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Tijdschrift voor Psychiatrie 58 (2016) 6, 455 - 462

Review article

Metacognition in psychotic disorders: from concepts to intervention

S. de Jong, R.J.M. van Donkersgoed, J. Arends, P.H. Lysaker, L. Wunderink, M. van der Gaag, A. Aleman, G.H.M. Pijnenborg

background Persons with a psychotic disorder commonly experience difficulties with what is considered to be metacognitive capacity. In this article we discuss several definitions of this concept, the measurement instruments involved and the clinical interventions that target this concept.
aim To present a review of various frequently used definitions of metacognition and related concepts and to describe the measurement instruments involved and the treatment options available for improving the metacognitive capacity of persons with a psychotic disorder.
method We present an overview of several definitions of metacognition in psychotic disorders and we discuss frequently used measurement instruments and treatment options. The article focuses on recent developments in a model devised by Semerari et al. The measurement instrument involved (Metacognition Assessment Scale – A) is discussed in terms of it being an addition to existing methods.
results On the basis of the literature it appears that metacognition and related concepts are measurable constructs, although definitions and instruments vary considerably. The new conceptualisation of social information processing also leads to the development of a new form of psychotherapy that aims to help patients suffering from psychotic disorders to improve metacognitive capacity.
conclusion There seems to be evidence that metacognitive abilities are a possible target for treatment, but further research is needed.

keywords metacognition, psychotic disorders, psychosis, schizophrenia, theory of mind