61.2 The Functional Significance of Metacognitive Capacity in Schizophrenia: Associations With Negative Symptoms and Insight

Abstract

Background: Metacognition refers to a range of mental activities which lay at the root of the formation of complex and integrated ideas which allow for a sense of one's self and of others. Metacognitive acts involve both notic-ing discrete cognitive, emotional and embodied experiences as well as the synthesis of those experiences into the larger deeply personal ideas which allow persons to decide how they should uniquely respond to the challenges of life. Metacognitive defcits have been broadly observed in schizophrenia and are of interest as a potential cause of negative symptoms as well as lack of insight. It has been suggested that without a suffciently complex sense of self it may be more diffcult to engage the world meaningfully and form an adaptive narrative about psychiatric challenges. This study explored this possibility using geographically disparate north American samples from central Indiana and an urban area of New Jersey surrounding New York city. We hypothesized that the metacognitive capacities of both samples would be similar and that metacognitive capacity would be negatively correlated with negative symptom severity and lack of insight. Method(s): Participants were 103 adults with a schizophrenia spectrum disorder in a post-acute phase of illness (42 from Indiana and 61 from New Jersey) who completed assessments of symptoms using the Positive and Negative Syndrome Scale and metacognition using the Metacognitive Assessment Scale-Abbreviated (MAS-A). Result(s): Independent of demographic variables and positive symptoms, lower levels of overall metacognition were related to higher levels of negative symptoms (r =-.45; P