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Hohendorf M, Bauer M. Metacognitive sensitivity and symptoms of mental disorder: A systematic review and meta-analysis. Front Psychol 2023; 14:991339. [PMID: 36818089 PMCID: PMC9932734 DOI: 10.3389/fpsyg.2023.991339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Metacognition is a term used to refer to cognition about cognitive processes. In this systematic review and meta-analysis, we reviewed studies that investigated the relationship between experimentally measured objective metacognitive sensitivity and diverse symptoms of mental disorder. In these studies, metacognitive sensitivity is operationalized as the correspondence between the accuracy of task performance and reported confidence therein. Methods A literature search was conducted across four databases and studies were selected for review based on predefined eligibility criteria. Twenty studies were included in the review and separate meta-analyses were conducted for psychotic and non-psychotic categories of psychiatric symptoms. Results A significant reduction (medium effect size) in metacognitive sensitivity was found in individuals with psychosis-related symptoms of mental disorder compared to healthy control groups, but no significant difference was found for individuals with non-psychotic symptoms. It should be noted though, that fewer studies were available for the latter group. Sub-group analysis found no evidence that the effect of metacognitive impairment depended on whether perceptual or non-perceptual experimental tasks were employed. Discussion These findings are discussed in relation to other conceptualizations of metacognition and the role reduced metacognitive sensitivity may play in forms of mental disorder.
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Affiliation(s)
- Marianne Hohendorf
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Markus Bauer
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
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Benwell CSY, Mohr G, Wallberg J, Kouadio A, Ince RAA. Psychiatrically relevant signatures of domain-general decision-making and metacognition in the general population. NPJ MENTAL HEALTH RESEARCH 2022; 1:10. [PMID: 38609460 PMCID: PMC10956036 DOI: 10.1038/s44184-022-00009-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/04/2022] [Indexed: 04/14/2024]
Abstract
Human behaviours are guided by how confident we feel in our abilities. When confidence does not reflect objective performance, this can impact critical adaptive functions and impair life quality. Distorted decision-making and confidence have been associated with mental health problems. Here, utilising advances in computational and transdiagnostic psychiatry, we sought to map relationships between psychopathology and both decision-making and confidence in the general population across two online studies (N's = 344 and 473, respectively). The results revealed dissociable decision-making and confidence signatures related to distinct symptom dimensions. A dimension characterised by compulsivity and intrusive thoughts was found to be associated with reduced objective accuracy but, paradoxically, increased absolute confidence, whereas a dimension characterized by anxiety and depression was associated with systematically low confidence in the absence of impairments in objective accuracy. These relationships replicated across both studies and distinct cognitive domains (perception and general knowledge), suggesting that they are reliable and domain general. Additionally, whereas Big-5 personality traits also predicted objective task performance, only symptom dimensions related to subjective confidence. Domain-general signatures of decision-making and metacognition characterise distinct psychological dispositions and psychopathology in the general population and implicate confidence as a central component of mental health.
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Affiliation(s)
- Christopher S Y Benwell
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK.
| | - Greta Mohr
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK
| | - Jana Wallberg
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Aya Kouadio
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Robin A A Ince
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK
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Adámek P, Langová V, Horáček J. Early-stage visual perception impairment in schizophrenia, bottom-up and back again. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:27. [PMID: 35314712 PMCID: PMC8938488 DOI: 10.1038/s41537-022-00237-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/17/2022] [Indexed: 01/01/2023]
Abstract
Visual perception is one of the basic tools for exploring the world. However, in schizophrenia, this modality is disrupted. So far, there has been no clear answer as to whether the disruption occurs primarily within the brain or in the precortical areas of visual perception (the retina, visual pathways, and lateral geniculate nucleus [LGN]). A web-based comprehensive search of peer-reviewed journals was conducted based on various keyword combinations including schizophrenia, saliency, visual cognition, visual pathways, retina, and LGN. Articles were chosen with respect to topic relevance. Searched databases included Google Scholar, PubMed, and Web of Science. This review describes the precortical circuit and the key changes in biochemistry and pathophysiology that affect the creation and characteristics of the retinal signal as well as its subsequent modulation and processing in other parts of this circuit. Changes in the characteristics of the signal and the misinterpretation of visual stimuli associated with them may, as a result, contribute to the development of schizophrenic disease.
