title: Metacognitive beliefs in the at-risk mental state: A systematic review and meta-analysis.
abstract: Dysfunctional metacognitive beliefs are common among people with psychosis. In this meta-analysis we examined whether these are also present in people meeting at-risk mental state (ARMS) criteria. We also explored the relationship between metacognitive beliefs and symptoms in the ARMS group. An electronic database search of Ovid MEDLINE, PsycINFO and Embase from inception until August 2016 was conducted using keyword search terms synonymous with ARMS and metacognition. Eligible studies were original research articles that examined metacognitive beliefs using the Metacognitions Questionnaire (MCQ) among people meeting ARMS criteria. Studies included in the meta-analyses also reported comparison MCQ data acquired from healthy controls, help-seeking individuals, or people with psychotic disorders. Eleven eligible studies were identified, reporting data from six unique ARMS samples. People with ARMS did not differ from those with established psychotic disorders on any MCQ subscale, but they reported significantly more dysfunctional metacognitive beliefs than healthy or help-seeking controls. Maladaptive metacognitive beliefs were associated with a range of symptoms in ARMS individuals, but evidence for associations with specific subthreshold psychotic phenomena was inconsistent. This evidence indicates how valuable assessment and treatment of dysfunctional metacognitive beliefs may be but suggests that specific aspects of methodology should be addressed.
authors.affiliation: Division of Psychology and Mental Health, University of Manchester, UK. Electronic address: jack.cotter@manchester.ac.uk.
authors.forename: Jack
authors.initials: J
authors.lastname: Cotter
authors.affiliation: Division of Psychology and Mental Health, University of Manchester, UK; Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Yung
authors.affiliation: Division of Psychology and Mental Health, University of Manchester, UK.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Carney
authors.affiliation: Division of Psychology and Mental Health, University of Manchester, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Drake
mesh_terms: D016022:Case-Control Studies; D003469:Culture; D006801:Humans; D000067489:Metacognition; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*
keywords: At-risk mental state; Clinical high-risk; Meta-analysis; Metacognition; Psychosis; Ultra-high risk