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Calmette T, Meunier H. Is self-awareness necessary to have a theory of mind? Biol Rev Camb Philos Soc 2024; 99:1736-1771. [PMID: 38676546 DOI: 10.1111/brv.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
Forty years ago, Gallup proposed that theory of mind presupposes self-awareness. Following Humphrey, his hypothesis was that individuals can infer the mental states of others thanks to the ability to monitor their own mental states in similar circumstances. Since then, advances in several disciplines, such as comparative and developmental psychology, have provided empirical evidence to test Gallup's hypothesis. Herein, we review and discuss this evidence.
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Affiliation(s)
- Tony Calmette
- Centre de Primatologie de l'Université de Strasbourg, Niederhausbergen, 67207, France
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364, CNRS, Université de Strasbourg, Strasbourg, 67000, France
| | - Hélène Meunier
- Centre de Primatologie de l'Université de Strasbourg, Niederhausbergen, 67207, France
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364, CNRS, Université de Strasbourg, Strasbourg, 67000, France
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McGuire N, Gumley A, Hasson-Ohayon I, Allan S, Aunjitsakul W, Aydin O, Bo S, Bonfils KA, Bröcker AL, de Jong S, Dimaggio G, Inchausti F, Jansen JE, Lecomte T, Luther L, MacBeth A, Montag C, Pedersen MB, Pijnenborg GHM, Popolo R, Schwannauer M, Trauelsen AM, van Donkersgoed R, Wu W, Wang K, Lysaker PH, McLeod H. Investigating the relationship between specific negative symptoms and metacognitive functioning in psychosis: A systematic review. Psychol Psychother 2024; 97:191-214. [PMID: 37864383 DOI: 10.1111/papt.12505] [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: 02/17/2023] [Revised: 07/20/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Disrupted metacognition is implicated in development and maintenance of negative symptoms, but more fine-grained analyses would inform precise treatment targeting for individual negative symptoms. AIMS This systematic review identifies and examines datasets that test whether specific metacognitive capacities distinctly influence negative symptoms. MATERIALS & METHODS PsycINFO, EMBASE, Medline and Cochrane Library databases plus hand searching of relevant articles, journals and grey literature identified quantitative research investigating negative symptoms and metacognition in adults aged 16+ with psychosis. Authors of included articles were contacted to identify unique datasets and missing information. Data were extracted for a risk of bias assessment using the Quality in Prognostic Studies tool. RESULTS 85 published reports met criteria and are estimated to reflect 32 distinct datasets and 1623 unique participants. The data indicated uncertainty about the relationship between summed scores of negative symptoms and domains of metacognition, with significant findings indicating correlation coefficients from 0.88 to -0.23. Only eight studies investigated the relationship between metacognition and individual negative symptoms, with mixed findings. Studies were mostly moderate-to-low risk of bias. DISCUSSION The relationship between negative symptoms and metacognition is rarely the focus of studies reviewed here, and negative symptom scores are often summed. This approach may obscure relationships between metacognitive domains and individual negative symptoms which may be important for understanding how negative symptoms are developed and maintained. CONLCLUSION Methodological challenges around overlapping participants, variation in aggregation of negative symptom items and types of analyses used, make a strong case for use of Individual Participant Data Meta-Analysis to further elucidate these relationships.
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Affiliation(s)
| | | | | | | | | | - Orkun Aydin
- International University of Sarajevo, Sarajevo, Bosnia and Herzegovinia
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark
| | - Kelsey A Bonfils
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | | | - Steven de Jong
- Lentis Psychiatric Institute, Groningen, The Netherlands
| | | | - Felix Inchausti
- Department of Mental Health, Servicio Riojano de Salud, Logroño, Spain
| | - Jens Einar Jansen
- Mental Health Center Copenhagen, Capital Region, Copenhagen, Denmark
| | | | | | | | | | - Marlene Buch Pedersen
- Early Psychosis Intervention Centre, Psychiatry East, Region Zealand, Roskilde, Denmark
| | | | | | | | | | | | - Weiming Wu
- Anhui Medical University, Hefei City, China
| | - Kai Wang
- Anhui Medical University, Hefei City, China
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Knobloch S, Leiding D, Wagels L, Regenbogen C, Kellermann T, Mathiak K, Schneider F, Derntl B, Habel U. Empathy in schizophrenia: neural alterations during emotion recognition and affective sharing. Front Psychiatry 2024; 15:1288028. [PMID: 38855645 PMCID: PMC11157094 DOI: 10.3389/fpsyt.2024.1288028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 05/01/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Deficits in emotion recognition and processing are characteristic for patients with schizophrenia [SCZ]. Methods We targeted both emotion recognition and affective sharing, one in static and one in dynamic facial stimuli, during functional magnetic resonance imaging [fMRI] in 22 SCZ patients and 22 matched healthy controls [HC]. Current symptomatology and cognitive deficits were assessed as potential influencing factors. Results Behaviorally, patients only showed a prolonged response time in age-discrimination trials. For emotion-processing trials, patients showed a difference in neural response, without an observable behavioral correlate. During emotion and age recognition in static stimuli, a reduced activation of the bilateral anterior cingulate cortex [ACC] and the right anterior insula [AI] emerged. In the affective sharing task, patients showed a reduced activation in the left and right caudate nucleus, right AI and inferior frontal gyrus [IFG], right cerebellum, and left thalamus, key areas of empathy. Discussion We conclude that patients have deficits in complex visual information processing regardless of emotional content on a behavioral level and that these deficits coincide with aberrant neural activation patterns in emotion processing networks. The right AI as an integrator of these networks plays a key role in these aberrant neural activation patterns and, thus, is a promising candidate area for neurofeedback approaches.
