“…Previous studies have demonstrated relationships between substance abuse and deficits in discrete components of metacognition, such as the ability to name and express one’s own emotions (a condition known as alexithymia; e.g., Thorberg, Young, Sullivan, & Lyvers, 2009). In a more recent study, Highland, Herschl, Klanecky, and McChargue (2013) found that in persons with a specific gene expression, greater levels of alexithymia were associated with greater levels of substance abuse, and Lysaker et al (2014) found that low metacognitive mastery—the ability to use mental states to solve social problems—moderated the effects of alexithymia in persons with substance-abuse problems. In addition, metacognitive deficits have been linked to poorer outcomes in substance-abuse recovery (Saladin et al, 2012; Thorberg et al, 2011), deliberate self-harm (Verrocchio, Conti, & Fulcheri, 2010), and emotional distress (De Rick, Vanheule, & Verhaeghe, 2009) as well as more excessive use of alcohol in nonclinical samples (Lyvers, Onuoha, Thorberg, & Samios, 2012).…”