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Affiliation(s)
- Petr Adámek
- Third Faculty of Medicine, Charles University, Prague, Czech Republic. .,Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic.
| | - Veronika Langová
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
| | - Jiří Horáček
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
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Muthesius A, Grothey F, Cunningham C, Hölzer S, Vogeley K, Schultz J. Preserved metacognition despite impaired perception of intentionality cues in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 27:100215. [PMID: 34692428 PMCID: PMC8517602 DOI: 10.1016/j.scog.2021.100215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 11/03/2022]
Abstract
Social cognition and metacognition are frequently impaired in schizophrenia, and these impairments complicate recovery. Recent work suggests that different aspects of metacognition may not be impaired to the same degree. Furthermore, metacognition and the cognitive capacity being monitored need not be similarly impaired. Here, we assessed performance in detecting cues of intentional behaviour as well as metacognition about detecting those cues in schizophrenia. Thirty patients and controls categorized animations of moving dots into those displaying a dyadic interaction demonstrating a chase or no chase and indicated their confidence in these judgments. Perception and metacognition were assessed using signal detection theoretic measures, which were analysed using frequentist and Bayesian statistics. Patients showed a deficit compared to controls in detecting intentionality cues, but showed preserved metacognitive performance into this task. Our study reveals a selective deficit in the perception of intentionality cues, but preserved metacognitive insight into the validity of this perception. It thus appears that impairment of metacognition in schizophrenia varies across cognitive domains - metacognition should not be considered a monolithic stone that is either impaired or unimpaired.
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Affiliation(s)
- Ana Muthesius
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Farina Grothey
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Carter Cunningham
- Masters in Neuroscience Program, Medical Faculty, University of Bonn, Bonn, Germany
| | - Susanne Hölzer
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM-3), Research Centre Jülich, Jülich, Germany
| | - Johannes Schultz
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany.,Institute of Experimental Epileptology and Cognition Research, Medical Faculty, University of Bonn, Bonn, Germany
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Zheng Y, Wang L, Gerlofs DJ, Duan W, Wang X, Yin J, Yan C, Allé MC, Berna F, Wang J, Tang Y, Kwok SC. Atypical meta-memory evaluation strategy in schizophrenia patients. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 27:100220. [PMID: 34646754 PMCID: PMC8501761 DOI: 10.1016/j.scog.2021.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022]
Abstract
Background Previous research has reported that patients with schizophrenia would regard false memories with higher confidence, and this meta-memory deficit was suggested as a neurocognitive marker of schizophrenia. However, how schizophrenia patients determine their memory decision confidence has received scant consideration. This study, therefore, aimed to characterize the extent to which meta-memory evaluation strategy differs between schizophrenia patients and healthy individuals, and how such difference contributes to the patients' meta-memory performance. Methods 27 schizophrenia patients and 28 matched healthy controls performed a temporal-order judgement (TOJ) task, in which they judged which movie frame occurred earlier in an encoded video, and then made retrospective confidence rating. Mixed effect regression models were performed to assess the between-group metacognitive evaluation strategy difference and its relationship to clinical symptoms. Results Compared to the control group, the patients' confidence ratings were correlated more with the recent confidence history and less with the TOJ-related evidence. The degree of dependence on recent history of confidence was negatively correlated with the severity of positive symptoms. Furthermore, by controlling for the first-order TOJ performance, we observed that the patients discriminated correct memory decisions from the incorrect ones as accurately as the controls. Conclusion The present investigation revealed that schizophrenia patients tend to use more heuristics in making meta-memory evaluations, and such atypical strategy is related to their clinical symptoms. This study provides new insights into how schizophrenia patients perform meta-memory processes. Future research could consider examining such metacognitive deficits in light of other cognitive domains in psychosis.
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Affiliation(s)
- Yunxuan Zheng
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Division of Natural and Applied Sciences, Duke Kunshan University, Kunshan, Jiangsu, China.,School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Lei Wang
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - D Jacob Gerlofs
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Wei Duan
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Xinyi Wang
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Jia Yin
- Department of Neurosurgery, Tenth People's Hospital of Tongji University, Shanghai, China
| | - Chao Yan
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Mélissa C Allé
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Fabrice Berna
- University Hospital of Strasbourg - Department of Psychiatry, University of Strasbourg, INSERM U1114, FMTS, France
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sze Chai Kwok
- Shanghai Key Laboratory of Brain Functional Genomics, Key Laboratory of Brain Functional Genomics Ministry of Education, Shanghai Key Laboratory of Magnetic Resonance, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Division of Natural and Applied Sciences, Duke Kunshan University, Kunshan, Jiangsu, China.,Shanghai Changning Mental Health Center, Shanghai, China
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