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Associations of Metacognition With Symptoms, Insight, and Neurocognition in Clinically Stable Outpatients With Schizophrenia

Nicolò, Giuseppe MD*†‡; Dimaggio, Giancarlo MD*; Popolo, Raffaele MD*; Carcione, Antonino MD*†; Procacci, Michele MD*†; Hamm, Jay MA§; Buck, Kelly D. CNS; Pompili, Enrico MD; Buccione, Ivana PhD*; Lagrotteria, Brunella PhD*; Lysaker, Paul H. PhD∥¶

The Journal of Nervous and Mental Disease: July 2012 - Volume 200 - Issue 7 - p 644–647
doi: 10.1097/NMD.0b013e31825bfb10
Brief Report

Research indicates that many with schizophrenia experience deficits in metacognitive capacity or the ability to form complex representations of themselves and others. Previous work has found that metacognitive capacity in schizophrenia is correlated with symptoms, insight, and neurocognitive deficits. We sought to replicate these results in a sample of Italian participants treated in a community setting. Metacognition was assessed with the abbreviated Metacognition Assessment Scale and correlated with concurrent assessment of symptoms, insight, and neurocognitive abilities, including verbal and visual memory, premorbid intelligence, processing speed, and executive function. Correlations revealed that, consistent with previous work, lesser capacity for self-reflectivity was related to greater levels of negative symptoms, poorer insight, neurocognitive impairment (particularly impairments in verbal and visual memory) premorbid intelligence, and processing speed. Other metacognitive domains were also linked to poorer neurocognition. Results support contentions that deficits in metacognition are linked with negative symptoms, insight, and neurocognitive deficits.

*Terzo Centro di Psicoterapia Cognitiva, Rome, Italy; †Associazione di Psicologia Cognitiva, Mental Health Department ASL Roma G, Rome Italy; ‡Mental Health Department ASL Roma G, Rome Italy; §School of Psychological Science, University of Indianapolis, IN; ∥Roudebush VA Medical Center, Indianapolis Indiana; and ¶Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN.

Send reprint requests to Giuseppe Nicolò MD, Terzocentro Psicoterapia Cognitiva, Via Ravenna 9 c 00161 Rome, Italy. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.