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Affiliation(s)
- Simon Knobloch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Institute of Systems Neuroscience, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Delia Leiding
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
| | - Christina Regenbogen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Thilo Kellermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Department of the History, Philosophy and Ethics of Medicine, Centre for Health and Society (chs), School of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University, Aachen, Germany
- Jülich-Aachen Research Alliance (JARA) – Translational Brain Medicine, Aachen, Germany
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Myers EJ, Abel DB, Mickens JL, Russell MT, Rand KL, Salyers MP, Lysaker PH, Minor KS. Meta-analysis of the relationship between metacognition and disorganized symptoms in psychosis. Schizophr Res 2024; 264:178-187. [PMID: 38154360 DOI: 10.1016/j.schres.2023.12.009] [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: 07/07/2023] [Revised: 10/10/2023] [Accepted: 12/10/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE Disorganized symptoms show associations with metacognitive deficits in psychosis. However, the magnitude of this relationship is unclear. This meta-analysis aimed to 1) quantify relationships between metacognition and both disorganized symptoms and disorganized speech; and 2) examine moderators of these relationships (e.g., metacognition type, neurocognition). METHOD A literature search was conducted using PsycINFO, Web of Science, PubMed, and EMBASE databases. English-language studies measuring disorganized symptoms and metacognition (i.e., introspective accuracy, metacognitive beliefs, or metacognitive capacity) in psychosis were included. Random effects meta-analyses were conducted using Pearson's r. RESULTS Meta-analysis of 20 studies (n = 1490) resulted in a significant negative medium correlation between disorganized symptoms and metacognition (r = -0.332, 95 % CI [-0.423, -0.235]). Magnitude was moderated by metacognition type. A significant negative small correlation between disorganized speech and metacognition (r = -0.173, 95 % CI [-0.254, -0.089], n = 1470) was observed, with no significant moderators. CONCLUSIONS Results clarify the magnitude of the relationships between metacognition and both disorganized symptoms and disorganized speech. Significant relationships may indicate conceptual links, yet the different magnitudes may reflect a distinction between disorganized symptoms and speech. The moderator finding highlights that metacognitive capacity has an especially strong link to disorganized symptoms and underscores the need for careful distinction between types of metacognition in future work.
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Affiliation(s)
- Evan J Myers
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Danielle B Abel
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Jessica L Mickens
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Madisen T Russell
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Kevin L Rand
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Michelle P Salyers
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
| | - Paul H Lysaker
- Richard L. Roudebush VA Medical Center, Department of Psychiatry, 1481 W. 10th St., Indianapolis, IN 46202, United States; Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, United States.
| | - Kyle S Minor
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St., LD 124, Indianapolis, IN 46202, United States.
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Montemagni C, Brasso C, Bellino S, Bozzatello P, Villari V, Rocca P. Conceptual disorganization as a mediating variable between visual learning and metacognition in schizophrenia. Front Psychiatry 2023; 14:1278113. [PMID: 38179251 PMCID: PMC10765532 DOI: 10.3389/fpsyt.2023.1278113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/16/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives The aim of this study was to evaluate the relative contributions of visual learning and conceptual disorganization to specific metacognitive domains in a sample of outpatients with stable schizophrenia. Methods A total of 92 consecutive outpatients with stable schizophrenia were recruited in a cross-sectional study. We analyzed the data with five path analyses based on multiple regressions to analyze the specific effect of visual learning on metacognitive capacity and metacognitive domains and the possible mediating role of conceptual disorganization. Results We found that (i) visual learning was negatively correlated to metacognitive capacity and its domains on the one hand and conceptual disorganization on the other hand; (ii) conceptual disorganization was negatively associated with metacognition and its domains; and (iii) when the mediation effect was considered, conceptual disorganization fully mediated the relationship between visual learning and mastery, whereas it served as a partial mediator of the effect of visual learning on the other metacognition domains, i.e., self-reflectivity, understanding others' mind, and decentration. Conclusion These results delineate an articulated panorama of relations between different dimensions of metacognition, visual learning, and conceptual disorganization. Therefore, studies unable to distinguish between different components of metacognition fail to bring out the possibly varying links between neurocognition, disorganization, and metacognition.
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Affiliation(s)
- Cristiana Montemagni
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Claudio Brasso
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Silvio Bellino
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Paola Bozzatello
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Vincenzo Villari
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Paola Rocca
- Dipartimento di Neuroscienze "Rita Levi Montalcini", Università Degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città Della Salute e Della Scienza di Torino, Turin, Italy
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Wasmuth S, Horsford C, Mahaffey L, Lysaker PH. "Metacognitive Reflection and Insight Therapy" (MERIT) for the Occupational Therapy Practitioner. Can J Occup Ther 2023; 90:333-343. [PMID: 36426583 DOI: 10.1177/00084174221142172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Background. Metacognitive Reflection and Insight Therapy (MERIT) is a manualized, evidence-based approach that supports occupational participation through its focus on the inter-related constructs of meaning making, positionality, and self-definition (Lysaker et al., 2020). MERIT's core tenets parallel the fundamentals of occupational therapy, making it an ideal guiding methodology for mental health occupational therapy practice. Purpose. We outline key constructs of MERIT and detail how occupational therapy practitioners can apply MERIT to support occupational engagement. Key Issues. Few manualized, evidence-based interventions exist to guide occupational therapy mental health practice (Kirsch et al., 2019). Detailing MERIT and its application in occupational therapy is an important first step in future studies of its feasibility, acceptability, and effectiveness in this context. Implications. MERIT provides a clear methodology for delivering mental health occupational therapy services that is amenable to large-scale hybrid implementation and effectiveness studies, thereby supporting practice and rigour in research.
