Metacognition in schizophrenia: Metacognitive deficits and psychotherapy

Abstract

The concept of Metacognition, initially defined by Flavell, refers to the ability to have mental states about their own mental states, and the mental states of others, in order to solve the challenges of life. Through a modular hypothesis of Metacognition, Semerari and Lysaker have identified domains that cover diverse areas of this, being very useful in the understanding of patients with serious psychiatric disorders: Self-reflectivity, Understanding of others’ minds, Decentration and Mastery. These domains have been studied mainly through the Metacognitive Assessment Scale-Abbreviated (MAS-A). The present work reviews the current knowledge of the metacognitive deficits in Schizophrenia, the evaluation method, and its relation with the symptomatology, neurocognitive function, social functioning and therapeutic alliance in these patients. Finally, the different models of integrative psychotherapies are presented, with a rehabilitative approach over the metacognitive deficits of patients with schizophrenia, reviewing the most studied currently, the Metacognitive Reflection and Insight Therapy (MERIT).