Metacognitive deficits are a stable feature of schizophrenia related with negative symptoms.

Schizophrenia spectrum disorders (SSDs) and dissociative disorders (DDs) are described in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) and tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) as 2 categorically distinct diagnostic categories. However, several studies indicate high levels of co-occurrence between these diagnostic groups, which might be explained by overlapping symptoms. The aim of this systematic review is to provide a comprehensive overview of the research concerning overlap and differences in symptoms between schizophrenia spectrum and DDs. For this purpose the PubMed, PsycINFO, and Web of Science databases were searched for relevant literature. The literature contained a large body of evidence showing the presence of symptoms of dissociation in SSDs. Although there are quantitative differences between diagnoses, overlapping symptoms are not limited to certain domains of dissociation, nor to nonpathological forms of dissociation. In addition, dissociation seems to be related to a history of trauma in SSDs, as is also seen in DDs. There is also evidence showing that positive and negative symptoms typically associated with schizophrenia may be present in DD. Implications of these results are discussed with regard to different models of psychopathology and clinical practice.

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It has been proposed that mixed findings in studies investigating social cognition as a risk factor for violence in psychosis may be explained by utilizing a framework distinguishing between social-cognitive tests which measure relatively more basic operations (e.g. facial affect recognition) and measures of more complex operations (mentalizing, metacognition). The current study investigated which social cognitive and metacognitive processes are related to a violent history over and above illness-related deficits. Data from control participants (n = 33), patients with a psychotic disorder and no violent history (n = 27), and patients with a psychotic disorder in a forensic clinic (n = 23) were analyzed utilizing discriminant analysis. Metacognition and associative learning emerged as significant factors in predicting group membership between the three groups. In a follow-up analysis between only the patient groups, metacognitive Self-Reflectivity and Empathic Accuracy emerged as statistically significant predictors of group membership. The control group presented with higher levels of social cognitive and metacognitive capacity than patient groups, and the forensic patient group had lower levels than the non-forensic patient group. Our findings support previous research findings implying impaired metacognitive Self-Reflectivity in particular as a risk factor for violence.

Objective: A range of recent studies suggest that overall mindset about stress is related to health, performance, and well-being. Therefore, an exploratory study was conducted to examine whether virtual reality (VR) with real-time biofeedback would have potential in training people in an engaging way to develop a new stress-is-enhancing mindset.Materials and Methods: The specific application to improve people's stress mindset that was used in this study is Stressjam. The application was tested on its attractiveness by 111 healthy participants, specifically on their personal involvement through the Personal Involvement Inventory and its usability through the System Usability Scale. In addition to the healthy participants, a group of 64 patients dealing with stress used Stressjam for at least three sessions. The Stress Mindset Measure was used to assess the stress mindset of both groups, at baseline and after finishing their session(s).Results: Stressjam appears to be an application that is user friendly with good user involvement. The healthy participants and the patient sample both had a more positive stress mindset after using the application than at baseline, t(111) = 4.38, P < 0.001, and F(1,63) = 66.57, P < 0.001, respectively.Conclusion: The results of this study give some indications that using VR with biofeedback might be useful in working toward a more positive stress mindset. As such, further research into applications such as Stressjam is warranted.