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Vita A, Barlati S, Deste G, Nibbio G, Penn DL, Pinkham AE, McIntyre RS, Harvey PD. Life engagement in people living with schizophrenia: predictors and correlates of patient life engagement in a large sample of people living in the community. Psychol Med 2023; 53:7943-7952. [PMID: 37522514 PMCID: PMC10755242 DOI: 10.1017/s0033291723002106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/24/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Life engagement represents a holistic concept that encompasses outcomes reflecting life-fulfilment, well-being and participation in valued and meaningful activities, which is recently gaining attention and scientific interest. Despite its conceptual importance and its relevance, life engagement represents a largely unexplored domain in schizophrenia. The aims of the present study were to independently assess correlates and predictors of patient life engagement in a large and well-characterized sample of schizophrenia patients. METHODS To assess the impact of different demographic, clinical, cognitive and functional parameters on life engagement in a large sample of patients with schizophrenia, data from the social cognition psychometric evaluation project were analyzed. RESULTS Overall schizophrenia and depressive symptom severity, premorbid IQ, neurocognitive performance, social cognition performance both in the emotion processing and theory of mind domains, functional capacity, social skills performance and real-world functioning in different areas all emerged as correlates of patient life engagement. Greater symptom severity and greater impairment in real-world interpersonal relationships, social skills, functional capacity and work outcomes emerged as individual predictors of greater limitations in life engagement. CONCLUSIONS Life engagement in people living with schizophrenia represents a holistic and complex construct, with several different clinical, cognitive and functional correlates. These features represent potential treatment targets to improve the clinical condition and also facilitate the process of recovery and the overall well-being of people living with schizophrenia.
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Affiliation(s)
- Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giacomo Deste
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - David L. Penn
- Department of Psychology, University of North Carolina, Chapel Hill, NC, USA
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Amy E. Pinkham
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Roger S. McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
- Brain and Discovery Foundation (BCDF), Toronto, Canada
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Research Service, Miami VA Healthcare System, Miami, FL, USA
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Xue J, Li B, Huang B, Feng H, Li X, Liang S, Yuan F, Wang S, Shi H, Shao J, Shi Y. Sex-dependent and long-lasting effects of adolescent sleep deprivation on social behaviors in adult mice. Pharmacol Biochem Behav 2023; 232:173657. [PMID: 37804868 DOI: 10.1016/j.pbb.2023.173657] [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: 08/23/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
Increasing evidence indicates that sleep deprivation (SD) can exert multiple negative effects on neuronal circuits, resulting in memory impairment, depression, and anxiety, among other consequences. The long-term effects of SD during early life on behavioral phenotypes in adulthood are still poorly understood. In this study, we investigated the long-lasting effects of SD in adolescence on social behaviors, including empathic ability and social dominance, and the role of the gut microbiota in these processes, using a series of behavioral paradigms in mice combined with 16S rRNA gene pyrosequencing. Behavioral assay results showed that SD in adolescence significantly reduced the frequency of licking, the total time spent licking, and the time spent sniffing during the emotional contagion test in male mice, effects that were not observed in female mice. These findings indicated that SD in adolescence exerts long-term, negative effects on empathic ability in mice and that this effect is sex-dependent. In contrast, SD in adolescence had no significant effect on locomotor activities, social dominance but decreased social interaction in male mice in adulthood. Meanwhile, 16S rRNA gene pyrosequencing results showed that gut microbial richness and diversity were significantly altered in adult male mice subjected to SD in adolescence. Our data provide direct evidence that SD in youth can induce alterations in empathic ability in adult male mice, which may be associated with changes in the gut microbiota. These findings highlight the long-lasting effects of sleep loss in adolescence on social behaviors in adulthood and the role played by the brain-gut axis.
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Affiliation(s)
- Jiping Xue
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Bingyu Li
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Boya Huang
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China
| | - Hao Feng
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Xinrui Li
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Shihao Liang
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Fang Yuan
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Sheng Wang
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Haishui Shi
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key Laboratory of Neurophysiology, Hebei Medicinal University, Shijiazhuang 050017, China; Nursing School, Hebei Medicinal University, Shijiazhuang 050031, China.
| | - Juan Shao
- Department of Senile Disease, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.
| | - Yun Shi
- Neuroscience Research Center, Institute of Medical and Health Science, Hebei Medical University, Shijiazhuang 050017, China.
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Abel DB, Minor KS. Social pleasure in daily life: A meta-analysis of experience sampling studies in schizophrenia. Schizophr Res 2023; 260:56-64. [PMID: 37625224 DOI: 10.1016/j.schres.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Social anhedonia is considered a key feature of schizophrenia that leads to impaired social functioning. Although traditional laboratory measures assess non-current social pleasure, researchers have begun using experience sampling methods (ESM) to measure current, or consummatory, experiences of social pleasure in daily life. A recent meta-analysis examined deficits in consummatory social pleasure in schizophrenia and found vast heterogeneity in effect sizes across ESM studies. Thus, this meta-analysis aimed to extend those results by testing moderators of this effect. Meta-analysis of 14 ESM studies suggests those with psychotic disorders exhibit a moderate deficit in consummatory social pleasure compared to healthy controls. Yet, this effect was significantly moderated by the type of measure used to assess social pleasure. Measures that directly assessed positive emotional experience during socialization yielded small effects that failed to reach significance; indirect measures of other social factors related to pleasure yielded large, significant effects. This suggests daily social anhedonia observed in psychotic disorders is not due to reduced experience of positive emotion. Instead, social anhedonia may be driven by other elements of social functioning. Most clinical variables did not influence effects, but there was a trend such that patient groups with lower cognitive functioning exhibited greater pleasure deficits. Inconsistent reporting across studies limited our ability to examine other real-world variables that may contribute to deficits in social pleasure. Yet, results show different ESM items used to measure social pleasure do not assess the same construct. Future research is needed to validate ESM measures and standardize protocols across studies.
