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The association between metacognitive abilities and outcome measures among people with schizophrenia: A meta-analysis

Published online by Cambridge University Press:  23 March 2020

N. Arnon-Ribenfeld ,
I. Hasson-Ohayon ,
M. Lavidor ,
D. Atzil-Slonim  and
P.H. Lysaker
N. Arnon-Ribenfeld
Affiliation:
Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel
I. Hasson-Ohayon*
Affiliation:
Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel
M. Lavidor
Affiliation:
Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel
D. Atzil-Slonim
Affiliation:
Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel
P.H. Lysaker
Affiliation:
Roudebush VA Medical Center, Indianapolis, IN, United States
*
* Corresponding author. E-mail address:ilanithasson@gmail.com (I. Hasson-Ohayon).
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Abstract

Background:

Deficits in metacognition are one of the major causes of the difficulties experienced by individuals with schizophrenia. Studies have linked these deficits to symptom exacerbation and deterioration in psychosocial functioning. The aim of the present meta-analysis was to examine the extensive existing literature regarding metacognitive deficits among persons with schizophrenia; a further aim was to assess the extent to which metacognitive abilities are linked to outcome measures of symptoms and psychosocial functioning.

Method:

We conducted a systematic literature search of studies examining the relationship between metacognitive abilities and outcome measures among people with schizophrenia. We then analyzed the data using a random-effects meta-analytic model with Cohen's d standardized mean effect size.

Results:

Heterogeneity analyses (k = 32, Cohen's d = −.12, 95% CI.−1.92 to 1.7) produced a significant Q-statistic (Q = 456.89) and a high amount of heterogeneity, as indicated by the I2 statistic (93.04%), suggesting that moderator analyses were appropriate. As hypothesized, measure type moderated the metacognitive deficit with homogenous effect for psychosocial functioning measures (Q = 9.81, I2 = 19.47%, d = .94. 95% CI .58 to 1.2) and symptoms (Q = 19.87, I2 = 0%, d = −1.07, 95% CI −1.18 to −.75). Further analysis found homogenous effects for MAS-A subscales as well as PANSS factors of symptoms.

Conclusion:

Our meta-analysis results illustrated a significant association between metacognitive deficits and both symptomatic and psychosocial functioning measures. These links suggest that the associations between metacognitive abilities and symptomatic outcomes are different from those between metacognitive abilities and psychosocial functioning measures. Intriguing hypotheses are raised regarding the role that metacognitive abilities play in both symptoms and psychosocial functioning measures of people diagnosed with schizophrenia spectrum disorders.

Keywords

Meta-analysisMetacognitionSchizophrenia
Type
Review
Information
European Psychiatry , Volume 46 , October 2017 , pp. 33 - 41
Copyright
Copyright © European Psychiatric Association 2017

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