Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity

Paul H. Lysaker, Jenifer Vohs, Jay A. Hamm, Marina Kukla, Kyle S. Minor, Steven de Jong, Rozanne van Donkersgoed, Marieke H.M. Pijnenborg, Jerillyn S. Kent, Sean C. Matthews, Jamie M. Ringer, Bethany L. Leonhardt, Michael M. Francis, Kelly D. Buck, Giancarlo Dimaggio

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Research has suggested that many with schizophrenia experience decrements in synthetic metacognition, or the abilities to form integrated representations of oneself and others and then utilize that knowledge to respond to problems. Although such deficits have been linked with functional impairments even after controlling for symptoms and neurocognition, it is unclear to what extent these deficits can distinguish persons with schizophrenia from others experiencing significant life adversity but without psychosis. To explore this issue we conducted logistic regression analysis to determine whether assessment of metacognition could distinguish between 166 participants with schizophrenia and 51 adults with HIV after controlling for social cognition and education. Metacognition was assessed with the Metacognitive Assessment Scale Abbreviated (MAS-A), and social cognition with the Bell Lysaker Emotion Recognition Test. We observed that the MAS-A total score was able to correctly classify 93.4% of the schizophrenia group, with higher levels of metacognition resulting in increased likelihood of accurate categorization. Additional exploratory analyses showed specific domains of metacognition measured by the MAS-A were equally able to predict membership in the schizophrenia group. Results support the assertion that deficits in the abilities to synthesize thoughts about oneself and others into larger representations are a unique feature of schizophrenia.

Original languageEnglish (US)
Pages (from-to)126-132
Number of pages7
JournalJournal of Psychiatric Research
Volume55
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Adversity
  • Metacognition
  • Schizophrenia
  • Social cognition
  • Theory of mind

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Arts and Humanities (miscellaneous)
  • Medicine(all)

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  • Cite this

    Lysaker, P. H., Vohs, J., Hamm, J. A., Kukla, M., Minor, K. S., de Jong, S., van Donkersgoed, R., Pijnenborg, M. H. M., Kent, J. S., Matthews, S. C., Ringer, J. M., Leonhardt, B. L., Francis, M. M., Buck, K. D., & Dimaggio, G. (2014). Deficits in metacognitive capacity distinguish patients with schizophrenia from those with prolonged medical adversity. Journal of Psychiatric Research, 55(1), 126-132. https://doi.org/10.1016/j.jpsychires.2014.04.011