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Investigation of metamemory functioning in the at-risk mental state for psychosis

Published online by Cambridge University Press:  23 July 2015

S. Eisenacher ,
F. Rausch ,
F. Ainser ,
D. Mier ,
R. Veckenstedt ,
F. Schirmbeck ,
A. Lewien ,
S. Englisch ,
C. Andreou  and
S. Moritz
...Show all authors
S. Eisenacher*
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
F. Rausch
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
F. Ainser
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
D. Mier
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim, Germany
R. Veckenstedt
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
F. Schirmbeck
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, AZ Amsterdam, The Netherlands
A. Lewien
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
S. Englisch
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
C. Andreou
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
S. Moritz
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
A. Meyer-Lindenberg
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
P. Kirsch
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim, Germany
M. Zink
Affiliation:
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
*
* Address for correspondence: S. Eisenacher, M.Sc. (Psych.), Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim/Heidelberg University, Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany. (Email: sarah.eisenacher@zi-mannheim.de)
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Abstract

Background

Metamemory describes the monitoring and knowledge about one's memory capabilities. Patients with schizophrenia have been found to be less able in differentiating between correct and false answers (smaller confidence gap) when asked to provide retrospective confidence ratings in previous studies. Furthermore, higher proportions of very-high-confident but false responses have been found in this patient group (high knowledge corruption). Whether and how these biases contribute to the early pathogenesis of psychosis is yet unclear. This study thus aimed at investigating metamemory function in the early course of psychosis.

Method

Patients in an at-risk mental state for psychosis (ARMS, n = 34), patients with a first episode of psychosis (FEP, n = 21) and healthy controls (HCs, n = 38) were compared on a verbal recognition task combined with retrospective confidence-level ratings.

Results

FEP patients showed the smallest confidence gap, followed by ARMS patients, followed by HCs. All groups differed significantly from each other. Regarding knowledge corruption, FEP patients differed significantly from HCs, whereas a statistical trend was revealed in comparison of ARMS and FEP groups. Correlations were revealed between metamemory, measures of positive symptoms and working memory performance.

Conclusions

These data underline the presence of a metamemory bias in ARMS patients which is even more pronounced in FEP patients. The bias might represent an early cognitive marker of the beginning psychotic state. Longitudinal studies are needed to unravel whether metacognitive deficits predict the transition to psychosis and to evaluate therapeutic interventions.

Keywords

At-risk mental statecognitive biasesfirst episode of psychosismemory confidencemetacognition
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 15 , November 2015 , pp. 3329 - 3340
Copyright
Copyright © Cambridge University Press 2015 

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