title: Combined neurocognitive and metacognitive rehabilitation in schizophrenia: Effects on bias against disconfirmatory evidence.
abstract: BACKGROUND
  A Metacognitive Training for Schizophrenia patients (MCT) was developed to target the cognitive biases that characterize the illness. Results suggest positive MCT effects encompassing several aspects of psychopathology and subjective well-being. There are still open questions concerning the effect on different cognitive biases and the interplay between them and both psychopathology and neurocognition. Specifically, the bias against disconfirmatory evidence (BADE) has never been tested in previous trials on MCT. In this study we evaluated the feasibility of MCT combined with a cognitive remediation therapy (CACR) in schizophrenia and its effect on BADE. Moreover, we investigated the relationships between BADE and both neuropsychology and psychopathology, taking into account mutual influences on the degree of improvement.
  
  
  METHODS
  Fifty-seven schizophrenia outpatients were randomly assigned to CACR + control group or MCT+CACR and assessed at baseline and after treatment for psychopathology, neurocognition and BADE.
  
  
  RESULTS
  After MCT+CACR patients showed significantly greater improvements on BADE. Although BADE baseline performances correlated with several cognitive domains, no association was found between BADE improvement and neurocognitive nor psychopathological measures.
  
  
  CONCLUSIONS
  This study enlightened for the first time the efficacy of MCT+CACR on BADE in schizophrenia, suggesting the importance to develop a more specific intervention tailored on individual needs of patients.
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy. Electronic address: buonocore.mariachiara@hsr.it.
authors.forename: M
authors.initials: M
authors.lastname: Buonocore
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy; Center for Neurolinguistics and Theoretical Syntax (NeTS), Institute for Advanced Study, IUSS, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bosia
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Riccaboni
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bechi
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita -Salute San Raffaele, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Spangaro
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Piantanida
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cocchi
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Guglielmino
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita -Salute San Raffaele, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Smeraldi
authors.affiliation: Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127 Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cavallaro
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010469:Perceptual Distortion; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology
keywords: Cognitive biases; Metacognitive training; Neurocognition; Rehabilitation; Schizophrenia