One of the core features in schizophrenia is a deficit in real-world functioning as expressed through difficulties in the ability to work, engage in social relationships, attend to self-care, and participate in recreational and community activities. Due to this impact on overall quality of life, experts have investigated possible links between the observable symptoms of the illness, such as negative symptoms, with functional outcomes. Ample research has shown that neurocognition is one possible candidate, although fewer studies have explored the specific contributions of executive functioning, or the cognitive process associated with top-down regulation of cognition and behavior. The links between EF and the complementary entities of metacognition (thinking about one’s own thinking) and Theory of Mind (understanding the mind of others) could be the reason for the strong link between negative symptomology and functioning in those with schizophrenia. Of the 25 participants, there was a mean of age 37.21 for the healthy control group (SD = 14.09) and 34.69 for the psychiatric group (SD = 12.51), with a majority of participants identifying as female (64%) and Caucasian (36%). The first finding of this study confirmed previous research that executive functioning, metacognition, Theory of Mind, and functional capacity are significantly impaired in individuals with schizophrenia spectrum disorders. Next, in examining the relationships between these variables for those with schizophrenia spectrum disorders, an interesting finding was the mediative role that Theory of Mind plays in the relationship between executive functioning and metacognition. Next, this study found that the specific metacognitive capacity of self-reflectivity plays an important role in the relationship between higher order cognition and daily functioning, a finding that was not present with other domains of metacognition. The current study suggests that integrating ToM interventions in treatment programs that target metacognitive functions, such as Metacognitive Reflection and Insight Therapy (MERIT) may help to facilitate the formation of this construct. Additionally, it may be beneficial to integrate MERIT intervention that specifically target self-reflectivity with traditional Cognitive Remediation Programs, especially those that target higher-order cognition.
Yasmine Kolahi (Sun,) studied this question.