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Wang Y, Chen T, Cui JF, Liu JL, Li TH, Du TJ. Comparison of trait and state mind wandering among schizotypal, subclinically depressed, and control individuals. BMC Psychiatry 2024; 24:422. [PMID: 38840083 PMCID: PMC11151557 DOI: 10.1186/s12888-024-05871-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/28/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Mind wandering is a common phenomenon in daily life. However, the manifestations and cognitive correlates of mind wandering in different subclinical populations remain unclear. In this study, these aspects were examined in individuals with schizotypal traits and individuals with depressive symptoms, i.e., subclinical populations of patients with schizophrenia and depression. METHODS Forty-two individuals with schizotypal traits, 42 individuals with subclinical depression, and 42 controls were recruited to complete a mind wandering thought sampling task (state level) and a mind wandering questionnaire (trait level). Measures of rumination and cognitive functions (attention, inhibition, and working memory) were also completed by participants. RESULTS Both subclinical groups exhibited more state and trait mind wandering than did the control group. Furthermore, individuals with schizotypal traits demonstrated more trait mind wandering than individuals with subclinical depression. Rumination, sustained attention, and working memory were associated with mind wandering. In addition, mind wandering in individuals with subclinical depression can be accounted for by rumination or attention, while mind wandering in individuals with high schizotypal traits cannot be accounted for by rumination, attention, or working memory. CONCLUSIONS The results suggest that individuals with high schizotypal traits and subclinical depression have different patterns of mind wandering and mechanisms. These findings have implications for understanding the unique profile of mind wandering in subclinical individuals.
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Affiliation(s)
- Ya Wang
- School of Psychology, Capital Normal University, Baiduizi 23A, Haidian District, Beijing, 100073, China.
| | - Tao Chen
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Ji-Fang Cui
- Institute of Educational Information and Statistics, National Academy of Educational Sciences, Beijing, China
| | - Jia-Li Liu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Healthy, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tian-Hong Li
- Department of Psychology, School of Medical Humanities, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Tian-Jiao Du
- Department of Psychology, School of Medical Humanities, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
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Wiesepape CN, Smith EA, Hillis-Mascia JD, Queller Soza SE, Morris MM, James AV, Stokes A. Metacognition as a Transdiagnostic Determinant of Recovery in Schizotypy and Schizophrenia Spectrum Disorders. Behav Sci (Basel) 2024; 14:336. [PMID: 38667132 PMCID: PMC11047686 DOI: 10.3390/bs14040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/24/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
The term schizotypy refers to the latent personality organization that is thought to underpin the liability to develop schizophrenia and associated disorders. Metacognition, or the ability to understand and form increasingly complex and integrated ideas of oneself, others, and one's community, has been proposed to be an important transdiagnostic construct across schizophrenia spectrum disorders and a range of both clinical and non-clinical manifestations of schizotypy. In this paper, we review evidence that deficits in metacognition are present in individuals with relatively high levels of schizotypy and that these deficits are related to symptomology, function, and quality of life. We address the idea that decrements in metacognition may also contribute to the progression from schizotypy to more severe manifestations, while the amelioration of these deficits may enhance aspects of recovery, including the ability to form an integrated sense of self, others, and the wider world. We also review the following two recovery-oriented psychotherapies that target metacognition to promote recovery in individuals with clinical manifestations of schizotypy: Evolutionary Systems Therapy for Schizotypy (ESTS) and Metacognitive Reflection and Insight Therapy (MERIT).
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Affiliation(s)
- Courtney N Wiesepape
- Austin VA Clinic, Veterans Affairs Central Texas Health Care, Austin, TX 78744, USA
| | - Elizabeth A Smith
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
| | | | | | - Madyson M Morris
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA
| | | | - Alexis Stokes
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
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3
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Lehmann M, Ettinger U. Metacognitive monitoring in schizotypy: Systematic literature review and new empirical data. J Behav Ther Exp Psychiatry 2023; 81:101891. [PMID: 37453406 DOI: 10.1016/j.jbtep.2023.101891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Deficits in metacognition, the ability to monitor one's own mental states, are key elements of the functional pathology of schizophrenia spectrum disorders. Little is known, however, about the integrity of metacognitive processes in subclinical schizotypy. The purpose of the present investigation was two-fold: First, we conducted a preregistered, systematic literature review to synthesize previous research efforts on the role of metacognition in schizotypy. Second, we investigated the relationship between self-reported dimensions of schizotypy and psychometric as well as behavioral measures of metacognition in a preregistered online study. METHODS A large sample (N = 330) completed a questionnaire battery and an episodic memory experiment; task-based metacognition was tapped via trial-by-trial confidence ratings. RESULTS In keeping with findings from our literature review, higher schizotypy was associated with diminished introspective insight and an overly self-referential and maladaptive metacognitive style in metacognition questionnaires. Importantly, low task-based metacognitive efficiency was predictive of high levels of cognitive disorganization, whereas task-related overconfidence (i.e., increased metacognitive bias) was linked with positive schizotypy. LIMITATIONS Due to the comparatively small number of k = 20 studies meeting our inclusion criteria, the systematic literature review provides only preliminary indications for potential conclusions. Furthermore, control over potential disturbing influences in the experimental study was limited due to its online format. CONCLUSIONS Overall, we provide evidence for specific metacognitive deficits in schizotypy and discuss a potential continuity of preserved and impaired aspects of metacognitive monitoring along the psychosis continuum.