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Affiliation(s)
- Danielle B Abel
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States.
| | - Kyle S Minor
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States
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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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11
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Luther L, Hochheiser J, Wiesepape C, Lysaker PH. Negative Schizotypy Mediates the Relationship Between Metacognition and Social Functioning in a Nonclinical Sample. J Nerv Ment Dis 2023; 211:74-78. [PMID: 36596289 DOI: 10.1097/nmd.0000000000001585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
ABSTRACT Reduced metacognitive abilities-difficulty making sense of and understanding oneself and others-have been found to be key predictors of social functioning across a range of clinical and nonclinical groups. However, the exact processes through which metacognition impacts social functioning are unclear. This study examined whether subclinical negative symptoms mediated the relationship between metacognition and social functioning in a nonclinical sample of young adults (n = 98). Results demonstrated that lower metacognitive mastery was found to be uniquely associated with greater subclinical negative symptoms, whereas higher subclinical negative symptoms were associated with reduced social functioning. Further, the effects of lower metacognition on reduced social function were mediated by subclinical negative symptoms and not positive or disorganized subclinical symptoms. Results suggest that subclinical negative symptoms may link reductions in metacognition with social functioning in nonclinical samples. Training aimed at enhancing metacognition may support normative social functioning in the general population.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, Georgia
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12
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Shiota S, Nomura M. Role of fantasy in emotional clarity and emotional regulation in empathy: A preliminary study. Front Psychol 2022; 13:912165. [DOI: 10.3389/fpsyg.2022.912165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/12/2022] [Indexed: 11/18/2022] Open
Abstract
Fantasy is the experience of identifying with characters in movies, novels, plays, and other fictional situations. In social contexts, individuals take on the perspective of others by sensing their emotions through empathy. During this process, perspective-taking and emotional sharing affect one’s metacognition, which deals with the distinction between and the understanding of one’s emotions (clarity) and their regulation (repair); previous studies have primarily focused on these processes. However, perspective-taking—considering another individual’s viewpoint—requires one to imagine their outlook; it also induces emotional responses. This study examined the role of fantasy in clarity and repair in metacognition, for which data derived from 475 Japanese participants were analyzed. The results of the Interpersonal Reactivity Index showed that fantasy was positively associated with clarity and repair in the Trait Meta-Mood Scale; these relationships were moderated by perspective-taking and personal distress. Our results revealed that the emotions experienced within oneself might be understood as the distinction between “imagining” (through their imagination; e.g., internal or mental pictures) and “imaging” (from an image; e.g., external pictures). Individuals imagine their immersion into others using lower-level automatic body sensations (emotional contagion), and the accompanying negative emotions are regulated by metacognition.
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13
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Psychotherapy for Serious Mental Illness in Solitary Confinement: Metacognition and the Promotion of Meaning and Recovery. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09567-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Faith LA, Lecomte T, Corbière M, Lysaker PH. Metacognitive mastery moderates the relationship between positive symptoms and distress in adults with serious mental illness. J Ment Health 2022:1-8. [PMID: 35766302 DOI: 10.1080/09638237.2022.2091758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Research supports the possibility that a person's metacognitive ability may influence the impact of positive symptoms. This connection is important because understanding how metacognitive capacity relates to positive symptoms and distress can guide treatment and bolster recovery. AIMS To explore this, we assessed the moderating role of Metacognitive Mastery on the relationship of positive symptoms to affective symptoms, or markers of distress, measured both concurrently and at a later time point (to assess durability of metacognition) with persons with serious mental illness. To rule out the possibility that any findings were the result of cognitive impairments or general psychopathology we included measures of neurocognition and symptoms as potential covariates. METHODS Participants were 67 individuals with the majority diagnosed with either schizophrenia spectrum disorder, major depressive disorder, or bipolar disorder. Metacognition was measured with the Metacognitive Assessment Scale-Abbreviated, symptoms were measured using the Brief Psychiatric Rating Scale and verbal memory was measured using the California Verbal Learning Test. RESULTS Metacognitive Mastery moderated the relationship between positive symptoms and affective symptoms at both time points with differential patterns at each point. CONCLUSIONS Metacognitive Mastery may exert a complex influence upon the effects of positive symptoms on distress.
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Affiliation(s)
- Laura A Faith
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychology, University of Missouri, Kansas City, MO, USA
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Marc Corbière
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Paul H Lysaker
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
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Zheng H, Dong Y, Sun Y, Yang J, Yuan C, Wang J, Dong W. Effectiveness of Metacognitive Regulation Intervention on Attention-Deficit-Hyperactivity Disorder Students' Scientific Ability and Motivation. Front Psychol 2021; 12:747961. [PMID: 35002845 PMCID: PMC8732764 DOI: 10.3389/fpsyg.2021.747961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022] Open
Abstract
This study investigated the effect of metacognitive regulation (McR) intervention on attention-deficit-hyperactivity disorder (ADHD) students' astronomy knowledge acquisition and learning motivation. Through a cognitive-behavioural treatment design, this study selected 97 ADHD learners who had poor academic performance. This study divided ADHD students randomly into one experimental group and one control group. After 15 weeks of intervention, results showed that the experimental group students performed significantly better than the control group in scientific abilities, learning motivation, and metacognition. Results suggested that the McR intervention is an effective approach for improving the ADHD students' science knowledge learning abilities.
