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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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Ferrer-Quintero M, Fernández D, López-Carrilero R, Birulés I, Barajas A, Lorente-Rovira E, Díaz-Cutraro L, Verdaguer M, García-Mieres H, Sevilla-Llewellyn-Jones J, Gutiérrez-Zotes A, Grasa E, Pousa E, Huerta-Ramos E, Pélaez T, Barrigón ML, González-Higueras F, Ruiz-Delgado I, Cid J, Moritz S, Ochoa S. Persons with first episode psychosis have distinct profiles of social cognition and metacognition. NPJ SCHIZOPHRENIA 2021; 7:61. [PMID: 34887442 PMCID: PMC8660816 DOI: 10.1038/s41537-021-00187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/08/2021] [Indexed: 11/09/2022]
Abstract
Subjects with first-episode psychosis experience substantial deficits in social cognition and metacognition. Although previous studies have investigated the role of profiles of individuals in social cognition and metacognition in chronic schizophrenia, profiling subjects with first-episode psychosis in both domains remains to be investigated. We used latent profile analysis to derive profiles of the abilities in 174 persons with first-episode psychosis using the Beck's Cognitive Insight Scale, the Faces Test, the Hinting Task, the Internal, Personal and Situational Attributions Questionnaire, and the Beads Task. Participants received a clinical assessment and a neuropsychological assessment. The best-fitting model was selected according to the Bayesian information criterion (BIC). We assessed the importance of the variables via a classification tree (CART). We derived three clusters with distinct profiles. The first profile (33.3%) comprised individuals with low social cognition. The second profile (60.9%) comprised individuals that had more proneness to present jumping to conclusions. The third profile (5.7%) presented a heterogeneous profile of metacognitive deficits. Persons with lower social cognition presented worse clinical and neuropsychological features than cluster 2 and cluster 3. Cluster 3 presented significantly worst functioning. Our results suggest that individuals with FEP present distinct profiles that concur with specific clinical, neuropsychological, and functional challenges. Each subgroup may benefit from different interventions.
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Affiliation(s)
- M Ferrer-Quintero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - D Fernández
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Fundació Sant Joan de Déu, Esplugues de Llobregat (Barcelona), Barcelona, Spain.,Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain
| | - R López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Fundació Sant Joan de Déu, Esplugues de Llobregat (Barcelona), Barcelona, Spain
| | - I Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain
| | - A Barajas
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - E Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Psychiatry Service, Hospital Clínico Universitario de Valencia, Barcelona, Spain
| | - L Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - M Verdaguer
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - H García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - J Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC), Clinico San Carlos Hospital, Madrid, Spain
| | - A Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Spain
| | - E Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Pousa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.,Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Barcelona, Spain.,Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - E Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - T Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - M L Barrigón
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital (Madrid), Madrid, Spain.,Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril (Granada), Spain
| | | | - I Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, Málaga, Spain
| | - J Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - S Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | | | - S Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain. .,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
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