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Kilicoglu MFV, Lundin NB, Angers K, Moe AM. Narrative-Derived Indices of Metacognition among People with Schizophrenia: Associations with Self-Reported and Performance-Based Social Functioning. Behav Sci (Basel) 2024; 14:265. [PMID: 38667061 PMCID: PMC11047350 DOI: 10.3390/bs14040265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
Metacognitive functioning-which broadly encompasses the mental processes involved in thinking about the thinking of one's self and the thinking of others-is often impaired among individuals living with schizophrenia and may contribute to difficulties in social and interpersonal functioning. Although the majority of studies assessing metacognition among individuals with schizophrenia use standardized, laboratory-based measurements, an increasing number of studies have measured metacognitive capacity using natural language produced by individuals living with mental illness. At the same time, less is known about how language-derived indices of metacognitive function relate to key social outcomes among people with schizophrenia. The primary objective of this study was to employ a validated language coding system (the Metacognition Assessment Scale, Abbreviated; MAS-A) to assess metacognitive functioning from the spoken life narratives of individuals with schizophrenia (n = 32) and community controls (n = 15). Among individuals with schizophrenia, we also examined the associations between language-derived metacognition and measures of self-reported and performance-based social functioning. Our results suggest that most aspects of metacognition in our sample were not significantly diminished in people with schizophrenia compared to community controls. Unexpectedly, the MAS-A subscale related to one's ability to master psychological difficulties was rated higher among individuals with schizophrenia. Further, our results suggest that among people with schizophrenia, higher metacognitive functioning in the domain of self-reflectivity was associated with poorer self-reported social functioning, while a greater metacognitive awareness of other individuals' minds was associated with better scores on aspects of performance-based social functioning. Collectively, these results underscore the utility of assessing metacognitive functioning via life-story narratives to understand social outcomes and highlight possible aspects of resiliency among individuals who have experienced a serious mental illness.
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Affiliation(s)
- Melissa F. V. Kilicoglu
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH 43210, USA; (M.F.V.K.); (N.B.L.)
| | - Nancy B. Lundin
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH 43210, USA; (M.F.V.K.); (N.B.L.)
| | - Kaley Angers
- Department of Psychiatry, Neuropsychology Section, University of Michigan-Ann Arbor, Ann Arbor, MI 48109, USA;
| | - Aubrey M. Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH 43210, USA; (M.F.V.K.); (N.B.L.)
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Mori T, Hattori R, Irie K, Tsurumi K, Murai T, Ishii R, Inadomi H. Relationship between personal recovery, autobiographical memory, and clinical recovery in people with mental illness in the acute phase. Heliyon 2024; 10:e26075. [PMID: 38390044 PMCID: PMC10881879 DOI: 10.1016/j.heliyon.2024.e26075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Aim Narratives are important in psychiatric rehabilitation. People with a psychiatric diagnosis find it difficult to recall specific autobiographical memories of events that lasted less than a day. Although personal narratives play a central role in personal recovery, the factors influencing personal and clinical recovery, such as psychiatric symptoms and cognitive function, have not been fully explored. Therefore, this study examined the associations between personal recovery and autobiographical memory, age, psychiatric symptoms, and neurocognitive function. Method The Self-Identified Stage of Recovery, Parts A and B (SISR-A, SISR-B), Autobiographical Memory Test (AMT), Japanese version of the Brief Assessment Scale of Schizophrenia Cognitive Function, and Brief Psychiatric Symptom Rating Scale were administered to 40 individuals with psychiatric disorders who were undergoing psychiatric rehabilitation. Results A significant positive correlation was found between the total number of specific memories in the AMT and total SISR-B scores. A binary logistic regression analysis revealed that the total number of specific memories, especially high responsiveness to negative cue words, significantly predicted greater personal recovery. Age, psychiatric symptoms, and neurocognitive function did not significantly predict higher personal recovery. Conclusion In psychiatric rehabilitation, negative episodes should be treated with caution; however, they may also facilitate personal recovery.