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Affiliation(s)
- Haoyuan Zheng
- Department of Teacher Education, Guangzhou Huashang College, Guangzhou, China
- Research Center for Overseas Studies and Media Reports on Hainan, Hainan University, Haikou, China
| | - Yang Dong
- Research Center for Overseas Studies and Media Reports on Hainan, Hainan University, Haikou, China
- Department of English, Hainan University, Haikou, China
| | - YuanKe Sun
- Department of Science and Environmental Studies, Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jie Yang
- Department of English, Hainan University, Haikou, China
| | - Chongbo Yuan
- Department of Chinese Studies, Hong Kong Open University, Hong Kong, Hong Kong SAR, China
| | - JinDao Wang
- Department of Teacher Education, Guangzhou Huashang College, Guangzhou, China
| | - Weiyang Dong
- Research Center for Overseas Studies and Media Reports on Hainan, Hainan University, Haikou, China
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16
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Lysaker PH, Hasson-Ohayon I, Wiesepape C, Huling K, Musselman A, Lysaker JT. Social Dysfunction in Psychosis Is More Than a Matter of Misperception: Advances From the Study of Metacognition. Front Psychol 2021; 12:723952. [PMID: 34721183 PMCID: PMC8552011 DOI: 10.3389/fpsyg.2021.723952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Many with psychosis experience substantial difficulties forming and maintaining social bonds leading to persistent social alienation and a lack of a sense of membership in a larger community. While it is clear that social impairments in psychosis cannot be fully explained by symptoms or other traditional features of psychosis, the antecedents of disturbances in social function remain poorly understood. One recent model has proposed that deficits in social cognition may be a root cause of social dysfunction. In this model social relationships become untenable among persons diagnosed with psychosis when deficits in social cognition result in inaccurate ideas of what others feel, think or desire. While there is evidence to support the influence of social cognition upon social function, there are substantial limitations to this point of view. Many with psychosis have social impairments but not significant deficits in social cognition. First person and clinical accounts of the phenomenology of psychosis also do not suggest that persons with psychosis commonly experience making mistakes when trying to understand others. They report instead that intersubjectivity, or the formation of an intimate shared understanding of thoughts and emotions with others, has become extraordinarily difficult. In this paper we explore how research in metacognition in psychosis can transcend these limitations and address some of the ways in which intersubjectivity and more broadly social function is compromised in psychosis. Specifically, research will be reviewed on the relationship between social cognitive abilities and social function in psychosis, including measurement strategies and limits to its explanatory power, in particular with regard to challenges to intersubjectivity. Next, we present research on the integrated model of metacognition in psychosis and its relation to social function. We then discuss how this model might go beyond social cognitive models of social dysfunction in psychosis by describing how compromises in intersubjectivity occur as metacognitive deficits leave persons without an integrated sense of others' purposes, relative positions in the world, possibilities and personal complexities. We suggest that while social cognitive deficits may leave persons with inaccurate ideas about others, metacognitive deficits leave persons ill equipped to make broader sense of the situations in which people interact and this is what leaves them without a holistic sense of the other and what makes it difficult to know others, share experiences, and sustain relationships. The potential of developing clinical interventions focused on metacognition for promoting social recovery will finally be explored.
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Affiliation(s)
- Paul H. Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Courtney Wiesepape
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
| | - Kelsey Huling
- School of Psychological Sciences, University of Indianapolis, Indianapolis, IN, United States
| | - Aubrie Musselman
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
| | - John T. Lysaker
- Department of Philosophy, Emory University, Atlanta, GA, United States
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17
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Lysaker PH, Cheli S, Dimaggio G, Buck B, Bonfils KA, Huling K, Wiesepape C, Lysaker JT. Metacognition, social cognition, and mentalizing in psychosis: are these distinct constructs when it comes to subjective experience or are we just splitting hairs? BMC Psychiatry 2021; 21:329. [PMID: 34215225 PMCID: PMC8254212 DOI: 10.1186/s12888-021-03338-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/21/2021] [Indexed: 02/01/2023] Open
Abstract
Research using the integrated model of metacognition has suggested that the construct of metacognition could quantify the spectrum of activities that, if impaired, might cause many of the subjective disturbances found in psychosis. Research on social cognition and mentalizing in psychosis, however, has also pointed to underlying deficits in how persons make sense of their experience of themselves and others. To explore the question of whether metacognitive research in psychosis offers unique insight in the midst of these other two emerging fields, we have offered a review of the constructs and research from each field. Following that summary, we discuss ways in which research on metacognition may be distinguished from research on social cognition and mentalizing in three broad categories: (1) experimental procedures, (2) theoretical advances, and (3) clinical applications or indicated interventions. In terms of its research methods, we will describe how metacognition makes a unique contribution to understanding disturbances in how persons make sense of and interpret their own experiences within the flow of life. We will next discuss how metacognitive research in psychosis uniquely describes an architecture which when compromised - as often occurs in psychosis - results in the loss of persons' sense of purpose, possibilities, place in the world and cohesiveness of self. Turning to clinical issues, we explore how metacognitive research offers an operational model of the architecture which if repaired or restored should promote the recovery of a coherent sense of self and others in psychosis. Finally, we discuss the concrete implications of this for recovery-oriented treatment for psychosis as well as the need for further research on the commonalities of these approaches.
