Conceptual review explores metacognition in personality disorders, emphasizing clinical implications and frameworks.
Cluster A personality disorders, including schizotypal, schizoid, and paranoid personality disorders, remain among the least studied forms of personality pathology. Partly due to this lack of research, empirically supported interventions remain limited. Recently, the Alternative Model of Personality Disorders (AMPD) has emerged as a dimensional approach to understanding personality disorders; however, treatment implications remain underdeveloped. We propose that the integrated model of metacognition may offer a clinically actionable framework for conceptualizing and measuring core self- and interpersonal disturbances that are central to the AMPD. In this conceptual review, we consider the following: (1) how the integrated model of metacognition aligns with dimensional models of personality pathology, (2) metacognitive functioning in Cluster A personality disorders with emphasis on schizotypal personality disorder, and (3) metacognitive treatments that could potentially have relevance for these presentations.
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Wiesepape et al. (2026) studied this question.
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