflective and insight therapy for persons in early phase of a schizophrenia spectrum disorder. J Clin Psychol. 71:125-135.
26. Irarrázaval L, Sharim D (2014) Intersubjectivity in schizophrenia: Life story analysis of three cases. Front Psychol. 5:100.
27. Kay SR, Flszbein A, Opfer LA (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 13:261-276.
28. Keshavan MS, Clementz BA, Pearlson GD, Sweeney JA, Tamminga CA (2013) Reimagining psychoses: An agnostic approach to diagnosis. Schizophr Res. 146:10-16.
29. Kukla M, Lysaker PH, Salyers MP (2013) Do persons with schizophrenia who have better metacognitive capacity also have a stronger subjective experience of recovery? Psychiatr Res. 209:381-385.
30. Leonhardt BL, Hamm JA, Belanger EA, Lysaker PH (In press) Childhood sexual abuse moderates the relationship of self-reflectivity with increased emotional distress in schizophrenia. Psychosis.
31. Lincoln TM, Lüllmann E, Rief W (2007) Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophr Bull. 33:1324-1342.
32. Luedtke BL, Kukla M, Renard S, Dimaggio G, Buck KD, Lysaker PH (2012) Metacognitive functioning and social cognition as predictors of accuracy of selfappraisals of vocational function in schizophrenia. Schizophr Res. 137:260-261.
33. Lysaker PH, Carcione A, Dimaggio G, Johannesen JK, Nicolò G, Procacci M, Semerari A (2005) Metacognition amidst narratives of self and illness in schizophrenia: Associations with neurocognition, symptoms, insight and quality of life. Acta Psychiatr Scand. 112:64-71.
34. Lysaker PH, Clements CA, Plascak-Hallberg CD, Knipscheer SJ, Wright DE (2002) Insight and personal narratives of illness in schizophrenia. Psychiatry Interpers Biol Processes. 65:197-206.
35. Lysaker PH, Dimaggio G (2014) Metacognitive capacities for reflection in schizophrenia: Implications for developing treatments. Schizophr Bull. 40:487-491.
36. Lysaker PH, Dimaggio G, Buck KD, Callaway SS, Salvatore G, Carcione A, Nicolo G, Stanghellini G (2011a) Poor insight in schizophrenia: Links between different forms of metacognition with awareness of symptoms, treatment need, and consequences of illness. Compr Psychiatry. 52:253-260.
37. Lysaker PH, Dimaggio G, Buck KD, Carcione A, Nicolò G (2007) Metacognition within narratives of schizophrenia: Associations with multiple domains of neurocognition. Schizophr Res. 93:278-287.
38. Lysaker PH, Dimaggio G, Carcione A, Procacci M, Buck KD, Davis LW, Nicolò G (2010a) Metacognition and schizophrenia: The capacity for self-reflectivity as a predictor for prospective assessments of work performance over six months. Schizophr Res. 122:124-130.
39. Lysaker PH, Dimaggio G, Daroyanni P, Buck KD, LaRocco VA, Carcione A, NicolòG (2010b) Assessing metacognition in schizophrenia with the Metacognition Assessment Scale: Associations with the Social Cognition and Object Relations Scale. Psychol Psychother. 83:303-315.
40. Lysaker PH, Dimaggio G, Wicket-Curtis A, Kukla M, Luedtke BL, Vohs J, Leonhardt BL, James AV, Buck KD, Davis LW (In press) Deficits in metacognitive capacity are related to subjective distress and heightened levels of hyperarousal symptoms in adults with Posttraumatic Stress Disorder. J Trauma Dissociation.
41. Lysaker PH, Erickson MA, Buck B, Buck KD, Olesek K, Grant MLA, Salvatore G, Popolo R, Dimaggio G (2011c) Metacognition and social function in schizophrenia: Associations over a period of five months. Cogn Neuropsychiatry. 16: 241-255.