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Affiliation(s)
- P H Lysaker
- Richard L Roudebush VA Medical Center, Department of Psychiatry, 1481 W. 10th St., Indianapolis, IN, 46202, USA. .,Department of Psychiatry, Indiana University School of Medicine, 340 W. 10th St., Indianapolis, IN, 46202, USA.
| | - S Cheli
- University of Florence, School of Human Health Sciences, Piazza di San Marco, 4, 50121, Florence, FI, Italy
| | - G Dimaggio
- Terzocentro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Via Ravenna, 9, 00161, Rome, RM, Italy
| | - B Buck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Behavioral Research in Technology and Engineering (BRiTE) Center, 1851 NE Grant Ln., Seattle, WA, 98185, USA
| | - K A Bonfils
- University of Southern Mississippi, School of Psychology, 118 College Dr., Hattiesbury, MS, 39406, USA
| | - K Huling
- University of Indianapolis, School of Psychological Sciences, 1400 E. Hanna Ave., Indianapolis, IN, 46277, USA
| | - C Wiesepape
- Indiana State University, Department of Psychology, 200 N. 7th St., Terre Haute, IN, 47809, USA
| | - J T Lysaker
- Department of Philosophy, Emory University, 201 Dowman Dr., Atlanta, GA, 30322, USA
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18
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Bonfils KA, Luther L, Lysaker PH. Metacognition & social cognition differentially influence experiential & expressive negative symptoms in schizophrenia. Schizophr Res 2021; 233:13-15. [PMID: 34216940 DOI: 10.1016/j.schres.2021.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Kelsey A Bonfils
- The University of Southern Mississippi, School of Psychology, 118 College Dr., #5025, Hattiesburg, MS 39406, USA.
| | - Lauren Luther
- Massachusetts General Hospital, Department of Psychiatry, 149 13th Street, Room 2603, Charlestown, MA 02129, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Paul H Lysaker
- Richard L. Roudebush VA Medical Center, Day Hospital 116H, 1481 W. 10th Street, Indianapolis, IN 46202, USA; Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th Street, Suite 4800, Indianapolis, IN 46202, USA
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19
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Lysaker P, Chernov NV, Karpenko OA, Moiseeva TV, Sozinova MV, Dmitrieva ND, Alyoshin VA, Faith L, Kostyuk GP. [Metacognition as a pathway to the study and treatment of fragmentation in schizophrenia]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:160-164. [PMID: 33834735 DOI: 10.17116/jnevro2021121031160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This paper explores the potential of recent research on metacognition to offer new avenues to assess and address the phenomenon of fragmentation in schizophrenia, which was described by E.Bleuler as «splitting». The concepts of metacognition characterize and quantify alterations or decrements in the processes by which fragments or pieces of information are integrated into a coherent sense of self and others. A method for assessing metacognition is presented along with research examining the presence and importance of metacognitive deficits in schizophrenia. Greater levels of metacognitive deficits have been detected in different phases of schizophrenia and linked to poorer psychosocial outcomes. These data were obtained both in foreign and preliminary Russian studies. The authors suggest that treatments, which successfully target metacognitive capacity, may uniquely promote wellness and recovery in schizophrenia.
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Affiliation(s)
- P Lysaker
- Indiana University School of Medicine, Indianapolis, USA
| | - N V Chernov
- Alexeev Mental Health Hospital, Moscow, Russia
| | | | | | | | | | | | - L Faith
- University of Missouri - Kansas City (USA)
| | - G P Kostyuk
- Alexeev Mental Health Hospital, Moscow, Russia
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20
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Wang P, Zhu M, Mo S, Li X, Wang J. The effect of somatosensory alpha transcranial alternating current stimulation on pain empathy is trait empathy and gender dependent. CNS Neurosci Ther 2021; 27:687-693. [PMID: 33739605 PMCID: PMC8111491 DOI: 10.1111/cns.13631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/30/2022] Open
Abstract
Background Pain empathy enables a person to experience and understand other's pain state by observing others in pain condition. Such prosocial ability is deficient in many psychopathological disorders. Somatosensory alpha suppression is considered as neural correlates of pain empathy and is hypothesized as a target for enhancement of pain empathy. Researches demonstrated that alpha suppression could be enhanced by transcranial alternating current stimulation (tACS) at alpha frequency non‐invasively. Aims We applied alpha tACS over the primary somatosensory cortex of healthy subjects to investigate whether alpha tACS is able to enhance the pain empathy performance. Results The results showed that there was no difference of pain empathy performance between alpha tACS and sham tACS either when tACS was applied during the task or before task. While in the alpha tACS group, the pain empathy performance was positively correlated with empathic concern of male subjects, the sub‐component of personal trait empathy. Conclusions Alpha tACS cannot alter the empathy performance overall, but the modulation effect of alpha tACS on pain empathy is dependent on the gender and trait empathy of subjects.
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Affiliation(s)
- Peipei Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Minjia Zhu
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Shaohua Mo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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21
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Chuang SP, Wu JYW, Wang CS. Metacognitive Beliefs, Cognitive Functioning, Psychiatric Symptoms and Empathy in People with Schizophrenia. Neuropsychiatr Dis Treat 2021; 17:2209-2217. [PMID: 34262281 PMCID: PMC8274239 DOI: 10.2147/ndt.s313932] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND People with schizophrenia often exhibit deficits in empathy, which plays a major role in social cognition and interpersonal relationship. However, little work has investigated potential factors that influence empathy in schizophrenia. The study aimed to investigate the relationship among metacognition, psychiatric symptoms, cognitive functioning and empathy in patients diagnosed with schizophrenia. METHODS Forty-eight people with schizophrenia were enrolled in the study group. All subjects participated in the metacognitions questionnaire-30 (MCQ-30), brief psychiatric rating scale (BPRS), neurocognitive functioning, interpersonal reactivity index (IRI), and the pictorial empathy test (PET). RESULTS Stepwise regression analysis revealed that cognitive self-consciousness (domain of metacognitions questionnaire-30) accounted for 37% of the variance in perspective taking scores (domain of interpersonal reactivity index). Resistance (subscale of brief psychiatric rating scale) and positive beliefs about worry (domain of metacognitions questionnaire-30) accounted for 34% of the variance in fantasy (domain of interpersonal reactivity index). Activation (subscale of brief psychiatric rating scale) was a significant predictor for empathic concern (domain of interpersonal reactivity index). Resistance, cognitive confidence (domain of metacognitions questionnaire-30), intellectual processes and inhibitory control (go-no-go task) accounted for 38% of the variance in personal distress. Negative symptoms (subscale of brief psychiatric rating scale) and cognitive self-consciousness were significant predictors for the pictorial empathy test. CONCLUSION The study was aimed to examine self-perception of metacognitive beliefs and empathy. More research is needed to explore the association between metacognitive beliefs, cognitive functioning and psychiatric symptoms on empathy in people with schizophrenia.
