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Moeller SJ, Abeykoon S, Dhayagude P, Varnas B, Weinstein JJ, Perlman G, Gil R, Fleming SM, Abi-Dargham A. Neural correlates of metacognition impairment in opioid addiction. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00202-7. [PMID: 39059467 DOI: 10.1016/j.bpsc.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/15/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Individuals with substance use disorder show impaired self-awareness of ongoing behavior. This deficit suggests problems with metacognition, operationalized in the cognitive neuroscience literature as the ability to monitor and evaluate the success of one's own cognition and behavior. However, the neural mechanisms of metacognition have not been characterized in a drug-addicted population. METHODS Community samples of participants with opioid use disorder (OUD) (N=27) and healthy controls (N=29) performed a previously-validated fMRI metacognition task (perceptual decision-making task along with confidence ratings of performance). Measures of recent drug use and addiction severity were also acquired. RESULTS Individuals with OUD had lower metacognitive sensitivity than controls (i.e., disconnection between task performance and task-related confidence). Trial-by-trial analyses showed that this overall group difference was driven by (suboptimally) low confidence in OUD during correct trials. In fMRI analyses, the task engaged an expected network of brain regions (e.g., rostrolateral prefrontal cortex and dorsal anterior cingulate/supplementary motor area, both previously linked to metacognition); group differences emerged in a large ventral anterior cluster that included the medial and lateral orbitofrontal cortex and striatum (higher activation in OUD). Trial-by-trial fMRI analyses showed group differences in rostrolateral prefrontal cortex activation, which further correlated with metacognitive behavior across all participants. Exploratory analyses suggested that the behavioral and neural group differences were exacerbated by recent illicit opioid use and unexplained by general cognition. CONCLUSIONS With confirmation and extension of these findings, metacognition and its associated neural circuits could become new, promising therapeutic targets in addiction.
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Affiliation(s)
- Scott J Moeller
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794.
| | - Sameera Abeykoon
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
| | - Pari Dhayagude
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Benjamin Varnas
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
| | - Jodi J Weinstein
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
| | - Greg Perlman
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
| | - Roberto Gil
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
| | - Stephen M Fleming
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, WC1B 5EH, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London, WC1N 3BG, United Kingdom; Department of Experimental Psychology, University College London, 26 Bedford Way, London, WC1H 0AP, United Kingdom
| | - Anissa Abi-Dargham
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794
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Friedemann M, Fox CA, Hanlon AK, Tighe D, Yeung N, Gillan CM. Confidence biases in problem gambling. J Behav Addict 2024; 13:650-664. [PMID: 38850516 PMCID: PMC11220811 DOI: 10.1556/2006.2024.00030] [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: 12/04/2023] [Revised: 02/22/2024] [Accepted: 05/01/2024] [Indexed: 06/10/2024] Open
Abstract
Background and aims Subjective confidence plays an important role in guiding behaviour, especially when objective feedback is unavailable. Systematic misjudgements in confidence can foster maladaptive behaviours and have been linked to various psychiatric disorders. In this study, we adopted a transdiagnostic approach to examine confidence biases in problem gamblers across three levels: local decision confidence, global task performance confidence, and overall self-esteem. The importance of taking a transdiagnostic perspective is increasingly recognised, as it captures the dimensional nature of psychiatric symptoms that often cut across diagnostic boundaries. Accordingly, we investigated if any observed confidence biases could be explained by transdiagnostic symptom dimensions of Anxiety-Depression and Compulsive Behaviour and Intrusive Thought. This approach allows us to gain a more comprehensive understanding of the role of metacognitive processes in problem gambling, beyond the constraints of traditional diagnostic categories. Methods Thirty-eight problem gamblers and 38 demographically matched control participants engaged in a gamified metacognition task and completed self-report questionnaires assessing transdiagnostic symptom dimensions. Results Compared to controls, problem gamblers displayed significantly elevated confidence at the local decision and global task levels, independent of their actual task performance. This elevated confidence was observed even after controlling for the heightened symptom levels of Anxiety-Depression and Compulsive Behaviour and Intrusive Thought among the problem gamblers. Discussion The results reveal a notable disparity in confidence levels between problem gamblers and control participants, not fully accounted for by the symptom dimensions Anxiety-Depression and Compulsive Behaviour and Intrusive Thought. This suggests the contribution of other factors, perhaps linked to gambling-specific cognitive distortions, to the observed confidence biases. Conclusion The findings highlight the intricate link between metacognitive confidence and psychiatric symptoms in the context of problem gambling. It underscores the need for further research into metacognitive biases, which could enhance therapeutic approaches for individuals with psychiatric conditions.