42. Lysaker PH, Erickson MA, Ringer J, Buck KD, Semerari A, Carcione A, Dimaggio G (2011b) Metacognition in schizophrenia: The relationship of mastery to coping, insight, self-esteem, social anxiety, and various facets of neurocognition. Br J Clin Psychol. 50:412-424.
43. Lysaker PH, Leonhardt BL, Brüne M, Buck KD, James A, Vohs J, Francis M, Hamm JA, Salvatore G, Ringer J, Dimaggio G (2014a) Capacities for theory of mind, metacognition, and neurocognitive function are independently related to emotional recognition in schizophrenia. Psychiatr Res. 219:79-85.
44. Lysaker PH, McCormick BP, Snethen G, Buck KD, Hamm JA, Grant M, Nicolò G, Dimaggio G (2011d) Metacognition and social function in schizophrenia: Associations ofmastery with functional skills competence. Schizophr Res. 131:214-218.
45. Lysaker PH, Shea AM, Buck KD, Dimaggio G, Nicolò G, Procacci M, Salvatore G, Rand KL (2010c) Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders. Acta Psychiatr Scand. 122:405-413.
46. Lysaker PH, Vohs J, Hamm JA, Kukla M, Minor KS, de Jong S, van Donkersgoed R, Pijnenborg MH, Kent JS, Matthews SC, Ringer JM, Leonhardt BL, Francis MM, Buck KD, Dimaggio G (2014b) Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity. J Psychiatr Res. 55:126-132.
47. Lysaker PH, Vohs J, Ohayon IH, Kukla M, Wierwille J, Dimaggio G (2013a) Depression and insight in schizophrenia: Comparisons of levels of deficits in social cognition and metacognition and internalized stigma across three profiles. Schizophr Res. 148:18-23.
48. Lysaker PH, Vohs JL, Ballard R, Fogley R, Salvatore G, Popolo R, Dimaggio G (2013b) Metacognition, self-reflection and recovery in schizophrenia. Future Neurol. 8:103-115.
49. Lysaker PH, Warman DM, Dimaggio G, Procacci M, LaRocco VA, Clark LK, Dike CA, Nicolò G (2008) Metacognition in schizophrenia: Associations with multiple assessments of executive function. J Nerv Ment Dis. 196:384-389.
50. MacBeth A, Gumley A, Schwannauer M, Carcione A, Fisher R, McLeod HJ, Dimaggio G (2014) Metacognition, symptoms and premorbid functioning in a First Episode Psychosis sample. Compr Psychiatry. 55:268-273.
51. Main M (1991) Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) models of attachment: Findings and directions for future research. In Harris P, Stevenson-Hinde J, Parkes C (Eds), Attachment across the life cycle (pp 127-159). New York: Routledge.
52. Massé M, Lecomte T. (In press) Metacognitive profiles in individuals with a first episode of psychosis and their relation to social functioning and perceived social support. Schizophr Res.
53. McLeod HJ, Gumley AI, MacBeth A, Schwannauer M, Lysaker PH (2014) Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis. J Psychiatr Res. 54:109-115.
54. Minor KS, Lysaker PH (2014) Necessary, but not sufficient: Links between neurocognition, social cognition, and metacognition in schizophrenia are moderated by disorganized symptoms. Schizophr Res. 159:198-204.
55. Moritz S, Veckenstedt R, Andreou C, Bohn F, Hottenrott B, Leighton L, Köther U, Woodward TS, Treszl A, Menon M, Schneider BC, Pfueller U, Roesch-Ely D (2014) Sustained and "sleeper" effects of group metacognitive training for schizophrenia: A randomized clinical trial. JAMA Psychiatry. 71:1103-1111.
56. Nabors LM, Yanos PT, Roe D, Hasson-Ohayon I, Leonhardt BL, Buck KD, Lysaker PH (2014) Stereotype endorsement, metacognitive capacity, and self-esteem as predictors of stigma resistance in persons with schizophrenia. Compr Psychiatry. 55:792-798.
57. Nemeroff CB, Weinberger D, Rutter M, MacMillan HL, Bryant RA, Wessely S, Berk M (2013) DSM-5:A collection of psychiatrist views on the changes, controversies, and future directions. BMC Med. 11:202.
