Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia.
Psychol Med
; 49(2): 303-313, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-29692285
ABSTRACT
BACKGROUND:
Impaired metacognition is associated with difficulties in the daily functioning of people with psychosis. Metacognition can be divided into four domains Self-Reflection, Understanding the Other's Mind, Decentration, and Mastery. This study investigated whether Metacognitive Reflection and Insight Therapy (MERIT) can be used to improve metacognition.METHODS:
This study is a randomized controlled trial. Patients in the active condition (n = 35) received forty MERIT sessions, the control group (n = 35) received treatment as usual. Multilevel intention-to-treat and completers analyses were performed for metacognition and secondary outcomes (psychotic symptomatology, cognitive insight, Theory of Mind, empathy, depression, self-stigma, quality of life, social functioning, and work readiness).RESULTS:
Eighteen out of 35 participants finished treatment, half the drop-out stemmed from therapist attrition (N = 5) or before the first session (N = 4). Intention-to-treat analysis demonstrated that in both groups metacognition improved between pre- and post-measurements, with no significant differences between the groups. Patients who received MERIT continued to improve, while the control group returned to baseline, leading to significant differences at follow-up. Completers analysis (18/35) showed improvements on the Metacognition Assessment Scale (MAS-A) scales Self Reflectivity and metacognitive Mastery at follow-up. No effects were found on secondary outcomes.CONCLUSIONS:
On average, participants in the MERIT group were, based on MAS-A scores, at follow-up more likely to recognize their thoughts as changeable rather than as facts. MERIT might be useful for patients whose self-reflection is too limited to benefit from other therapies. Given how no changes were found in secondary measures, further research is needed. Limitations and suggestions for future research are discussed.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Psicoterapia
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Esquizofrenia
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Autoimagem
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Percepção Social
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Avaliação de Resultados em Cuidados de Saúde
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Metacognição
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Psychol Med
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Holanda