# Metacognitive function and fragmentation in schizophrenia: Relationship to cognition, self-experience and developing treatments https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889776/ **What is Metacognition?** "MERIT uses the term “metacognition” to refer to ==the psychological processes that enable us to make sense of ourselves and the world. ==Metacognition is at play when we notice discrete things about ourselves and others and then synthesize that information into more complex and nuanced understandings. It is a mental process that is critical to the psychological health of all human beings. Awareness of our own and others’ emotions, for example, enables us to determine how we might best respond when facing changing circumstances and situations. The capacity to appreciate what others may feel, their motivations, and how they may differ from us as individuals allow for relationships to endure and evolve when change or conflict emerge." - Klion, Reid E._ Lysaker, Paul H. - [[Book - Recovery meaning making and severe mental illness a comprehensive guide to metacognitive reflection and insight therapy]] (2017, Routledge) - libgen.li.pdf # The construct of Metacognition - This paper cited [[Promoting recovery from severe mental illness - Implications from research on metacognition and metacognitive reflection and insight therapy]] authors. ---- Reading https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862649/ [[Promoting recovery from severe mental illness - Implications from research on metacognition and metacognitive reflection and insight therapy]] - ## Research on metacognition in schizophrenia - Research has addressed two broad questions (1)Are individuals with schizophrenia spectrum disorders more likely to experience disruptions in earlier or more basic aspects of metacognitive capacity; - They tend to experience disruptions in more basic levels of metacognitive capacity ([26](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862649/#B26),[28](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862649/#B28)[29](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862649/#B29)[30](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862649/#B30)) - and (2) when disruptions occur at more basic levels of metacognitive function, individuals are more likely to experience greater levels of impairment in current and future function. - It predicts generally poorer function, functional competence, poorer subjective sense of recovery, weaker therapeutic alliance in CBT, less ability to reject stigma, anhedonia, more sedentary life style, reduced awareness of negative changes in psychological and social function states, a lesser level of behaviour driven by internal reward. More likely to have vocational problems, more negative symptoms, and reduce intrinsic motivation. - "Concerning the relationship with function, disruptions observed in basic or more elemental levels of metacognition (referred to as more severe metacognitive deficits) have been found to predict generally poorer function[35]. This includes greater reductions in functional competence[36], reports of poorer subjective sense of recovery[37], a weaker therapeutic alliance in cognitive-behavior therapy[38], less reported ability to reject stigma[39], anhedonia in the absence of depression[40], a more sedentary life style[41], reduced awareness of negative changes in psychological and social function states[42] and lesser levels of behavior that is driven by internal rewards[43], all regardless of concurrent symptom severity. Individuals with schizophrenia spectrum disorders who experience disruptions in basic metacognitive function have also been found to be more likely to have future problems with vocational function[44], more likely to develop negative symptoms[45-47], and to experience reduced intrinsic motivation[48], regardless of baseline assessments of these phenomena." [[Does Metacognitive therapies work]]