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Metacognitive Functioning in Individuals at Clinical High Risk for Psychosis

Published online by Cambridge University Press:  21 March 2013

Mariapaola Barbato*
Affiliation:
University of Calgary, Canada
David L. Penn
Affiliation:
University of North Carolina at Chapel Hill, USA
Diana O. Perkins
Affiliation:
University of North Carolina at Chapel Hill, USA
Scott W. Woods
Affiliation:
Yale University, New Haven, USA
Lu Liu
Affiliation:
University of Calgary, Canada
Jean Addington
Affiliation:
University of Calgary, Canada
*
Reprint requests to Mariapaola Barbato, Mathison Centre for Mental Health Research and Education, 3280 Hospital Drive NW, Calgary AB T2N 4Z6, Canada. E-mail: mbarbato@ucalgary.ca

Abstract

Background: Metacognition has been described as the knowledge of our own cognitive processes. Metacognitive deficits are common in schizophrenia, but little is known about metacognition before the onset of full-blown psychosis. Aims: This study aimed to longitudinally characterize metacognition in a sample of individuals at clinical high risk (CHR) for psychosis, and to determine if metacognition was related to later conversion to psychosis. Method: Participants (153 CHR individuals; 68 help seeking controls, HSC) were part of the large multi-site PREDICT study, which sought to determine predictors of conversion to psychosis. They were tested at baseline and 6 months using the Meta-Cognitions Questionnaire (MCQ) that has five sub-scales assessing different domains of metacognition. Results: Results of the mixed-effect models demonstrated significantly poorer scores at baseline for the CHR group compared to the HSC group in Negative beliefs about uncontrollability, Negative beliefs and the overall MCQ score. At the 6-month assessment, no difference was observed in metacognition between the two groups, but both groups showed improvement in metacognition over time. Those who later converted to psychosis had poorer performance on metacognitive beliefs at baseline. Conclusions: A poorer performance in metacognition can be seen as a marker of developing a full blown psychotic illness and confirms the potential value of assessing metacognitive beliefs in individuals vulnerable for psychosis.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Addington, J., Epstein, I., Liu, L., French, P., Boydell, K. M. and Zipursky, R. B. (2011). A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research, 125, 5461.CrossRefGoogle ScholarPubMed
Barkus, E., Stirling, J., French, P., Morrison, A., Bentall, R. and Lewis, S. N. (2010). Distress and metacognition in psychosis prone individuals: comparing high schizotypy to the at-risk mental state. The Journal of Nervous and Mental Disease, 198, 99104.Google Scholar
Brett, C. M. C., Johns, L. C., Peters, E. P. and McGuire, P. K. (2009). The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomalies. Psychological Medicine, 39, 939950.CrossRefGoogle ScholarPubMed
Cartwright-Hatton, S. and Wells, A. (1997). Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279296.CrossRefGoogle ScholarPubMed
First, M., Spitzer, R. L., Gibbon, M., Williams, B. and Williams, J. B. W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition. New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Launay, G. and Slade, P. (1981). The measurement of hallucinatory predisposition in male and female prisoners. Personality and Individual Differences, 2, 221234.Google Scholar
McGlashan, T., Walsh, B. C. and Woods, S. W. (2010). The Psychosis Risk Syndrome: handbook for diagnosis and follow-up. New York: Oxford University Press.Google Scholar
Moritz, S., Veckenstedt, R., Randjbar, S., Vitzthum, F. and Woodward, T. S. (2011). Antipsychotic treatment beyond antipsychotics: metacognitive intervention for schizophrenia patients improves delusional symptoms. Psychological Medicine, 41, 18231832.Google Scholar
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257276.CrossRefGoogle Scholar
Morrison, A. P., Bentall, R. P., French, P., Walford, L., Kilcommons, A., Knight, A., et al. (2002). Randomised controlled trial of early detection and cognitive therapy for preventing transition to psychosis in high-risk individuals. The British Journal of Psychiatry, 181, s78s84.CrossRefGoogle Scholar
Morrison, A. P., French, P., Stewart, S. L. K., Birchwood, M., Fowler, D., Gumley, D. I., et al. (2012). Early detection and intervention evaluation for people at risk of psychosis: multisite randomised controlled trial. British Medical Journal, 344. doi: 10.1136/bmj.e2233 Google Scholar
Morrison, A. P., French, P. and Wells, A. (2007). Metacognitive beliefs across the continuum of psychosis: comparisons between patients with psychotic disorders, patients at ultra-high risk and non-patients. Behaviour Research and Therapy, 45, 22412246.Google Scholar
Morrison, A. P., Nothard, S., Bowe, S. E. and Wells, A. (2004). Interpretations of voices in patients with hallucinations and non-patient controls: a comparison and predictors of distress in patients. Behaviour Research and Therapy, 42, 13151323.CrossRefGoogle ScholarPubMed
Morrison, A. P. and Wells, A. (2003). A comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behaviour Research and Therapy, 41, 251256.Google Scholar
Morrison, A. P., Wells, A. and Nothard, S. (2000). Cognitive factors in predisposition to auditory and visual hallucinations. British Journal of Clinical Psychology, 39, 6778.Google Scholar
Semerari, A., Carcione, A., Dimaggio, G., Falcone, M., Nicolo, G., Procaci, M., et al. (2003). How to evaluate metacognitive function in psychotherapy? The Metacognition assessment scale and its applications. Clinical Psychology and Psychotherapy, 10, 238261.Google Scholar
Wells, A. and Matthews, G. (1994). Attention and Emotion: a clinical perspective. Hove, UK: Lawrence Erlbaum.Google Scholar
Wells, A. and Matthews, G. (1996). Modelling cognition in emotional disorder: the S-REF model. Behaviour Research and Therapy, 34, 881888.Google Scholar
Wells, A. and Papageorgiou, C. (1998). Relationships between worry, obsessive-compulsive symptoms and meta-cognitive beliefs. Behaviour Research and Therapy, 36, 899913.Google Scholar
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