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Affiliation(s)
- Shu Ping Chuang
- Department of Psychiatry, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | | | - Chien Shu Wang
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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22
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Atypical EEG Responses to Nonverbal Emotionally Charged Stimuli in Children with ASD. Behav Neurol 2020; 2020:2807946. [PMID: 33082881 PMCID: PMC7556070 DOI: 10.1155/2020/2807946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/17/2022] Open
Abstract
This study focused on auditory emotional perception in children with low-functioning autism and investigated the children's response to emotionally charged nonverbal sounds which regularly induced emotional response in typically developing (TD) peers. An EEG was conducted, and emotional reactions were assessed using analog scales and images of presented sounds with additional images during the presentation of emotional stimuli. The results showed that EEG and emotional responses to the fearful sounds were similar in TD children and children with autism spectrum disorders (ASD). Both groups of children showed an increase in peak alpha frequency and power of alpha2-band and a decrease in low-frequency bands. Sounds of crying and laughter induced an atypical EEG response in children with ASD, with no change in alpha-band's power and frequency observed in them; this was contrary to the observation in TD children. The decrease in the fractal dimension detected in children with ASD only for sounds of crying and laughter correlated with the accuracy of assessment of these stimuli.
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Lysaker PH, Chernov N, Moiseeva T, Sozinova M, Dmitryeva N, Alyoshin V, Kukla M, Wiesepape C, Karpenko O, Kostyuk G. The association of metacognition with emotion recognition and perspective taking in a Russian sample with psychosis. J Clin Psychol 2020; 77:1034-1044. [PMID: 33085987 DOI: 10.1002/jclp.23076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Schizophrenia may reflect an interactive network of disturbances in cognition. In this study we have examined the relationship between two forms of cognition: metacognition and social cognition among a sample with schizophrenia (n = 41), early episode psychosis (n = 37), and major depression (n = 30) gathered in Moscow, Russia. METHODS Metacognition was assessed with the Metacognition Assessment Scale-Abbreviated. Social cognition was assessed with the Ekman 60 Faces Test and the Interpersonal Reactivity Index. Verbal memory and global psychopathology were included as potential covariates. RESULTS Partial correlations controlling for demographics, neurocognition, and psychopathology revealed greater metacognitive capacity was linked to better facial emotion recognition and perspective taking in the prolonged schizophrenia group. Greater metacognitive capacity in the early psychosis group was linked with greater facial emotion recognition. Metacognition and social cognition were not related to one another in the depression group. CONCLUSIONS Social cognition and metacognition may be uniquely related in psychosis.
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Affiliation(s)
- Paul H Lysaker
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nikita Chernov
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Tatyana Moiseeva
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Marta Sozinova
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | | | - Vitaliy Alyoshin
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Marina Kukla
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Courtney Wiesepape
- Richard L Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychology, Indiana State University, Terra Haute, Indiana, USA
| | - Olga Karpenko
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Georgiy Kostyuk
- Mental-health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
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Moritz S, Klein JP, Lysaker PH, Mehl S. Metacognitive and cognitive-behavioral interventions for psychosis: new developments
. DIALOGUES IN CLINICAL NEUROSCIENCE 2020; 21:309-317. [PMID: 31749655 PMCID: PMC6829173 DOI: 10.31887/dcns.2019.21.3/smoritz] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This review describes four cognitive approaches for the treatment of
schizophrenia: cognitive-behavioral therapy for psychosis (CBTp), metacognitive therapy,
metacognitive training, and metacognitive reflection insight therapy (MERIT). A central
reference point of our review is a seminal paper by James Flavell, who introduced the
term metacognition (“cognition about cognition”). In a way, every psychotherapeutic
approach adopts a metacognitive perspective when therapists reflect with clients about
their thoughts. Yet, the four approaches map onto different components of metacognition.