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Affiliation(s)
- Maja Friedemann
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Celine A. Fox
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Anna K. Hanlon
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Daniel Tighe
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Nick Yeung
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Claire M. Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Lin S, Chen X, Tan L, Liao Z, Li Y, Tang Y, Huang Q, Shen H. Psychometric Properties of the Metacognitions About Online Gaming Scale in the Chinese Population and Its Relationship With Internet Gaming Disorder: Cross-Sectional Study. JMIR Serious Games 2024; 12:e45985. [PMID: 38648634 DOI: 10.2196/45985] [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: 01/25/2023] [Revised: 09/28/2023] [Accepted: 02/21/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Metacognitions about online gaming have been shown to be correlated with Internet Gaming Disorder (IGD). Knowledge of metacognitions about online gaming can help to understand IGD. The Metacognitions about Online Gaming Scale (MOGS) is a reliable and valid tool to measure specific metacognitions about online gaming in both adults and adolescents, which is lacking in China. OBJECTIVE This study was conducted to assess the psychometric properties of the Chinese version of the MOGS (C-MOGS) and its relationship with IGD in the Chinese population. METHODS A total of 772 Chinese individuals (age: mean 21.70, SD 8.81 years; age range: 13-57 years; 458/772, 59.3% male) completed a web-based questionnaire survey, including the C-MOGS and a battery of validated scales measuring IGD, gaming motives, depression, and anxiety. RESULTS Through exploratory and confirmatory factor analyses, the 3-factor structure was confirmed to have adequate model fit and internal consistency reliability (Cronbach α≥.799, Guttman split-half coefficients≥0.754). Concurrent validity of the C-MOGS was supported by its correlations with IGD (P<.001), gaming motives (P<.001), depression (P<.001), and anxiety (P<.001). Furthermore, the incremental validity analysis showed that the C-MOGS predicted 13% of the variance in IGD while controlling for gender, age, weekly gaming hours, gaming motives, depression, and anxiety. CONCLUSIONS This study provides evidence that the psychometric properties of the C-MOGS are appropriate and emphasizes its positive association with IGD. The C-MOGS is a reliable and valid instrument for mental health workers to assess metacognitions about online gaming in the Chinese population.
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Affiliation(s)
- Shuhong Lin
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
| | - Xinxin Chen
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
| | - Linxiang Tan
- Education Center for Mental Health, Central South University, Changsha, China
| | - Zhenjiang Liao
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yifan Li
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
| | - Ying Tang
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
| | - Qiuping Huang
- School of Humanities and Management, Hunan University of Chinese Medicine, Changsha, China
| | - Hongxian Shen
- Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
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Hoven M, Luigjes J, van Holst RJ. Learning and metacognition under volatility in GD: Lower learning rates and distorted coupling between action and confidence. J Behav Addict 2024; 13:226-235. [PMID: 38340145 PMCID: PMC10988407 DOI: 10.1556/2006.2023.00082] [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: 10/06/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 02/12/2024] Open
Abstract
Background and aims Decisions and learning processes are under metacognitive control, where confidence in one's actions guides future behaviour. Indeed, studies have shown that being more confident results in less action updating and learning, and vice versa. This coupling between action and confidence can be disrupted, as has been found in individuals with high compulsivity symptoms. Patients with Gambling Disorder (GD) have been shown to exhibit both higher confidence and deficits in learning. Methods In this study, we tested the hypotheses that patients with GD display increased confidence, reduced action updating and lower learning rates. Additionally, we investigated whether the action-confidence coupling was distorted in patients with GD. To address this, 27 patients with GD and 30 control participants performed a predictive inference task designed to assess action and confidence dynamics during learning under volatility. Action-updating, confidence and their coupling were assessed and computational modeling estimated parameters for learning rates, error sensitivity, and sensitivity to environmental changes. Results Contrary to our expectations, results revealed no significant group differences in action updating or confidence levels. Nevertheless, GD patients exhibited a weakened coupling between confidence and action, as well as lower learning rates. Discussion and conclusions This suggests that patients with GD may underutilize confidence when steering future behavioral choices. Ultimately, these findings point to a disruption of metacognitive control in GD, without a general overconfidence bias in neutral, non-incentivized volatile learning contexts.
