Preserved metacognition despite impaired perception of intentionality cues in schizophrenia

Recovery Notion of Individuals With Schizophrenia and Their Families in Eastern Turkey: A Qualitative Study

PURPOSE

To determine the recovery notion among individuals with schizophrenia and their families in Eastern Turkey.

METHOD

A descriptive phenomenological study was performed. Individual in-depth interviews were conducted, and data were analyzed using Braun and Clarke's thematic analysis.

RESULTS

Three themes were revealed-Meaning of Recovery, which emphasizes a multifaceted definition of recovery based on the individual's and family's experiences; Necessities of Recovery, emphasizing the requirements of recovery from the individual's and family's perspectives (e.g., treatment adherence, support of health care professionals); and Recovery Journey, which emphasizes the dynamic aspect of the recovery process from the individual's perspective.

CONCLUSION

Individuals with schizophrenia are able to define their own recovery and self-determined recovery goals, which will enable them to evaluate treatment outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 63(4), 34-42.].

Paranoid and teleological thinking give rise to distinct social hallucinations in vision

Paranoia (believing others intend harm) and excess teleological thinking (ascribing too much purpose) are non-consensual beliefs about agents. Human vision rapidly detects agents and their intentions. Might paranoia and teleology have roots in visual perception? Using displays that evoke the impression that one disc ('wolf') is chasing another ('sheep'), we find that paranoia and teleology involve perceiving chasing when there is none (studies 1 and 2) - errors we characterize as social hallucinations. When asked to identify the wolf or the sheep (studies 3, 4a, and 4b), we find high-paranoia participants struggled to identify sheep, while high-teleology participants were impaired at identifying wolves - both despite high-confidence. Both types of errors correlated with hallucinatory percepts in the real world. Although paranoia and teleology both involve excess perception of agency, the current results collectively suggest a perceptual distinction between the two, perhaps with clinical import.

Link between metacognition and social cognition in schizophrenia: a systematic review and meta-analysis

Introduction

Metacognition is the ability to reflect on one's own cognitive processes, monitor and regulate them to enhance mental performance. Social cognition involves the capacity to perceive and respond to social cues from others. The study of metacognition and social cognition is an expanding research field in psychiatry. Both domains are related to neurocognition, symptoms and psychosocial functioning in schizophrenia. Understanding the relationship between social cognition and metacognition may be pivotal for enhancing the treatment of cognitive symptoms in schizophrenia.

Methods

We conducted a PRISMA systematic review and meta-analysis on quantitative studies comparing metacognition to social cognitive outcomes in adult outpatients with a schizophrenia spectrum disorder. Reports were retrieved from the Medline, ScienceDirect and PsycINFO databases up to July 13th, 2023. Risk of bias was assessed with the Cochrane tool.

Results

Our review included 1,036 participants across 17 reports, with 12 reports included in the meta-analysis. We found a significant positive correlation (r = 0.28, 95% CI: [0.14, 0.41]) between social cognition and metacognition. Subgroup analyses indicated that metacognition was specifically associated with theory of mind, attribution, and emotion processing. Different patterns of correlations were observed according to the assessment of metacognition and its subdimensions.

Conclusion

Despite discrepancies among the included studies, no publication bias was detected. The results suggest that metacognition and social cognition are distinct but related constructs. Those processes should be assessed and treated together, along with neurocognition, in schizophrenia.