Metacognitive capacity and negative symptoms in first episode psychosis: Evidence of a prospective relationship over a 3-year follow-up

Stephen Fitzgerald Austin*, Paul H. Lysaker, Jens Einar Jansen, Anne Marie Trauelsen, Hanne Grethe Lyse Nielsen, Marlene Buch Pedersen, Ulrik Helt Haahr, Erik Simonsen


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Negative symptoms can be linked to Bleuler’s concept of splitting or fragmentation of thought, affect, and will. Research has shown a link between disturbances in metacognition and negative symptoms, although relatively few studies have examined this relationship longitudinally. The aim of this article is to examine whether metacognitive capacity among patients with first episode psychosis (FEP) predicted negative symptoms after a follow-up period of 3 years. Metacognition was assessed using the Metacognition Assessment Scale abbreviated and symptoms were assessed using Positive and Negative Syndrome Scale among 59 adults with FEP. Symptoms were then reassessed at a 3-year follow-up. Significant correlations were found between baseline metacognitive scores and the expressive component of negative symptoms as well as for individual negative symptoms such as blunted affect, poor rapport, and alogia at 3-year follow-up after controlling for baseline negative symptoms. Self-reflectivity was significantly correlated with the expressive component of negative symptoms at 3-year follow-up. The results are partly consistent with a Bleulerian model which understands the emergence of negative symptoms as a response in part to the experience of fragmentation, particularly in terms of sense of self and others. Future research should clarify the likely role of metacognition in the development and maintenance of negative symptoms.

TidsskriftJournal of Experimental Psychopathology
Udgave nummer1
StatusUdgivet - jan. 2019
Udgivet eksterntJa

Bibliografisk note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Region Zealand Health Scientific Research Foundation.

Publisher Copyright:
© The Author(s) 2019.

Copyright 2021 Elsevier B.V., All rights reserved.


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