Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

TY - JOUR

T1 - Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

AU - Trauelsen, Anne Marie

AU - Gumley, Andrew

AU - Jansen, Jens Einar

AU - Pedersen, Marlene Buch

AU - Nielsen, Hanne Grethe Lyse

AU - Lind, Christopher Trier

AU - Haahr, Ulrik H.

AU - Simonsen, Erik

PY - 2016/4/30

Y1 - 2016/4/30

N2 - There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.

AB - There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.

KW - Case-control

KW - Mentalizing

KW - Negative symptoms

KW - Positive symptoms

KW - Risk

KW - Self-reflectivity

U2 - 10.1016/j.psychres.2016.02.003

DO - 10.1016/j.psychres.2016.02.003

M3 - Journal article

C2 - 27086205

AN - SCOPUS:84960931256

SN - 0165-1781

VL - 238

SP - 14

EP - 23

JO - Psychiatry Research

JF - Psychiatry Research

ER -