1
|
Comparison of Metacognition Features and Social Functionality of Patients with Mental Disorder. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00968-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
2
|
Concepts of Metacognition in the Treatment of Patients with Mental Disorders. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2019. [DOI: 10.1007/s10942-019-00333-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Philipp R, Kriston L, Lanio J, Kühne F, Härter M, Moritz S, Meister R. Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG). Clin Psychol Psychother 2018; 26:227-240. [PMID: 30456821 DOI: 10.1002/cpp.2345] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 01/08/2023]
Abstract
We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.
Collapse
Affiliation(s)
- Rebecca Philipp
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Lanio
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Kühne
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Potsdam, Potsdam, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ramona Meister
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
5
|
Inchausti F, García-Poveda NV, Ballesteros-Prados A, Ortuño-Sierra J, Sánchez-Reales S, Prado-Abril J, Aldaz-Armendáriz JA, Mole J, Dimaggio G, Ottavi P, Fonseca-Pedrero E. The Effects of Metacognition-Oriented Social Skills Training on Psychosocial Outcome in Schizophrenia-Spectrum Disorders: A Randomized Controlled Trial. Schizophr Bull 2018; 44:1235-1244. [PMID: 29267940 PMCID: PMC6192494 DOI: 10.1093/schbul/sbx168] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A pilot study of the effects of metacognition-oriented social skills training (MOSST) on social functioning in patients with schizophrenia spectrum disorders (SSDs) reported promising results. The main purpose of the current trial was to compare the effectiveness and potential benefits of MOSST vs conventional social skills training (SST). Single-blind randomized controlled trial with 2 groups of patients aged 18-65 with SSDs on partial hospitalization. Participants were randomly assigned (1:1) to receive 16 group sessions with MOSST or conventional SST, both in addition to standard care, over 4 months, with a 6-month follow-up. Psychosocial functioning, metacognition, and symptom outcomes were measured by blind assessors. Statistical analyses used mixed models to estimate treatment effects in each postrandomization time point. Thirty-six patients were randomly assigned to the MOSST group and 33 patients to the conventional SST group. Between-group differences were significant in favor of MOSST on Social and Occupational Functioning Assessment Scale (SOFAS) and Personal and Social Performance Scale (PSP) total scores at post-treatment and follow-up. Concerning PSP subscales, there were significant between-group differences in favor of MOSST at follow-up on socially useful activities, personal and social relationships, and disturbing and aggressive behaviors. Metacognition only improved following MOSST group. For people with SDDs, MOSST appears to have short- and long-term beneficial effects on social functioning and symptoms. Further studies are required to replicate the current results in other samples.
Collapse
Affiliation(s)
- Felix Inchausti
- Complejo Hospitalario of Navarra, CSM Ermitagaña, Pamplona, Spain,School of Medicine, University of Navarra, Pamplona, Spain,To whom correspondence should be addressed; Complejo Hospitalario of Navarra, CSM Ermitagaña, Pamplona, Spain; tel: 948-198-590, fax: 948-198-179, e-mail:
| | | | | | | | | | - Javier Prado-Abril
- Complejo Hospitalario of Navarra, CSMIJ Natividad Zubieta, Sarriguren, Spain,Research Network on Preventive Activities and Health Promotion (REDIAPP) (RD12/0005), Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | | | - Joe Mole
- Oxford Institute of Clinical Psychology Training, University of Oxford, Oxford, UK
| | | | - Paolo Ottavi
- Centro di Terapia Metacognitiva Interpersonale, Rome, Italy
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain,P3 Prevention Program of Psychosis, Oviedo, Spain
| |
Collapse
|