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Affiliation(s)
- Taisuke Mori
- Department of Day Care Unit, Kyoto University Hospital, Japan
- Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Japan
| | - Ritsuko Hattori
- Department of Day Care Unit, Kyoto University Hospital, Japan
| | - Keisuke Irie
- Kyoto University Graduate School of Medicine, Japan
| | | | | | - Ryouhei Ishii
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Japan
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Chen EYH, Wong SMY, Tang EYH, Lei LKS, Suen YN, Hui CLM. Spurious Autobiographical Memory of Psychosis: A Mechanistic Hypothesis for the Resolution, Persistence, and Recurrence of Positive Symptoms in Psychotic Disorders. Brain Sci 2023; 13:1069. [PMID: 37509001 PMCID: PMC10376952 DOI: 10.3390/brainsci13071069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Psychotic disorders are complex disorders with multiple etiologies. While increased dopamine synthesis capacity has been proposed to underlie psychotic episodes, dopamine-independent processes are also involved (less responsive to dopamine receptor-blocking medications). The underlying mechanism(s) of the reduction in antipsychotic responsiveness over time, especially after repeated relapses, remain unclear. Despite the consistent evidence of dopamine overactivity and hippocampal volume loss in schizophrenia, few accounts have been provided based on the interactive effect of dopamine on hippocampal synapse plasticity mediating autobiographical memory processes. The present hypothesis builds upon previous works showing the potential effects of dopamine overactivity on hippocampal-mediated neuroplasticity underlying autobiographical memory, alongside known patterns of autobiographical memory dysfunction in psychosis. We propose that spurious autobiographical memory of psychosis (SAMP) produced during active psychosis may be a key mechanism mediating relapses and treatment non-responsiveness. In a hyperdopaminergic state, SAMP is expected to be generated at an increased rate during active psychosis. Similar to other memories, it will undergo assimilation, accommodation, and extinction processes. However, if SAMP fails to integrate with existing memory, a discontinuity in autobiographical memory may result. Inadequate exposure to normalizing experiences and hyposalience due to overmedication or negative symptoms may also impede the resolution of SAMP. Residual SAMP is hypothesized to increase the propensity for relapse and treatment non-responsiveness. Based on recent findings on the role of dopamine in facilitating hippocampal synapse plasticity and autobiographical memory formation, the SAMP hypothesis is consistent with clinical observations of DUP effects, including the repetition of contents in psychotic relapses as well as the emergence of treatment non-responsiveness after repeated relapses. Clinical implications of the hypothesis highlight the importance of minimizing active psychosis, integrating psychosis memory, avoiding over-medication, and fostering normalizing experiences.
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Affiliation(s)
- Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Stephanie M Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Eric Y H Tang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lauren K S Lei
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yi-Nam Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Christy L M Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Lungu PF, Lungu CM, Ciobîcă A, Balmus IM, Boloș A, Dobrin R, Luca AC. Metacognition in Schizophrenia Spectrum Disorders-Current Methods and Approaches. Brain Sci 2023; 13:1004. [PMID: 37508936 PMCID: PMC10377717 DOI: 10.3390/brainsci13071004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023] Open
Abstract
Metacognition essentially represents "thinking about thinking", or the individual's capacity to control and monitor their own cognitive processes. Metacognition impairment in schizophrenia represents a core feature of the disease, and, in the last fifteen years, the subject has evolved into a growing study area concentrating on a wide variety of processes, such as clinical insight, autobiographical memory, cognitive beliefs, reasoning, and memory biases. Since metacognition is a complex subject, we wanted to focus on the different nuances of metacognition transposed into the lives of patients diagnosed with either schizophrenia or a schizoaffective disorder. Therefore, this narrative review aims to analyze the literature in order to provide an insight regarding the current methods and approaches in the study of metacognition in schizophrenia or schizoaffective disorders, as well as the results provided. Results from the reviewed studies showed that patients with schizophrenia have a lower metacognitive ability, which is strongly reflected in their lives. Studies to date have highlighted the interaction between schizophrenia symptoms and metacognition, which shows how metacognition impacts work performance, autobiographical memory, motivation, the severity of symptoms, and social cognition.