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Affiliation(s)
- Mirko Lehmann
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, NRW, Germany.
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, NRW, Germany.
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4
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Ye JY, Qin XJ, Cui JF, Jia LX, Shi HS, Yang TX, Lui SSY, Wang Y, Chan RCK. Mental time travel for self and others in individuals with a high level of schizotypy. Psych J 2023; 12:524-534. [PMID: 36653195 DOI: 10.1002/pchj.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/28/2022] [Indexed: 01/20/2023]
Abstract
Mental time travel (MTT) is the ability to project oneself to the past or future through mental simulation. Moreover, MTT can involve self-related or other-related information. This study aimed to compare MTT in individuals with high levels of schizotypy and that in their counterparts with low levels of schizotypy. Participants with high (n = 37) and low (n = 37) levels of schizotypy completed an MTT task with four conditions [2 (Condition: self vs. other) × 2 (Time orientation: past vs. future)]. They were required to recall past events that had happened to themselves or to a non-intimate person, and to imagine possible future events that might happen to themselves or to a non-intimate person, related to cue words. Outcome measures included specificity, vividness, sense of experience, emotional valence, emotional intensity, proportion of first-person visual perspective in events, and difficulty in event generation. A 2 (Group: high vs. low levels of schizotypy) × 2 (Condition) × 2 (Time orientation) mixed analysis of variance was conducted on each index. Results showed that self-related MTT was more specific than other-related MTT in low levels of schizotypy participants but not in high levels of schizotypy participants. Participants with a high level of schizotypy reported fewer specific events, and reported events with lower vividness and positive emotion than did those with a low level of schizotypy. Self-related MTT showed higher levels of phenomenological characteristics than did other-related MTT. In conclusion, individuals with a high level of schizotypy have altered MTT, and cannot benefit from the self-advantage effect on the specificity of MTT.
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Affiliation(s)
- Jun-Yan Ye
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiao-Jing Qin
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ji-Fang Cui
- Research Center for Information and Statistics, National Institute of Education Sciences, Beijing, China
| | - Lu-Xia Jia
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hai-Song Shi
- North China Electric Power University, Beijing, China
| | - Tian-Xiao Yang
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Hohendorf M, Bauer M. Metacognitive sensitivity and symptoms of mental disorder: A systematic review and meta-analysis. Front Psychol 2023; 14:991339. [PMID: 36818089 PMCID: PMC9932734 DOI: 10.3389/fpsyg.2023.991339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Metacognition is a term used to refer to cognition about cognitive processes. In this systematic review and meta-analysis, we reviewed studies that investigated the relationship between experimentally measured objective metacognitive sensitivity and diverse symptoms of mental disorder. In these studies, metacognitive sensitivity is operationalized as the correspondence between the accuracy of task performance and reported confidence therein. Methods A literature search was conducted across four databases and studies were selected for review based on predefined eligibility criteria. Twenty studies were included in the review and separate meta-analyses were conducted for psychotic and non-psychotic categories of psychiatric symptoms. Results A significant reduction (medium effect size) in metacognitive sensitivity was found in individuals with psychosis-related symptoms of mental disorder compared to healthy control groups, but no significant difference was found for individuals with non-psychotic symptoms. It should be noted though, that fewer studies were available for the latter group. Sub-group analysis found no evidence that the effect of metacognitive impairment depended on whether perceptual or non-perceptual experimental tasks were employed. Discussion These findings are discussed in relation to other conceptualizations of metacognition and the role reduced metacognitive sensitivity may play in forms of mental disorder.