CBTp conveys some “metacognitive knowledge” (eg, thoughts are not facts) but is mainly
concerned with individual beliefs. Metacognitive therapy focuses on unhelpful
metacognitive beliefs about thinking styles (eg, thought suppression). Metacognitive
training brings distorted cognitive biases to the awareness of patients; a central goal
is the reduction of overconfidence. MERIT focuses on larger senses of identity and
highlights metacognitive knowledge about oneself and other persons. For CBTp and
metacognitive training, meta-analytic evidence supports their efficacy; single studies
speak for the effectiveness of MERIT and metacognitive therapy.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Paul H Lysaker
- Department of Psychiatry, Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN, US
| | - Stephanie Mehl
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany;
Department of Health and Social Work, Frankfurt University of Applied Science Frankfurt, Germany
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25
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Hasson-Ohayon I, Gumley A, McLeod H, Lysaker PH. Metacognition and Intersubjectivity: Reconsidering Their Relationship Following Advances From the Study of Persons With Psychosis. Front Psychol 2020; 11:567. [PMID: 32269546 PMCID: PMC7109331 DOI: 10.3389/fpsyg.2020.00567] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/10/2020] [Indexed: 12/13/2022] Open
Abstract
As research on metacognition has progressed a significant array of definitions, methodologies and therapeutic applications have emerged. Some of this work has primarily framed metacognition as an activity carried out by one person in order to know, monitor, and adjust their beliefs, memories, and behaviors. Accordingly, problems with metacognition have often been characterized as issues related to cognition. This, however, risks neglecting how metacognition is also a fundamentally intersubjective act, one in which human beings know and reflect upon themselves and others primarily with and through connections with other people. In this paper, we review research on metacognition in schizophrenia using the integrative model of metacognition and a research paradigm in which metacognition is assessed within personal narratives. Stimulated by this work, we discuss how disturbances in intersubjective experience and metacognitive capacity mutually influence one another, with disruptions in metacognition perhaps more deeply understood as disruptions in relatedness with others. We then discuss how metacognition and intersubjectivity each affect mental health. We finally focus on the implications of this for treatments that target metacognition as well as future directions for research.
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Affiliation(s)
| | - Andrew Gumley
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Hamish McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul H. Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, United States
- School of Medicine, Indiana University–Purdue University Indianapolis, Indianapolis, IN, United States
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Bonfils KA, Haas GL, Salyers MP. Emotion-specific performance across empathy tasks in schizophrenia: Influence of metacognitive capacity. Schizophr Res Cogn 2020; 19:100139. [PMID: 31828016 PMCID: PMC6889363 DOI: 10.1016/j.scog.2019.100139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/06/2019] [Accepted: 03/17/2019] [Indexed: 11/18/2022]
Abstract
People with schizophrenia exhibit deficits in emotion recognition that are associated with community and social functioning. Emotion-specific performance within emotion recognition tasks has been investigated, suggesting differential patterns of recognition for positive and negative emotions. However, no study has yet examined emotion-specific performance for a higher-order social cognitive construct such as empathy. This study aimed to: 1) examine emotion-specific performance on an empathy task, and 2) elucidate associations with four metacognitive domains: self-reflectivity, understanding of others' minds, decentration, and mastery. Fifty-seven people with schizophrenia or schizoaffective disorder participated. All were administered a computerized, performance-based measure of empathy and an interview-based measure of metacognitive capacity. Results revealed that, consistent with research on facial affect recognition, participants performed significantly better when recognizing happiness in empathic stimuli than all other emotions. Results also revealed positive associations between empathic performance and metacognitive self-reflectivity, across types of emotions. Other metacognitive domains were also associated with performance, but in a less consistent manner. Together, results indicate that not all emotions are created equal - happiness is easier to recognize for those with schizophrenia, suggesting that social cognitive interventions may be more helpful if focused on recognizing negative emotions. Results also emphasize the importance of metacognitive capacity for basic and higher-order social cognitive skills.
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Affiliation(s)
- Kelsey A. Bonfils
- VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC), VA Pittsburgh Healthcare System, 4100 Allequippa St., Pittsburgh, PA, United States
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, United States
| | - Gretchen L. Haas
- VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC), VA Pittsburgh Healthcare System, 4100 Allequippa St., Pittsburgh, PA, United States
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA, United States
| | - Michelle P. Salyers
- Psychology Department, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, Indianapolis, IN, United States
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Lysaker PH, Minor KS, Lysaker JT, Hasson-Ohayon I, Bonfils K, Hochheiser J, Vohs JL. Metacognitive function and fragmentation in schizophrenia: Relationship to cognition, self-experience and developing treatments. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 19:100142. [PMID: 31828019 PMCID: PMC6889776 DOI: 10.1016/j.scog.2019.100142] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/13/2019] [Accepted: 03/25/2019] [Indexed: 12/26/2022]
Abstract
Bleuler suggested that fragmentation of thought, emotion and volition were the unifying feature of the disorders he termed schizophrenia. In this paper we review research seeking to measure some of the aspects of fragmentation related to the experience of the self and others described by Bleuler. We focus on work which uses the concept of metacognition to characterize and quantify alterations or decrements in the processes by which fragments or pieces of information are integrated into a coherent sense of self and others. We describe the rationale and support for one method for quantifying metacognition and its potential to study the fragmentation of a person's sense of themselves, others and the relative place of themselves and others in the larger human community. We summarize research using that method which suggests that deficits in metacognition commonly occur in schizophrenia and are related to basic neurobiological indices of brain functioning. We also present findings indicating that the capacity for metacognition in schizophrenia is positively related to a broad range of aspects of psychological and social functioning when measured concurrently and prospectively. Finally, we discuss the evolution and study of one therapy that targets metacognitive capacity, Metacognitive Reflection and Insight Therapy (MERIT) and its potential to treat fragmentation and promote recovery.
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Affiliation(s)
- Paul H Lysaker
- Roudebush Veteran Affairs Medical Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kyle S Minor
- Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | | | | | - Kelsey Bonfils
- VA Pittsburgh Healthcare System, Mental Illness Research, Education, & Clinical Center (MIRECC), Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jenifer L Vohs
- Indiana University School of Medicine, Indianapolis, IN, USA
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Moritz S, Lysaker PH. Metacognition Research in Psychosis: Uncovering and Adjusting the Prisms That Distort Subjective Reality. Schizophr Bull 2018; 45:5142537. [PMID: 30351363 PMCID: PMC6293209 DOI: 10.1093/schbul/sby151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul H Lysaker
- Department of Psychiatry, Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN
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