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Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC – University of Amsterdam, Amsterdam, The Netherlands
| | - Judy Luigjes
- Department of Psychiatry, Amsterdam UMC – University of Amsterdam, Amsterdam, The Netherlands
| | - Ruth J. van Holst
- Department of Psychiatry, Amsterdam UMC – University of Amsterdam, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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Ting CC, Salem-Garcia N, Palminteri S, Engelmann JB, Lebreton M. Neural and computational underpinnings of biased confidence in human reinforcement learning. Nat Commun 2023; 14:6896. [PMID: 37898640 PMCID: PMC10613217 DOI: 10.1038/s41467-023-42589-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
While navigating a fundamentally uncertain world, humans and animals constantly evaluate the probability of their decisions, actions or statements being correct. When explicitly elicited, these confidence estimates typically correlates positively with neural activity in a ventromedial-prefrontal (VMPFC) network and negatively in a dorsolateral and dorsomedial prefrontal network. Here, combining fMRI with a reinforcement-learning paradigm, we leverage the fact that humans are more confident in their choices when seeking gains than avoiding losses to reveal a functional dissociation: whereas the dorsal prefrontal network correlates negatively with a condition-specific confidence signal, the VMPFC network positively encodes task-wide confidence signal incorporating the valence-induced bias. Challenging dominant neuro-computational models, we found that decision-related VMPFC activity better correlates with confidence than with option-values inferred from reinforcement-learning models. Altogether, these results identify the VMPFC as a key node in the neuro-computational architecture that builds global feeling-of-confidence signals from latent decision variables and contextual biases during reinforcement-learning.
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Affiliation(s)
- Chih-Chung Ting
- General Psychology, Universität Hamburg, Von-Melle-Park 11, 20146, Hamburg, Germany.
- CREED, Amsterdam School of Economics (ASE), Universiteit van Amsterdam, Roetersstraat 11, 1018 WB, Amsterdam, the Netherlands.
| | - Nahuel Salem-Garcia
- Swiss Center for Affective Science, Faculty of Psychology and Educational Sciences, University of Geneva, Chem. des Mines 9, 1202, Genève, Switzerland
| | - Stefano Palminteri
- Département d'Études Cognitives, École Normale Supérieure, PSL Research University, 29 rue d'Ulm, 75230, Paris cedex 05, France
- Laboratoire de Neurosciences Cognitives et Computationnelles, Institut National de la Santé et de la Recherche Médicale, 29 rue d'Ulm 75230, Paris cedex 05, France
| | - Jan B Engelmann
- CREED, Amsterdam School of Economics (ASE), Universiteit van Amsterdam, Roetersstraat 11, 1018 WB, Amsterdam, the Netherlands.
- The Tinbergen Institute, Gustav Mahlerplein 117, 1082 MS, Amsterdam, the Netherlands.
| | - Maël Lebreton
- Swiss Center for Affective Science, Faculty of Psychology and Educational Sciences, University of Geneva, Chem. des Mines 9, 1202, Genève, Switzerland.
- Economics of Human Behavior group, Paris-Jourdan Sciences Économiques UMR8545, Paris School of Economics, 48 Boulevard Jourdan, 75014, Paris, France.
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Hoven M, Hirmas A, Engelmann J, van Holst RJ. Confidence and risky decision-making in gambling disorder. J Behav Addict 2023; 12:840-846. [PMID: 37603457 PMCID: PMC10562821 DOI: 10.1556/2006.2023.00041] [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: 04/02/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/23/2023] Open
Abstract
Background and aims People with Gambling Disorder (GD) often make risky decisions and experience cognitive distortions about gambling. Moreover, people with GD have been shown to be overly confident in their decisions, especially when money can be won. Here we investigated if and how the act of making a risky choice with varying monetary stakes impacts confidence differently in patients with GD (n = 27) relative to healthy controls (HCs) (n = 30). Methods We used data from our previous mixed-gamble study, in which participants were given the choice of a certain option or a 50/50 gamble with potential gains or losses, after which they rated their confidence. Results While HCs were more confident when making certain than risky choices, GD patients were specifically more confident when making risky choices than certain choices. Notably, relative to HCs, confidence of patients with GD decreased more strongly with higher gain values when making a certain choice, suggesting a stronger fear of missing out or "anticipated regret" of missing out on potential gains when rejecting the risky choice. Discussion The current findings highlight the potential relevance of confidence and "regret" as cognitive mechanisms feeding into excessive risk-taking as seen in GD. Moreover, this study adds to the limited previous work investigating how confidence is affected in value-based risky contexts.
