title: Metacognitive Reflection and Insight Therapy (MERIT) with a Patient with Persistent Negative Symptoms.
abstract: Metacognition comprises a spectrum of mental activities involving thinking about thinking. Metacognitive impairments may sustain and trigger negative symptoms in people with schizophrenia. Without complex ideas of the self and others, there may be less reason to pursue goal-directed activities and less ability to construct meaning in daily activities, leading to the experience of negative symptoms. As these symptoms tend to be nonresponsive to pharmacotherapy and other kinds of treatment metacognition might be a novel treatment target; improvement of metacognition might lead to improvements in negative symptoms. One therapy that seeks to promote metacognition is the Metacognitive Reflection and Insight Therapy (MERIT). In this study, a case is presented in which a first episode patient with severe negative symptoms is treated with MERIT. A case illustration and the eight core principles of MERIT are presented. Independent assessments of metacognition and negative symptoms before and after therapy show a significant increase of metacognition and decrease of negative symptoms over the course of 40 weeks.
authors: Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands ; Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, The Netherlands.
authors: R J M
authors: RJ
authors: van Donkersgoed
authors: Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands ; Department of Psychotic Disorders GGZ-Drenthe, Assen, The Netherlands.
authors: S
authors: S
authors: de Jong
authors: Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands ; Department of Psychotic Disorders GGZ-Drenthe, Assen, The Netherlands.
authors: G H M
authors: GH
authors: Pijnenborg
keywords: Case study; MERIT; Metacognition; Negative symptoms