Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel.
Department of Psychology, Bar-Ilan University, Max and Anna Webb St., Ramat-Gan, Israel.
Eur Psychiatry. 2017 Oct;46:33-41. doi: 10.1016/j.eurpsy.2017.08.002. Epub 2017 Aug 30.
Deficits in metacognition are one of the major causes of the difficulties experienced by individuals with schizophrenia. Studies have linked these deficits to symptom exacerbation and deterioration in psychosocial functioning. The aim of the present meta-analysis was to examine the extensive existing literature regarding metacognitive deficits among persons with schizophrenia; a further aim was to assess the extent to which metacognitive abilities are linked to outcome measures of symptoms and psychosocial functioning.
We conducted a systematic literature search of studies examining the relationship between metacognitive abilities and outcome measures among people with schizophrenia. We then analyzed the data using a random-effects meta-analytic model with Cohen's d standardized mean effect size.
Heterogeneity analyses (k=32, Cohen's d=-.12, 95% CI.-1.92 to 1.7) produced a significant Q-statistic (Q=456.89) and a high amount of heterogeneity, as indicated by the I statistic (93.04%), suggesting that moderator analyses were appropriate. As hypothesized, measure type moderated the metacognitive deficit with homogenous effect for psychosocial functioning measures (Q=9.81, I=19.47%, d=.94. 95% CI .58 to 1.2) and symptoms (Q=19.87, I=0%, d=-1.07, 95% CI -1.18 to -.75). Further analysis found homogenous effects for MAS-A subscales as well as PANSS factors of symptoms.
Our meta-analysis results illustrated a significant association between metacognitive deficits and both symptomatic and psychosocial functioning measures. These links suggest that the associations between metacognitive abilities and symptomatic outcomes are different from those between metacognitive abilities and psychosocial functioning measures. Intriguing hypotheses are raised regarding the role that metacognitive abilities play in both symptoms and psychosocial functioning measures of people diagnosed with schizophrenia spectrum disorders.
元认知缺陷是精神分裂症患者所面临困难的主要原因之一。研究表明，这些缺陷与症状恶化和社会心理功能下降有关。本元分析旨在检查大量关于精神分裂症患者元认知缺陷的现有文献；进一步的目的是评估元认知能力与症状和社会心理功能的结果测量之间的关联程度。
我们对检查元认知能力与精神分裂症患者的结果测量之间关系的研究进行了系统的文献检索。然后，我们使用随机效应元分析模型和 Cohen 的 d 标准化均数效应大小分析数据。
异质性分析（k=32，Cohen 的 d=-.12，95%CI.-1.92 至 1.7）产生了一个显著的 Q 统计量（Q=456.89）和高度的异质性，如 I 统计量（93.04%）所示，表明适合进行调节分析。正如假设的那样，测量类型调节了元认知缺陷，对社会心理功能测量（Q=9.81，I=19.47%，d=.94.95%CI.58 至 1.2）和症状（Q=19.87，I=0%，d=-1.07，95%CI -1.18 至 -.75）具有同质效应。进一步的分析发现 MAS-A 子量表和 PANSS 症状因子也具有同质效应。
我们的元分析结果表明，元认知缺陷与症状和社会心理功能测量之间存在显著关联。这些关联表明，元认知能力与症状结果之间的关联与元认知能力与社会心理功能测量之间的关联不同。有趣的假设是，元认知能力在精神分裂症谱系障碍患者的症状和社会心理功能测量中起着重要作用。
