The impact of metacognition on the development and maintenance of negative symptoms

McLeod, H. J. , Gumley, A. and Schwannauer, M. (2014) The impact of metacognition on the development and maintenance of negative symptoms. In: Lysaker, P. H., Dimaggio, G. and Brune, M. (eds.) Social Cognition and Metacognition in Schizophrenia: Psychopathology andTreatment Approaches. Academic Press: London, pp. 115-135. ISBN 9780124051720 (doi: 10.1016/B978-0-12-405172-0.00007-7)

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Negative symptoms are associated with burden, distress, and disablement for many people with a diagnosis of schizophrenia, but regrettably the range of effective treatment options is very narrow. Fortunately there are signs of renewed interest in the development and testing of models of negative symptoms, and these are increasingly being used to guide therapeutic efforts. This work has been informed by advances in the affective and cognitive neurosciences with the result that we now have an increasingly nuanced view of negative symptom subtypes and a better understanding of the forces that affect their expression. For example, the recognition that anhedonia can be decomposed into anticipatory and consummatory components has opened up new ways of modeling relevant core experiential processes and has started to influence the development of new treatment strategies. In this chapter, we attempt to expand this work further by providing an overview of recent theoretical and therapeutic developments as well as a detailed review of the current evidence showing how metacognitive functioning may exert a specific impact on negative symptom formation and maintenance. In particular, difficulties with identifying, labeling, and responding meaningfully to one’s own mental state and the mental state of others appears to be particularly associated with greater negative symptom expression. Although there is still a need for longitudinal research to determine the causal direction of this relationship, it is apparent that taking account of metacognitive difficulties has the potential to address deficits that are unaddressed in standard cognitive approaches. The chapter concludes with an account of the possible treatment implications of taking a metacognitive approach to the formulation and psychological treatment of negative symptoms.

Item Type:Book Sections
Glasgow Author(s) Enlighten ID:McLeod, Professor Hamish and Gumley, Professor Andrew
Authors: McLeod, H. J., Gumley, A., and Schwannauer, M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Publisher:Academic Press

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