Metacognition strengthens the association between neurocognition and attenuated psychosis syndrome: Preliminary evidence from a pilot study among treatment-seeking versus healthy adolescents

D. Koren, R. Scheyer, Yonatan Stern, M. Adres, Noa Reznik, Alan Apter, Larry J. Seidman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In a pilot study, we assessed the potential value of deficits at the metacognitive versus the neurocognitive level of functioning for identifying adolescents with attenuated psychotic syndrome (APS). Method: Twenty-two treatment-seeking adolescents with APS, 42 treatment-seeking comparisons, and 34 age-matched healthy comparisons were evaluated using the Prodromal Questionnaire, the Structured Interview for Prodromal Syndromes, and the Mood and Anxiety Symptom Questionnaire. Neurocognitive and metacognitive functioning were assessed in two non-social (verbal memory and executive functioning) and two social (facial emotion perception and theory of mind) cognitive domains. In addition to the standard neurocognitive administration of the tasks, subjects were asked to rate their confidence level on each answer and to choose whether they wanted it “counted” toward their overall task performance score on the task. Choices were rewarded. Results: As hypothesized, APS among treatment-seeking adolescents was more strongly associated with impaired neurocognition than with impaired metacognition. Likewise, as hypothesized, impaired metacognition was shown to significantly improve the APS prediction beyond the contribution of impaired neurocognition alone, even after controlling for general intellectual ability, negative symptoms, social functioning, and depression. Conclusions: These results suggest that metacognitive monitoring and control play a strengthening role in the association between neurocognition and APS. One possible explanation is that metacognition serves as an indicator of insight into the condition, accounting for differences in insight not explained by neurocognition alone. However, further research with larger samples that include non-treatment seeking individuals, established measures of insight, and follow-up data is required to assess this possibility.

Original languageEnglish
Pages (from-to)207-214
Number of pages8
JournalSchizophrenia Research
Volume210
DOIs
StatePublished - Aug 2019

Bibliographical note

Funding Information:
The authors wish to thank all study participants and their parents for their time and effort. The authors wish to thank Adi Dratler, Shahar Iger, Tout Naaman, Osnat Ziv, Assaf Gayer, and Yuval Tal for their help with subject recruitment and data collection. This work was supported by three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R. The authors declare no conflict of interest. The authors assert that all procedures contributing to this work complied with the ethical standards of the relevant national and institutional committees on human research and with the Helsinki Declaration.

Funding Information:
Support: This work was supported by a research grant to D.K. from the Israel Science Foundation, and three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R.This work was supported by a research grant to D.K. from the Israel Science Foundation (ISF 548/09), and three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R.? Support: This work was supported by a research grant to D.K. from the Israel Science Foundation, and three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R. The authors wish to thank all study participants and their parents for their time and effort. The authors wish to thank Adi Dratler, Shahar Iger, Tout Naaman, Osnat Ziv, Assaf Gayer, and Yuval Tal for their help with subject recruitment and data collection. This work was supported by three doctoral fellowships from the University of Haifa to R.S. M.A. and N.R. The authors declare no conflict of interest. The authors assert that all procedures contributing to this work complied with the ethical standards of the relevant national and institutional committees on human research and with the Helsinki Declaration.? Support: This work was supported by a research grant to D.K. from the Israel Science Foundation, and three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R.

Funding Information:
This work was supported by a research grant to D.K. from the Israel Science Foundation ( ISF 548/09 ), and three doctoral fellowships from the University of Haifa to R.S., M.A., and N.R.

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

  • Attenuated psychosis syndrome
  • Metacognition
  • Neurocognition
  • Prodrome
  • Psychosis
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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