Introduction
Paul H. Lysaker, Reid E. Klion in Recovery, Meaning-Making, and Severe Mental Illness, 2017
This introduction presents an overview of the concepts covered in the subsequent chapters of the book. The book explains briefly about the Metacognitive Reflection and Insight Therapy (MERIT), an integrative form of individual psychotherapy. MERIT is designed to assist persons with serious mental illness (SMI) to develop more integrative understandings of themselves and others in order to enable them to better manage their lives and achieve their personal goals and aspirations. SMI, such as schizophrenia and other forms of psychosis, lead to a dizzying array of psychosocial and biological challenges that affect not only individuals but their friends, families, and communities as well. MERIT is concerned with meaning-making and the capacity for synthesizing information into a greater awareness of self and others. MERIT uses the term "metacognition" to refer to the psychological processes that enable us to make sense of ourselves and the world. The practice of MERIT is defined by a set of measurable processes and therapist activities, called elements.
Healthcare as Complex, Entropic and Ethical
Lesley Kuhn, Kieran Le Plastrier in Managing Complexity in Healthcare, 2022
This chapter introduces ‘Complex Entropic Ethical’ (ComEntEth) model as an approach to understanding how people get things done in healthcare organisations. It discusses how ComEntEth model highlights the centrality of interaction between patient and practitioner, interdependence between bio-medicine and organisational dynamics and how the reduction in entropy across the interactions constituting healthcare supports the capacity of the practitioner to reduce patient entropy. Karen Kitchener developed ‘a three-level model of cognitive processing to account for complex monitoring when individuals are faced with ill-structured problems’. Kitchener describes personal epistemic development in terms of three, increasingly sophisticated, levels of cognitive processing: cognition, metacognition and epistemic cognition. Framing healthcare as complex directs attention to the interrelating, self-organising, dynamic and emergent nature of individuals, organisations, populations and environments involved. Self-organisation, dynamism and emergence can be drawn on as basic organising principles of complexity. Dynamism describes how living entities have the capacity to respond to, and influence others, and the environment within which they are situated.
Personality disorder psychopathology
Giancarlo Dimaggio, Paolo Ottavi, Raffaele Popolo, Giampaolo Salvatore in Metacognitive Interpersonal Therapy, 2020
Personality disorder (PD) patients have difficulty becoming aware of and comprehending their mental states, reflecting on them, and using the knowledge about what they themselves and others feel and think to lead socially enriched life, resolve problems and conflicts, pursue and achieve goals, and reduce suffering. Metacognitive skills vary depending on the quality of the relational context within which one operates. Patients with schizophrenia, who typically experience more pervasive metacognitive impairment, display better functioning in good psychotherapeutic relationship. Identification consists of recognising one’s mental states and distinguishing between them. Identifying one’s inner state makes it possible to define and describe the thoughts, beliefs, images and memories unfolding in the mind. Identification and Relating Variables processes together form Metacognitive Monitoring, which is very often impaired in PD patients, who frequently resort to generic expressions like “I’m tense”, “I feel uneasy”, “It’s annoying me”, “I’m going running because I feel on edge” to cover their difficulties in identifying the emotions they feel.
Feasibility and acceptability of brief cognitive remediation targeting metacognition in acute inpatients with psychosis: a case series
Published in Neuropsychological Rehabilitation, 2019
Dimosthenis Tsapekos, Rumina Taylor, Matteo Cella
Cognitive remediation (CR) is an intensive intervention targeting cognitive impairment with the aim of improving functioning in people with psychotic disorders. Shorter forms of CR based on metacognition and targeting awareness of cognitive problems may be more appropriate for acute inpatient settings where time is limited. The objective of the study was to evaluate the feasibility and acceptability of a new brief course of CR targeting cognitive and metacognitive difficulties within an acute inpatient psychiatric setting. Thirteen male service users with psychosis received a three-week course of CR. Participants were assessed at baseline and post-treatment on cognitive measures, subjective cognitive complaints, functional impairment, and symptom severity. Feasibility was assessed based on engagement, attendance, and attrition. Acceptability was evaluated through treatment satisfaction. Eight participants completed therapy, with 81% session attendance. Therapy was considered acceptable, with the majority of participants considering it satisfactory. Potential benefit analysis showed a significant post-treatment improvement in global cognition and memory. Subjective cognitive complaints did not change over time. It was concluded that it is feasible to deliver brief CR in an acute inpatient setting. Context of delivery and engagement are challenges for optimal therapy implementation. CR protocol adaptations made to promote metacognitive competencies may compensate for lack of intensive practice.
Desire Thinking and Metacognition Associated with Dysregulated Sexuality
Published in Sexual Addiction & Compulsivity, 2020
Jeremy Thomas, Mary Katsikitis, Andrew Allen, Lee Kannis-Dymand
Dysregulated sexuality refers to sexual thoughts, feelings, and behaviors that are perceived as out of control and distressing. This study aimed to explore the relationships between desire thinking and metacognition about desire thinking in relation to dysregulated sexuality and craving. Approximately 1,042 participants completed a battery of self-report questionnaires. The results suggest that increased desire thinking and metacognition around desire thinking are significantly associated with dysregulated sexuality. Furthermore, the verbal perseveration aspect of desire thinking significantly predicted dysregulated sexuality after controlling for trait sexual desire. These findings support both the model of desire thinking and craving and the tri-phasic metacognitive model of addictive behavior. Despite study limitations, there is a need for further research in this area.
The evaluation of metacognitive beliefs and emotion recognition in panic disorder and generalized anxiety disorder: effects on symptoms and comparison with healthy control
Published in Nordic Journal of Psychiatry, 2019
Orkun Aydın, Kuzeymen Balıkçı, Fikret Poyraz Çökmüş, Pınar Ünal Aydın
Background: The impairments in metacognitive functions and emotion recognition are considered as liable factors in anxiety disorders. Aims: The better understanding of these cognitive abilities might lead to develop more accurate treatment methods for patients who suffer from anxiety. Methods: Forty-four patients with panic disorder (PD), 37 individuals with generalized anxiety disorder (GAD) and 44 healthy control (HC) were participated in our study. Metacognition questionnaire-30 (MCQ-30), Reading The Mind From The Eyes Test and symptom severity tests were administered. Results: Statistical analyses estimated the dysfunctional metacognitive beliefs and disrupted emotion recognition in patients relative to HC. The ‘need to control thoughts’ aspect of metacognitive beliefs was accounted for symptom severity in GAD. Improper metacognitive beliefs were significantly predicted the PD and GAD. In addition, impoverished emotion recognition predicted the GAD. Conclusions: Our study revealed the role of inconvenient metacognitive beliefs and distorted emotion recognition in PD and GAD. These findings might facilitate the treatment management in cognitive therapies of anxiety disorders via pointing out more reasonable targets across improper cognitive fields.
Related Knowledge Centers
- Cognition
- Intelligence
- Self-Medication