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Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alejandro Hirmas
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, The Netherlands
- Behavioral and Experimental Economics, The Tinbergen Institute, The Netherlands
| | - Jan Engelmann
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
- Behavioral and Experimental Economics, The Tinbergen Institute, The Netherlands
| | - Ruth J. van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
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McWilliams A, Bibby H, Steinbeis N, David AS, Fleming SM. Age-related decreases in global metacognition are independent of local metacognition and task performance. Cognition 2023; 235:105389. [PMID: 36764048 PMCID: PMC10632679 DOI: 10.1016/j.cognition.2023.105389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
Metacognition refers to a capacity to reflect on and control other cognitive processes, commonly quantified as the extent to which confidence tracks objective performance. There is conflicting evidence about how "local" metacognition (monitoring of individual judgments) and "global" metacognition (estimates of self-performance) change across the lifespan. Additionally, the degree to which metacognition generalises across cognitive domains may itself change with age due to increased experience with one's own abilities. Using a gamified suite of performance-controlled memory and visual perception tasks, we measured local and global metacognition in an age-stratified sample of 304 healthy volunteers (18-83 years; N = 50 in each of 6 age groups). We calculated both local and global metrics of metacognition and quantified how and whether domain-generality changes with age. First-order task performance was stable across the age range. People's global self-performance estimates and local metacognitive bias decreased with age, indicating overall lower confidence in performance. In contrast, local metacognitive efficiency was spared in older age and remained correlated across the two cognitive domains. A stability of local metacognition indicates distinct mechanisms contributing to local and global metacognition. Our study reveals how local and global metacognition change across the lifespan and provide a benchmark against which disease-related changes in metacognition can be compared.
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Affiliation(s)
- Andrew McWilliams
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, UK; Department of Experimental Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK; Mental Health, Ethics and Law Research Group, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Room 3.21, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Hannah Bibby
- Institute of Cognitive Neuroscience, University College London, Alexandra House, 17-19 Queen Square, London WC1N 3AZ, UK
| | - Nikolaus Steinbeis
- Department of Experimental Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK
| | - Anthony S David
- Institute of Mental Health, University College London, Wing A, 6th floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - Stephen M Fleming
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3AR, UK; Department of Experimental Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
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8
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Hoven M, Hirmas A, Engelmann J, van Holst RJ. The role of attention in decision-making under risk in gambling disorder: An eye-tracking study. Addict Behav 2023; 138:107550. [PMID: 36444787 DOI: 10.1016/j.addbeh.2022.107550] [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: 06/30/2022] [Revised: 09/14/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
Gambling disorder (GD) is a behavioural addiction characterized by impairments in decision-making, favouring risk- and reward-prone choices. One explanatory factor for this behaviour is a deviation in attentional processes, as increasing evidence indicates that GD patients show an attentional bias toward gambling stimuli. However, previous attentional studies have not directly investigated attention during risky decision-making. 26 patients with GD and 29 healthy matched controls (HC) completed a mixed gambles task combined with eye-tracking to investigate attentional biases for potential gains versus losses during decision-making under risk. Results indicate that compared to HC, GD patients gambled more and were less loss averse. GD patients did not show a direct attentional bias towards gains (or relative to losses). Using a recent (neuro)economics model that considers average attention and trial-wise deviations in average attention, we conducted fine-grained exploratory analyses of the attentional data. Results indicate that the average attention for gains in GD patients moderated the effect of gain value on gambling choices, whereas this was not the case for HC. GD patients with high average attention for gains started gambling at less high gain values. A similar trend-level effect was found for losses, where GD patients with high average attention for losses stopped gambling at lower loss values. This study gives more insight into how attentional processes in GD play a role in gambling behaviour, which could have implications for the development of future treatments focusing on attentional training or for the development of interventions that increase the salience of losses.
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Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Alejandro Hirmas
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, the Netherlands; Behavioral and Experimental Economics, The Tinbergen Institute, the Netherlands.
| | - Jan Engelmann
- Center for Research in Experimental Economics and Political Decision Making, University of Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands; Behavioral and Experimental Economics, The Tinbergen Institute, the Netherlands.
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands.
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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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