Efficacy of metacognitive training on symptom severity, neurocognition and social cognition in patients with schizophrenia: A single‐blind randomized controlled trial

Abstract

Over the past decades, a number of complementary treatments for schizophrenia have emerged. One of these is metacognitive training (MCT), which combines the principles of cognitive‐behavioral therapies, cognitive remediation, and psychoeducation into a hybrid approach placing emphasis on increasing metacognitive awareness. The aim of our study was to investigate the efficacy of MCT on symptom severity, and neurocognitive and social cognitive functioning in schizophrenia; also, attention was paid to the assessment of subjective acceptability. Forty‐six patients diagnosed with schizophrenia were included in our single‐blind randomized controlled trial, who were assigned to the intervention or control group. The intervention group was provided standard MCT, while the control group received treatment as usual. We assessed symptom severity and cognitive functions before and after the training, as well as after a 6‐month follow‐up period. Compared to the control group, the intervention group showed improvement in overall symptom severity, and positive and disorganized symptoms. Training participans showed further improvement at the follow‐up assessment. Regarding neurocognitive functions, improvement in visuospatial functions was observed between pre‐ and post‐intervention assessments compared to the control group. Patients showed excellent adherence, and evaluated the training as useful and interesting. In line with the results of previous studies, our results demonstrate the efficacy of MCT on symptom severity in schizophrenia. Improvements in cognitive functions that are closely related to the onset and prevalence of symptoms of schizophrenia were also found.

Metacognition as a Transdiagnostic Determinant of Recovery in Schizotypy and Schizophrenia Spectrum Disorders

“…The integrated model of metacognition has expanded upon this definition to include the ability to understand and form increasingly complex and integrated ideas of oneself, others, and one's community [41]. This model of metacognition can be understood as a spectrum or "umbrella" [42] of activities, ranging from discrete cognitive activities (e.g., recognizing a thought or emotion) to more complex functions, including social cognition and neurocognition, which may support more cohesive understandings of the self and others. The integrated model of metacognition, as proposed by Lysaker and colleagues, includes four domains of metacognition, including self-reflectivity, understanding the mind of the other, decentration, and mastery, each of which can be measured using the Metacognition Assessment Scale-Abbreviated (MAS-A) [43]-which was developed from the original Metacognition Assessment Scale (MAS) [44].…”

Metacognition in schizophrenia: A practical overview of psychometric metacognition assessment tools for researchers and clinicians

“…The larger sense of self enabled by metacognition is crucial for orienting us in the inner and external world: it is a key element of human adaptive behavior as we move daily based on metacognitive insights, keeping us flexible and responsive to a complex and ever-changing reality ( 7 ). According to this model, metacognition can be more comprehensively defined as an “umbrella concept” aggregating elements ranging from discrete cognitive processes to more elaborated functions which also include neurocognitive and social cognitive abilities ( 8 ).…”

Metacognitions in patients with chronic obstructive pulmonary disease: a psychometric study of the metacognitions questionnaire-30

“…Nelson (1996) referred to metacognition as a function that acts as a monitor and controller over our cognitive processes. Whereas Wells developed a metacognitive model based on the S-ref model, Lysaker et al (2021) developed an integrated model of metacognitions in patients with psychosis that may be interpreted as an umbrella concept (Fekete et al, 2022).…”