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Affiliation(s)
- Marianne Hohendorf
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Markus Bauer
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
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6
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Luther L, Hochheiser J, Wiesepape C, Lysaker PH. Negative Schizotypy Mediates the Relationship Between Metacognition and Social Functioning in a Nonclinical Sample. J Nerv Ment Dis 2023; 211:74-78. [PMID: 36596289 DOI: 10.1097/nmd.0000000000001585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
ABSTRACT Reduced metacognitive abilities-difficulty making sense of and understanding oneself and others-have been found to be key predictors of social functioning across a range of clinical and nonclinical groups. However, the exact processes through which metacognition impacts social functioning are unclear. This study examined whether subclinical negative symptoms mediated the relationship between metacognition and social functioning in a nonclinical sample of young adults (n = 98). Results demonstrated that lower metacognitive mastery was found to be uniquely associated with greater subclinical negative symptoms, whereas higher subclinical negative symptoms were associated with reduced social functioning. Further, the effects of lower metacognition on reduced social function were mediated by subclinical negative symptoms and not positive or disorganized subclinical symptoms. Results suggest that subclinical negative symptoms may link reductions in metacognition with social functioning in nonclinical samples. Training aimed at enhancing metacognition may support normative social functioning in the general population.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, Georgia
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7
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Webster L, Norman C, Jones G, Marriott M. Mediating role for metacognitive processes in the relationship between schizotypy and anxiety and depression symptoms. Cogn Neuropsychiatry 2022; 27:393-410. [PMID: 35975632 DOI: 10.1080/13546805.2022.2108388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Introduction: Depression and anxiety symptoms are highly prevalent in schizophrenia-spectrum disorders and are commonly associated with schizotypy in non-clinical samples. However, it remains unclear what factors could be contributing to the relationships between schizotypy and anxiety and depression symptoms. Using path analysis, we explored the complex interplay between schizotypy, metacognitive beliefs, cognitive insight, and symptoms of emotional distress.Methods: Self-report data of schizotypy, metacognitive beliefs, cognitive insight, depression, and anxiety symptoms were collected from 344 participants from a predominantly student sample.Results: Path analysis confirmed unique associations between schizotypy dimensions, metacognitive beliefs, and cognitive insight. Furthermore, negative beliefs about worry mediated the link between the schizotypy dimensions, unusual experiences, cognitive disorganisation, and introvertive anhedonia and both depression and anxiety symptoms. Lack of cognitive confidence also mediated the relationship between cognitive disorganisation and depression symptoms. Finally, the cognitive insight subcomponent self-reflectiveness mediated the relationship between unusual experiences and cognitive disorganisation and anxiety.Conclusions: This study significantly furthers our understanding of the complex relationship between schizotypy, metacognitive processes, and emotional distress. Our findings also provide support for interventions which modify metacognitive beliefs and self-reflectiveness, which may prove beneficial for treatment in clinical settings.
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Affiliation(s)
- Lucy Webster
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Christine Norman
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Gary Jones
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Mike Marriott
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Drinkwater KG, Dagnall N, Denovan A, Parker A, Escolà-Gascón Á. Paranormal Experience Profiles and Their Association With Variations in Executive Functions: A Latent Profile Analysis. Front Psychol 2022; 12:778312. [PMID: 35082722 PMCID: PMC8784801 DOI: 10.3389/fpsyg.2021.778312] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/06/2021] [Indexed: 12/12/2022] Open
Abstract
This study investigated relationships between inter-class variations in paranormal experience and executive functions. A sample of 516 adults completed self-report measures assessing personal encounter-based paranormal occurrences (i.e., Experience, Practitioner Visiting, and Ability), executive functions (i.e., General Executive Function, Working and Everyday Memory, and Decision Making) together with Emotion Regulation and Belief in the Paranormal. Paranormal belief served as a measure of convergent validity for experience-based phenomena. Latent profile analysis (LPA) combined experience-based indices into four classes based on sample subpopulation scores. Multivariate analysis of variance (MANOVA) then examined interclass differences. Results revealed that breadth of paranormal experience was associated with higher levels of executive functioning difficulties for General Executive Function, Working Memory, Decision Making, and Belief in the Paranormal. On the Everyday Memory Questionnaire, scores differed on Attention Tracking (focus loss) and Factor 3 (visual reconstruction), but not Retrieval (distinct memory failure). In the case of the Emotion Regulation Scale, class scores varied on Expressive Suppression (control), however, no difference was evident on Cognitive Reappraisal (reframing). Overall, inter-class comparisons identified subtle differences in executive functions related to experience. Since the present study was exploratory, sampled only a limited subset of executive functions, and used subjective, self-report measures, further research is necessary to confirm these outcomes. This should employ objective tests and include a broader range of executive functions.
