Recovery, Meaning-Making, and Severe Mental Illness

Lysaker, Paul H.; Klion, Reid E.

doi:10.4324/9781315447001

Cited by 139 publications

(94 citation statements)

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“…Therefore, results of these comparisons have to be interpreted as imprecise. All included studies directly addressed the aim of this systematic review, which is why limitations due to indirectness of comparisons are unlikely Inchausti et al, 2017) suggest that their integrative treatment approach complements research in this field, alongside the cognitive-behavioural interventions (Lysaker & Klion, 2017).…”

Section: Methodological Evaluation Of the Systematic Reviewmentioning

confidence: 99%

“…According to this definition, we included three metacognitive interventions in our systematic review: Metacognitive Training (MCTrain), first developed by Steffen Moritz and Todd Woodward for patients with schizophrenia (Moritz & Woodward, 2007); Metacognitive Therapy (MCTherap), first developed by Adrian Wells and Gerald Matthews for patients with generalized anxiety disorder (GAD; Wells & Matthews, 1994); and metacognitively oriented integrative psychotherapies that are based on a narrative approach and were developed for patients with personality disorders and schizophrenia (Dimaggio & Semerari, 2001;Lysaker & Lysaker, 2001;Semerari et al, 2003). In this review, the latter group of interventions is represented by Metacognition Reflection and Insight Therapy (MERIT) as introduced by Lysaker and Klion (2017), because to date, there are no results of randomized controlled trials (RCTs) or non-RCTs (NRCTs) available for other conceptualizations like Metacognitive Interpersonal Therapy (Dimaggio et al, 2017). Despite a number of differences, all three metacognitive interventions share the assumption of a metalevel of cognition that affects emotions and behaviour through giving attention to and reflecting on thoughts and beliefs (for a review, see Moritz & Lysaker, 2018).…”

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confidence: 99%

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Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Philipp

Kriston

Lanio

et al. 2018

Clin Psychology and Psychoth

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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.

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Section: Methodological Evaluation Of the Systematic Reviewmentioning

confidence: 99%

mentioning

confidence: 99%

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Philipp

Kriston

Lanio

et al. 2018

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…The last two elements, the superordinate elements, necessitate therapist interventions that match patients’ metacognitive capacity for: (vii) reflection about the self and others; and (viii) metacognitive mastery or the ability to use metacognitive knowledge to respond effectively to psychosocial challenges. 56 MERIT, consistent with CBTp, emphasizes the development of the therapeutic alliance and reflection upon patients’ experience of their feelings and thoughts. It moves beyond these common aspects in its holistic consideration of how embodied and prereflective experience are integrated intersubjectively within session, alongside more effortful forms of cognition, to allow persons to make their own unique sense of their challenges and to respond as agents…”

Section: Metacognitive Insight and Reflection Therapymentioning

confidence: 96%

“…The term schizophrenia originally described psychotic disorders as conditions in which goal-directed behavior collapses because of the fragmentation or loss of coherence of three principle areas of psychological functions: cognition, emotion, and volition. 55 MERIT 56 is a treatment designed to address these experiences of fragmentation. MERIT relies on the integrated model of metacognition 57 which uses the term metacognition to describe both the top-down and bottom-up processes which allow for the elements of cognitive, emotional, social and embodied experience to be synthesized into a larger sense of self within the flow of life.…”

Section: Metacognitive Insight and Reflection Therapymentioning

confidence: 99%

Metacognitive and cognitive-behavioral interventions for psychosis: new developments

Moritz

Klein

Lysaker

et al. 2019

Dialogues in Clinical Neuroscience

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This review describes four cognitive approaches for the treatment of schizophrenia: cognitive-behavioral therapy for psychosis (CBTp), metacognitive therapy, metacognitive training, and metacognitive reflection insight therapy (MERIT). A central reference point of our review is a seminal paper by James Flavell, who introduced the term metacognition (“cognition about cognition”). In a way, every psychotherapeutic approach adopts a metacognitive perspective when therapists reflect with clients about their thoughts. Yet, the four approaches map onto different components of metacognition. CBTp conveys some “metacognitive knowledge” (eg, thoughts are not facts) but is mainly concerned with individual beliefs. Metacognitive therapy focuses on unhelpful metacognitive beliefs about thinking styles (eg, thought suppression). Metacognitive training brings distorted cognitive biases to the awareness of patients; a central goal is the reduction of overconfidence. MERIT focuses on larger senses of identity and highlights metacognitive knowledge about oneself and other persons. For CBTp and metacognitive training, meta-analytic evidence supports their efficacy; single studies speak for the effectiveness of MERIT and metacognitive therapy.

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“…The inability to integrate information into more complex ideas or representations about the self and others has been proposed to be a core source of dysfunction in schizophrenia. 1,2 Contemporary psychopathology has focused on the 2 related constructs that reflect failures of integration in psychosis: metacognition and insight. The term metacognition was defined by Flavell 3(p907) as “everything that you could come to believe about the nature of yourself and other people as cognitive processors.” Since that time, the definition of metacognition has expanded to encompass a spectrum of mental activities ranging from discrete processes, such as thinking about a thought, to more synthetic acts.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Metacognition and Insight to Neural Synchronization and Cognitive Function in Early Phase Psychosis

et al. 2019

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Metacognition is the process of thinking about one’s own mental states. It involves a range of faculties that allow an individual to integrate information and form understanding of self and others, and use this understanding to respond to life challenges. Clinical insight is the awareness of one’s mental illness, its consequences, and the need for treatment. Persons with psychotic disorders show impaired metacognition and insight, but the neurobiological bases for these impairments are not well characterized. We hypothesized that metacognition and insight may depend on capacity of neural circuits to synchronize at gamma frequencies, as well as the integrity of underlying cognitive processes. In order to test these hypotheses, 17 adults with early phase psychosis were evaluated. Metacognition was assessed with the Metacognition Assessment Scale–Abbreviated, and insight was assessed with the Scale of Unawareness of Illness–Abbreviated. The auditory steady state response (ASSR) to gamma range stimulation (40 Hz) was used as an index of neural synchronization. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia. Increases in ASSR power were associated with poorer metacognition and insight. Higher cognitive performance was associated with higher levels of metacognitive function and insight. These findings suggest that altered neural synchronization and constituent cognitive processes affect both metacognition and insight in early phase psychosis and may offer targets for both pharmacological and psychotherapeutic interventions.

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Recovery, Meaning-Making, and Severe Mental Illness

Cited by 139 publications

References 0 publications

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Metacognitive and cognitive-behavioral interventions for psychosis: new developments

Relationship of Metacognition and Insight to Neural Synchronization and Cognitive Function in Early Phase Psychosis

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