title: Metamemory in schizophrenia: retrospective confidence ratings interact with neurocognitive deficits.
abstract: Prior studies with schizophrenia patients described a reduced ability to discriminate between correct and false memories in terms of confidence compared to control groups. This metamemory bias has been associated with the emergence and maintenance of delusions. The relation to neuropsychological performance and other clinical dimensions is incompletely understood. In a cross-sectional study, metamemory functioning was explored in 32 schizophrenia patients and 25 healthy controls. Metamemory was assessed using a verbal recognition task combined with retrospective confidence level ratings. Associations of metamemory performance with six neuropsychological domains (executive functioning/problem solving, speed of processing, working memory, verbal and visual learning, and attention/vigilance) and psychopathological measures were analyzed. Results revealed a significantly smaller discrepancy between confidence ratings for correct and incorrect recognitions in the patient group. Furthermore, patients showed significantly lower recognition accuracy in the metamemory task and marked deficits in all neuropsychological domains. Across all participants, metamemory performance significantly correlated with executive functioning and working memory. No associations with delusions were found. This data confirms prior findings of metamemory biases in schizophrenia. Selective neuropsychological abilities seem to be modulating factors of metamemory functioning. Longitudinal studies in at risk mental state and first-episode patients are needed to reveal causal interrelations.
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany. Electronic address: sarah.eifler@zi-mannheim.de.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eifler
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rausch
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Frederike
authors.initials: F
authors.lastname: Schirmbeck
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Veckenstedt
authors.affiliation: Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mier
authors.affiliation: AWO Health Center, Dr.-Grosz-Straße 1-2, 39126 Magdeburg, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Esslinger
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Englisch
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.affiliation: Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kirsch
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Zink
mesh_terms: D000328:Adult; D001288:Attention; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003702:Delusions / Q000523:psychology; D004644:Emotions; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011340:Problem Solving; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology*; D012565:Schizophrenic Psychology
keywords: Cognition; Cognitive biases; Delusion; Memory confidence; Metacognition; Neuropsychiatry