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Affiliation(s)
- Petru Fabian Lungu
- Faculty of Biology, Biology Department, "Alexandru Ioan Cuza" University, 700506 Iasi, Romania
| | - Corina-Miruna Lungu
- Faculty of Psychology and Educational Sciences/Psychology Department, "Alexandru Ioan Cuza" University, 700506 Iasi, Romania
| | - Alin Ciobîcă
- Faculty of Biology, Biology Department, "Alexandru Ioan Cuza" University, 700506 Iasi, Romania
- Biomedical Research Center, Romanian Academy, 700506 Iasi, Romania
- Academy of Romanian Scientists, 010071 Bucharest, Romania
| | - Ioana Miruna Balmus
- Institute of Interdisciplinary Research, Department of Exact Sciences and Natural Sciences, "Alexandru Ioan Cuza" University, 700506 Iasi, Romania
| | - Alexandra Boloș
- Departament of Psychiatry, "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Romeo Dobrin
- Departament of Psychiatry, "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Costina Luca
- Department of Mother and Child Medicine-Pediatrics, "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
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Relations between parental metacognitive talk and children's early metacognition and memory. J Exp Child Psychol 2023; 226:105577. [PMID: 36335835 DOI: 10.1016/j.jecp.2022.105577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
After decades of research suggesting that metacognition-that is, processes whereby people monitor and regulate their cognitive performance-did not emerge and is not related to children's performance until late childhood, recent studies have provided evidence that even preverbal infants can access their internal states. The existence of this basic metacognition raises the question of the variables influencing its development at such a young age and whether such early skills could predict successful cognitive performance. The current study had two main goals: (a) exploring the relation between parental metacognitive style and children's early metacognition and (b) determining whether these early metacognitive skills can predict children's memory performance. To this end, 2.5- to 4.5-year-old children (N = 72) and their parents were recruited. To assess parental metacognitive style, parent-child dyads were invited to participate in a 15-min session during which they played memory games. The parents' speech during this session was later coded for metacognitive content. Children's memory was assessed using cued recall and recognition tests. During one of these recognition tests, participants had the opportunity to ask for a cue to help them decide whether their response was correct (i.e., metacognitive measure). Results revealed that parental metacognitive style predicted both children's metacognitive accuracy and memory performance. Interestingly, a mediation effect of children's metacognitive skills on the relation between parental style and memory performance was found. These findings suggest that environmental factors such as parental metacognitive style are related to children's early metacognition, which in turn is linked to children's memory development.
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Moulin CJA, Carreras F, Barzykowski K. The phenomenology of autobiographical retrieval. WIRES COGNITIVE SCIENCE 2022; 14:e1638. [DOI: 10.1002/wcs.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Chris J. A. Moulin
- Laboratoire de Psychologie et Neurocognition (LPNC CNRS 5105) Université Grenoble Alpes Grenoble France
- Institut Universitaire de France Paris France
| | - Fabien Carreras
- Laboratoire de Psychologie et Neurocognition (LPNC CNRS 5105) Université Grenoble Alpes Grenoble France
| | - Krystian Barzykowski
- Applied Memory Research Laboratory Institute of Psychology, Faculty of Philosophy, Jagiellonian University Kraków Poland
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Lysaker PH, Holm T, Kukla M, Wiesepape C, Faith L, Musselman A, Lysaker JT. Psychosis and the challenges to narrative identity and the good life: Advances from research on the integrated model of metacognition. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Davis BJ, Bonfils KA, Zalzala A, Lysaker PH, Minor KS. Meaning-making processes across the lifespan: An investigation of the developmental course of metacognitive capacity. Schizophr Res 2022; 248:240-245. [PMID: 36115188 DOI: 10.1016/j.schres.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/01/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022]
Abstract
Deficits in metacognitive capacity (i.e., the ability to integrate knowledge of oneself and others into a cohesive whole) have been shown to lead to poor functional outcome in psychosis. However, there is a gap in the literature concerning the role of metacognition in typically developing populations, which makes it difficult to define what level of metacognition is normative and at what point deficits in metacognition suggest pathology. To explore this issue, we utilized cross-sectional design to assess metacognitive capacities among 69 neurotypical adults whose ages varied from 18 to 65 using the Metacognitive Assessment Scale - Abbreviated (MAS-A) and then compared those with MAS-A scores from a second previously gathered sample of 360 adults diagnosed with psychosis across four key developmental windows: emerging adulthood, early adulthood, middle adulthood, and late adulthood. Our findings suggest that in our overall sample, individuals with psychosis had significantly lower levels of metacognitive capacity across all domains assessed by the MAS-A in comparison to neurotypical individuals. Additionally, our data suggest a deleterious effect of psychosis such that individuals with psychosis showed significantly lower metacognition in each developmental stage. Additionally, these differences were largest in emerging and late adulthood and for both groups awareness of others stood out as the single metacognitive domain which was significantly less impaired among older groups. Our results suggest a developmental course for metacognitive capacity such that awareness of others is the sole domain that grows over the lifespan.
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Affiliation(s)
- Beshaun J Davis
- University of Maryland School of Medicine, Department of Psychiatry.
| | - Kelsey A Bonfils
- The University of Southern Mississippi, Department of Psychology
| | | | - Paul H Lysaker
- Indiana University Purdue University Indianapolis, Department of Psychology; Roudebush Veterans Administration Medical Center
| | - Kyle S Minor
- Indiana University Purdue University Indianapolis, Department of Psychology
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