title: Metacognitive training (MCT) for schizophrenia improves cognitive insight: a randomized controlled trial in a Chinese sample with schizophrenia spectrum disorders.
abstract: Metacognitive training (MCT) is a group-based treatment program for people with schizophrenia that targets the cognitive biases thought to contribute to the pathogenesis and maintenance of delusions. Although effective in reducing the severity of delusions, the influence of MCT on cognitive insight, and its feasibility in Chinese culture, has yet to be investigated. The present randomized-controlled trial attempted to address these inconsistencies. A Chinese sample of 80 participants with schizophrenia spectrum disorders was randomized to the eight-module MCT program or continued treatment as usual (TAU). All participants were assessed using the Beck Cognitive Insight Scale, which assesses two components of cognitive insight (self-reflectiveness and self-certainty). Participants in the MCT condition subjectively rated their satisfaction with the training. Retention rates were high after four-weeks of MCT (n = 38) or TAU (n = 39). Clients randomized into the MCT condition rated the program favourably and showed significant improvements in cognitive insight (i.e., increased self-reflectiveness), relative to TAU controls, who exhibited decreases in cognitive insight at follow-up. These findings suggest that the MCT program is not only subjectively efficacious in Chinese samples, but also improves metacognitive awareness of the processes underlying delusional symptoms.
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Kino C K
authors.initials: KC
authors.lastname: Lam
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Christy P S
authors.initials: CP
authors.lastname: Ho
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Jimmy C
authors.initials: JC
authors.lastname: Wa
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Salina M Y
authors.initials: SM
authors.lastname: Chan
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Kevin K N
authors.initials: KK
authors.lastname: Yam
authors.affiliation: Occupational Therapy Department, Kwai Chung Hospital, Hong Kong.
authors.forename: Odelia S F
authors.initials: OS
authors.lastname: Yeung
authors.affiliation: Department of Psychiatry, Kwai Chung Hospital, Hong Kong.
authors.forename: Willy C H
authors.initials: WC
authors.lastname: Wong
authors.affiliation: School of Psychology, Flinders University, South Australia, Australia. Electronic address: drbalzan@gmail.com.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Balzan
mesh_terms: D000328:Adult; D002681:China; D003071:Cognition / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition / Q000502:physiology*; D008875:Middle Aged; D017060:Patient Satisfaction; D011615:Psychotherapy, Group / Q000379:methods; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
keywords: Chinese sample; Cognitive insight; Metacognitive training; Schizophrenia