61. Metacognition in Psychosis: From Evidence to Treatment

Abstract

Overall Abstract: Participants: Philip Harvey, Ph.D.,-Introspective Accuracy as a Predictor of Real-World Outcomes, Paul Lysaker, Ph.D.,-The functional signifcance of metacognitive capacity in schizophrenia: Associations with negative symptoms and insight., Steffen Moritz, Ph.D.,-Group and Individualized Metacognitive Training for Psychosis (MCT, MCT+): Latest Results on Its Effcacy in the Treatment of Psychotic Symptoms, and Amy E. Pinkham, Ph.D.,-Neural Correlates of Introspective Accuracy in Schizophrenia. The term metacognition has been used broadly to refer to “thinking about thinking” and has recently been conceptualized within schizophrenia research as a spectrum that ranges from discrete processes to more synthetic ones. At the discrete end of the continuum are activities consistent with self-assessment such as awareness of the accuracy of one's judgments (e.g., introspective accuracy). At the other end are more complex and integrated processes wherein individuals organize incoming information in order to form holistic representations of the self and others. Across this spectrum, metacognition has been found to be impaired individuals with severe mental illness and to be highly linked to functional outcomes, even when controlling for skill defcits and symptom severity. Treatment efforts aimed at improving metacognition have yielded reductions in symptoms and cognitive biases as well as improvements in quality of life. Metacognition therefore represents a promising new lead in the search for transdiagnostic determinants of real-world functional outcome and offers a feasible and tractable target for treatment. This symposium is designed to provide a comprehensive overview of meta-cognition that presents the most up-to-date fndings spanning both basic and applied work while also representing the full spectrum of processes included within the larger metacognitive construct. Phil Harvey, Ph.D., will frst present novel data demonstrating that introspective accuracy, or the ability to know what one knows, directly contributes to domain-specifc defcits in everyday functioning. Paul Lysaker, Ph.D., will then introduce new data linking poorer metacognition to greater negative symptoms and lack of insight. Next, Steffen Moritz, Ph.D., will present new developments and meta-analytic evidence for the effectiveness of metacognitive training (MCT), a program that is aimed to reduce cognitive biases such as over-confdence and jumping to conclusions. Finally, Amy Pinkham, Ph.D., will present data from a new study that identifes the neural correlates of impaired neurocognitive and social cognitive introspective accuracy in individuals with schizophrenia. This symposium will therefore take a brain-to-behavior approach that will highlight our current knowledge regarding metacognition in psychosis and identify important areas for continued work.