title: Metacognition in First Episode Psychosis: Item Level Analysis of Associations with Symptoms and Engagement.
abstract: Significant metacognitive impairments are observed in first episode psychosis (FEP) and chronic psychosis samples. There is evidence of associations between metacognition and presentation in FEP, but the relative contribution of metacognitive understanding of the self and the other is as yet unclear. The current study is a secondary analysis of date on metacognition, symptoms and engagement with treatment (help-seeking) in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology and help-seeking within treatment (clinician-rated service engagement) were also measured. An item level analysis of the MAS-R was conducted exploring associations between symptoms and cognitive, emotional, differentiation, integration and decentration aspects of metacognition. We report that associations between negative symptoms and deficits in the understanding of other's mental states extend across cognitive, emotional, integrative and decentration aspects of metacognition. We also report associations between negative symptoms and understanding one's own mind. We also note that cognitive and decentration aspects of metacognition were significantly associated with help-seeking once in treatment. Our findings suggest that an appreciation of metacognitive processes may inform treatment frameworks for FEP. Copyright © 2015 John Wiley & Sons, Ltd.
  
  
  CONCLUSIONS
  Individual components of metacognition including the capacity to relate cognitive and emotional variables are important in first episode phychosis. Impaired metacognitive understanding of both one's own and others' mental states is associated with increased negative symptoms. Metacognitive variables may be important in understanding how different individuals seek help or engage with services after the initiation of treatment.
authors.affiliation: The University of Edinburgh, Scotland, UK.
authors.forename: Angus
authors.identifier: http://orcid.org/0000-0002-0618-044X
authors.initials: A
authors.lastname: MacBeth
authors.affiliation: University of Glasgow, Scotland, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gumley
authors.affiliation: The University of Edinburgh, Scotland, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwannauer
authors.affiliation: Terzo Centro di Psicoterapia Cognitiva, Rome, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Carcione
authors.affiliation: University of Glasgow, Scotland, UK.
authors.forename: Hamish J
authors.initials: HJ
authors.lastname: McLeod
authors.affiliation: Centre for Metacognitive Interpersonal Therapy, Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Dimaggio
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D012606:Scotland; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: First Episode; Help-Seeking; Metacognition; Psychosis