Background: Interventions targeting cognition in people with schizophrenia have shown moderate effects on improving functioning. Recent cognitive remediation (CR) approaches have begun to target metacognition to improve functioning outcomes. This study aims to develop a novel measure of metacognition and assess whether metacognitive-based CR (mCR) can improve metacognition. Method: We use data from a single-blinded randomized controlled trial comparing mCR plus treatment as usual (TAU) to TAU alone in people with schizophrenia. Participants were assessed with measures of cognition, functioning, and a new measure of metacognition at three time points: Week 0 (baseline), Week 12, and Week 24. Results: The evaluation of the novel metacognition assessment suggests that it is a reliable and valid measure. The measure positively correlates with cognitive measures, in particular with executive function and IQ but also with a measure of functioning. We found that a course of mCR was able to increase metacognition compared to TAU by Week 24. Conclusions: Metacognition may be an important mechanism to explain how CR affects functioning outcomes in people with psychosis. The systematic assessment of metacognition as part of CR studies may help to evaluate more clearly its role and relevance to functioning.

中文翻译：

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探索认知治疗对精神分裂症患者元认知的影响

背景：针对精神分裂症患者的认知干预已显示出对改善功能的中等作用。最近的认知矫正（CR）方法已经开始针对元认知以改善功能结果。这项研究旨在开发一种新的元认知测量方法，并评估基于元认知的CR（mCR）是否可以改善元认知。方法：我们使用单盲随机对照试验的数据，比较了精神分裂症患者的mCR加常规治疗（TAU）与单独使用TAU的情况。在三个时间点（第0周（基线），第12周和第24周）对参与者的认知，功能和新的元认知测量进行了评估。结果：对新型元认知评估的评估表明，该方法可靠且可靠。有效措施。量度与认知量度呈正相关，特别是与执行功能和智商，但也与功能度呈正相关。我们发现，与TAU相比，第24周的mCR疗程能够提高元认知。结论：元认知可能是解释CR如何影响精神病患者功能预后的重要机制。作为CR研究的一部分，对元认知的系统评估可能有助于更清晰地评估其作用和与功能的相关性。