58. Nicolò G, Dimaggio G, Popolo R, Carcione A, Procacci M, Hamm J, Buck KD, Pompili E, Buccione I, Lagrotteria B, Lysaker PH (2012) Associations of metacognition with symptoms, insight, and neurocognition in clinically stable outpatients with schizophrenia. J Nerv Ment Dis. 200:644-647.
59. Patterson TL, Goldman S, McKibbin CL, Hughs T, Jeste DV (2001) UCSD Performance-Based Skills Assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophr Bull. 27:235-245.
60. Pinkham AE, Penn DL, Green MF, Buck B, Healey K, Harvey PD (2014) The Social Cognition Psychometric Evaluation Study: Results of the expert survey and RAND Panel. Schizophr Bull. 40:813-823.
61. Rabin SJ, Hasson-Ohayon I, Avidan M, Rozencwaig S, Shalev H, Kravetz S (2014) Metacognition in schizophrenia and schizotypy: Relation to symptoms of schizophrenia, traits of schizotypy and Social Quality of Life. Isr J Psychiatry Relat Sci. 51:44-53.
62. Salvatore G, Lysaker PH, Gumley A, Popolo R, Mari J, Dimaggio G (2012) Out of illness experience: Metacognition-oriented therapy for promoting self-awareness in individuals with psychosis. Am J Psychother. 66:85-106.
63. Semerari A, Carcione A, Dimaggio G, Falcone M, Nicolo G, Procacci M, Alleva G (2003) How to evaluate metacognitive functioning in psychotherapy? The Metacognition Assessment Scale and its applications. Clin Psychol Psychother. 10: 238-261.
64. Semerari A, Carcione A, Dimaggio G, Nicolò G, Procacci M (2007) Understanding minds, different functions and different disorders? The contribution of psychotherapeutic research. Psychother Res. 17:106-119.
65. Semerari A, Colle L, Pellecchia G, Buccione I, Carcione A, Dimaggio G, Nicolò G, Procacci M, Pedone R (2014) Metacognition: Severity and styles in personality disorders. J Pers Disord. 28:751-766.
66. Snethen GA, McCormick BP, Lysaker PH (2014) Physical activity and psychiatric symptoms in adults with schizophrenia spectrum disorders. J Nerv Ment Dis. 202:845-852.
67. Tarricone P (2011) The taxonomy of metacognition. Ney York: Psychology Press.
68. Tas C, Brown EC, Aydemir O, Brüne M, Lysaker PH (2014) Metacognition in psychosis: Comparison of schizophrenia with bipolar disorder. Psychiatr Res. 219:464-469.
69. Tas C, Brown EC, Esen-Danaci A, Lysaker PH, Brüne M (2012) Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia. J Psychiatr Res. 46:1086-1092.
70. Tracey TJ, Kokotovic AM (1989) Factor structure of the Working Alliance Inventory. Psychol Assess. 1:207-210.
71. van Donkersgoed RJM, de Jong S, van der Gaag M, Aleman A, Lysaker PH, Wunderink L, Pijnenborg GHM (2014) A manual-based individual therapy to improve metacognition in schizophrenia: Protocol of a multi-center RCT. BMC Psychiatry. 14:27.
72. Vohs JL, Lysaker PH (2014) Metacognitivemastery and intrinsic motivation in schizophrenia. J Nerv Ment Dis. 202:74-77.
73. Vohs JL, Lysaker PH, Francis MM, Hamm J, Buck KD, Olesek K, Outcalt J, Dimaggio G, Leonhardt B, Liffick E, Mehdiyoun N, Breier A (2014) Metacognition, social cognition, and symptoms in patients with first episode and prolonged psychoses. Schizophr Res. 153:54-59.
74. Wei Ming W, Yi D, Lysaker PH, Kai W (In press) The relationship among metacognition, empathy and psychosis in schizophrenia patients in a post acute phase of illness. Chin J Behav Med Brain Sci