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Affiliation(s)
| | - Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | | | - Andrew Parker
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
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9
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Drinkwater KG, Dagnall N, Denovan A, Parker A, Escolà-Gascón Á. Executive Functioning: Assessing the Role of Perceived Paranormal Ability. Front Psychol 2022; 12:798283. [PMID: 35002892 PMCID: PMC8733669 DOI: 10.3389/fpsyg.2021.798283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/30/2021] [Indexed: 01/24/2023] Open
Abstract
This study examined whether scores on self-report measures of executive functions varied in accordance with level of self-professed paranormal ability. The investigators compared three groups varying in attribution of paranormal facilities: practitioners (Mediums, Psychics, Spiritualists and Fortune-Tellers), self-professed ability and no ability. Consistent with recent research on cognitive-perceptual factors allied to delusional formation and thinking style, the researchers anticipated that practitioners would score higher on paranormal belief and self-reported executive function disruption. Correspondingly, the investigators also hypothesised that the self-professed ability group would demonstrate greater belief in the paranormal and higher levels of executive function disruption than the no ability group. A sample of 499 (219 males, 279 females) respondents completed the measures online. Multivariate analysis of variance (MANOVA) found a large effect size, alongside significant differences on all variables apart from Cognitive Reappraisal. Pairwise comparisons indicated that Paranormal Belief increased as a function of level of ability; practitioners scored higher than self-professed, who in turn scored higher than the no ability group. For executive functioning, significant differences emerged only for the no ability vs. self-professed ability and no ability vs. practising groups. Collectively, outcomes indicated that perception of ability, regardless of intensity of paranormal conviction, influenced subjective appraisal of executive functions. Failure to find consistent differences between practitioner and self-professed ability groups suggested that discernment of ability was sufficient to heighten awareness of executive functioning disruptions.
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Affiliation(s)
| | - Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | | | - Andrew Parker
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
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10
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Abstract
This paper introduces a new construct, the 'pivotal mental state', which is defined as a hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation. We believe this new construct bears relevance to a broad range of psychological and psychiatric phenomena. We argue that pivotal mental states serve an important evolutionary function, that is, to aid psychological transformation when actual or perceived environmental pressures demand this. We cite evidence that chronic stress and neurotic traits are primers for a pivotal mental state, whereas acute stress can be a trigger. Inspired by research with serotonin 2A receptor agonist psychedelics, we highlight how activity at this particular receptor can robustly and reliably induce pivotal mental states, but we argue that the capacity for pivotal mental states is an inherent property of the human brain itself. Moreover, we hypothesize that serotonergic psychedelics hijack a system that has evolved to mediate rapid and deep learning when its need is sensed. We cite a breadth of evidences linking stress via a variety of inducers, with an upregulated serotonin 2A receptor system (e.g. upregulated availability of and/or binding to the receptor) and acute stress with 5-HT release, which we argue can activate this primed system to induce a pivotal mental state. The pivotal mental state model is multi-level, linking a specific molecular gateway (increased serotonin 2A receptor signaling) with the inception of a hyper-plastic brain and mind state, enhanced rate of associative learning and the potential mediation of a psychological transformation.
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Affiliation(s)
- Ari Brouwer
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
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Cheli S, Lysaker PH, Dimaggio G. Metacognitively oriented psychotherapy for schizotypal personality disorder: A two-case series. Personal Ment Health 2019; 13:155-167. [PMID: 31169366 DOI: 10.1002/pmh.1447] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/31/2019] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
Schizotypal personality disorder represents a broad range of maladaptive behaviour, which has been linked to both personality disorder and schizophrenia spectrum disorders; however, to date, little effort has been devoted to developing psychosocial treatment approaches to address it. In response, we conducted two case studies exploring the effects of two metacognitively oriented forms of psychotherapy: metacognitive interpersonal therapy and metacognitive reflection and insight therapy for patients with schizotypal personality disorder. We chose these two forms of therapy as they have been successfully delivered, respectively, to persons with other personality disorders and schizophrenia spectrum disorders. Both treatments consisted of weekly individual psychotherapy sessions over a period of 6 months. General symptoms were assessed during the first week of treatment, at treatment end and at 1 month following treatment using the Symptom Check List-90-Revised, while schizotypal traits were assessed with the Structured Clinical Interview for DSM-5. Both patients completed all sessions, and there were no reports of any adverse outcomes. Both patients achieved reliable change in symptoms (ranging from 4.98 to 9.81) and a significant reduction in schizotypal features. Results provide preliminary evidence of the feasibility of metacognitively oriented interventions for schizotypal personality disorder. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
- Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy.,Center for Psychology and Health, Tages Charity, Florence, Italy
| | - Paul H Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
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12
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Hutton P, Di Rienzo F, Turkington D, Spencer H, Taylor P. Suicidal Ideation in People With Psychosis Not Taking Antipsychotic Medication: Do Negative Appraisals and Negative Metacognitive Beliefs Mediate the Effect of Symptoms? Schizophr Bull 2019; 45:37-47. [PMID: 30388270 PMCID: PMC6293212 DOI: 10.1093/schbul/sby153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Between 5% and 10% of people with psychosis will die by suicide, a rate which is 20-75 times higher than the general population. This risk is even greater in those not taking antipsychotic medication. We examined whether negative appraisals of psychotic experiences and negative metacognitive beliefs about losing mental control mediated a relationship between psychotic symptoms and suicidal ideation in this group. Participants were diagnosed with schizophrenia spectrum disorders, antipsychotic-free for 6 months at baseline, and were participating in an 18-month randomized controlled trial of cognitive therapy vs treatment as usual. We conducted a series of mediation analyses with bootstrapping on baseline (N = 68), follow-up data (9-18 mo; n = 49), and longitudinal data (n = 47). Concurrent general symptoms were directly associated with suicidal ideation at baseline, and concurrent negative symptoms were directly associated with suicidal ideation at 9-18 months. Concurrent positive, negative, general, and overall symptoms were each indirectly associated with suicidal ideation via negative appraisals and/or negative metacognitive beliefs, at baseline and 9-18 months, except for negative symptoms at baseline. Controlling for baseline suicidal ideation and treatment allocation, baseline general symptoms were indirectly associated with later suicidal ideation, via baseline negative appraisals and negative metacognitive beliefs. Baseline negative metacognitive beliefs also had a direct association with later suicidal ideation. These findings suggest the clinical assessment of suicidal ideation in psychosis may be enhanced by considering metacognitive beliefs about the probability and consequences of losing mental control.
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Affiliation(s)
- Paul Hutton
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom,To whom correspondence should be addressed; tel: +44(0)131-455-3335, e-mail:
| | - Francesca Di Rienzo
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Douglas Turkington
- Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, United Kingdom,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Helen Spencer
- Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, United Kingdom,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
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13
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Martin EA, McCleery A, Moore MM, Wynn JK, Green MF, Horan WP. ERP indices of performance monitoring and feedback processing in psychosis: A meta-analysis. Int J Psychophysiol 2018; 132:365-378. [PMID: 30102934 PMCID: PMC6157731 DOI: 10.1016/j.ijpsycho.2018.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although individuals with, or at risk for, psychotic disorders often show difficulties with performance monitoring and feedback processing, findings from studies using event-related potentials (ERPs) to index these processes are not consistent. This meta-analytic review focused on studies of two different indexes of performance monitoring, the early error-related negativity (ERN; n = 25) and the later error positivity (Pe; n = 17), and one index of feedback processing, the feedback negativity (FN; n = 6). METHODS We evaluated whether individuals (1) with psychotic disorders, or (2) at heightened risk for these disorders differ from healthy controls in available studies of the ERN, Pe, and FN. RESULTS There was a significant, large ERN reduction in those with psychosis (g = -0.96) compared to controls, and a significant, moderate ERN reduction in those at-risk (g = -0.48). In contrast, there were uniformly non-significant, small between-group differences for Pe and FN (gs ≤ |0.16|). CONCLUSIONS The results reveal a differential pattern of impairment in psychosis. Early performance monitoring (ERN) impairments are substantial among those with psychotic disorders in general and may be a useful vulnerability indicator for these disorders. However, later performance monitoring (Pe) and basic feedback processing (FN) appear to be relatively spared in psychosis.
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Affiliation(s)
- Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, United States of America.
| | - Amanda McCleery
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Melody M Moore
- Department of Psychological Science, University of California, Irvine, United States of America
| | - Jonathan K Wynn
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Michael F Green
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - William P Horan
- VA Greater Los Angeles Healthcare System, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
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Ettinger U, Aichert DS, Wöstmann N, Dehning S, Riedel M, Kumari V. Response inhibition and interference control: Effects of schizophrenia, genetic risk, and schizotypy. J Neuropsychol 2017; 12:484-510. [DOI: 10.1111/jnp.12126] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/06/2017] [Indexed: 01/18/2023]
Affiliation(s)
| | | | | | - Sandra Dehning
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy; University of Munich; Germany
| | | | - Veena Kumari
- Research and Development; Sovereign Health Group; San Clemente California USA
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15
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Fumero A, Rodríguez M, Roa A, Peñate W. Importancia diferencial de los componentes fundamentales de la esquizotipia: un metaanálisis. REVISTA LATINOAMERICANA DE PSICOLOGIA 2017. [DOI: 10.1016/j.rlp.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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