Assessing Patient Satisfaction With Metacognitive Training (MCT) for Psychosis: A Systematic Review of Randomized Clinical Trials.

OBJECTIVES: Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive-behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfaction with the intervention, have not been well studied despite their importance for adherence and overall success. A systematic review of randomized clinical trials was conducted to assess satisfaction with MCT among adults with psychotic spectrum disorders. METHODS: The search was conducted in Ovid Embase, Ovid MEDLINE, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL). PRISMA guidelines and the Cochrane Risk of Bias Tool were followed, and certainty of evidence was ascertained using the Grading of Recommendations Assessment, Development and Evaluation framework. The study is registered with PROSPERO (CRD42023418097). RESULTS: Patient satisfaction was considered the primary outcome in 3 of the 10 studies reviewed. Four studies compared MCT with other psychosocial interventions (a newspaper discussion group, cognitive remediation and supportive therapy), two of which found significantly higher satisfaction with MCT. A high percentage of all patients found MCT comprehensible and considered it an important part of their treatment; they would recommend the training to others and found the group setting advantageous. Most participants expressed high subjective satisfaction or acceptance of MCT. CONCLUSIONS: The authors found evidence that MCT may be associated with high levels of satisfaction in clinical trials whose main objective is to assess patient satisfaction, but more research is needed to consolidate the findings, especially for the extended version of MCT.

The Effect of Metacognitive Intervention on the Listening Performance and Metacognitive Awareness of High- and Low-Working Memory Capacity EFL Learners.

EFL listening comprehension has been a stark challenge for language learners, but little is known about the combined effect of individual differences, such as working memory capacity, and metacognitive intervention. Thus, the present experimental study investigates the effect of metacognitive intervention on the listening performance and metacognitive awareness of high- and low-WMC EFL learners. For this purpose, Oxford Placement Tests were distributed among 120 male Iranian EFL learners, of which 94 were identified as intermediate. Then, backward visual digit span tests were administered to measure their working memory capacity. Based on the median of all scores, 80 learners were selected and randomly assigned to two experimental groups and two control groups each with 20 participants. Next, their performance on the International English Language Testing System and the Metacognitive Awareness Listening Questionnaire was measured before and after the 8-session metacognitive intervention. Results showed that high-WMC experimental learners had a higher gain with a large effect size in terms of listening performance compared with all the other groups. In addition, the experimental group learners reported the significantly higher use of the metacognitive strategies with a moderate effect size. Interestingly, low-WMC learners' listening performance and metacognitive awareness also improved as a result of the intervention. Our findings bear pedagogical significance in that individual differences in WMC should be considered more in both EFL language classes and the future line of research involving the metacognitive intervention.

Research on metacognitive strategies of children's self-regulated learning.

Background: Learning involves numerous self-regulatory processes, and self-regulated learning includes a few metacognitive strategies. Metacognitive skills start to develop at a very young age, though preschool children face some challenges while using metacognitive strategies. Objectives: The study primarily aims to explore how young students are using metacognitive strategies in their daily activities and how effective they are. Method: The sample of the study is 15 students from a public kindergarten in China, with ages ranging from 3 years to 6 years. The investigation is qualitative in nature and has employed a case study research design. It involves an observational study along with an interview with the teachers. Results: From observational data and content analysis of the interviews, it is revealed that young children do use metacognitive strategies in their regular class activities, which vary according to their age. Teachers' support is found to be essential, especially for this age group of children, for effective use of these strategies. Moreover, it is also seen that metacognitive strategies are also important in developing social skills among young children. Conclusion: Consequently, the findings of this research have significant implications, especially for the teachers and parents who support the children and use metacognitive interventions for their holistic development.

Understanding disciplinary perspectives: a framework to develop skills for interdisciplinary research collaborations of medical experts and engineers.

BACKGROUND: Health professionals need to be prepared for interdisciplinary research collaborations aimed at the development and implementation of medical technology. Expertise is highly domain-specific, and learned by being immersed in professional practice. Therefore, the approaches and results from one domain are not easily understood by experts from another domain. Interdisciplinary collaboration in medical research faces not only institutional, but also cognitive and epistemological barriers. This is one of the reasons why interdisciplinary and interprofessional research collaborations are so difficult. To explain the cognitive and epistemological barriers, we introduce the concept of disciplinary perspectives. Making explicit the disciplinary perspectives of experts participating in interdisciplinary collaborations helps to clarify the specific approach of each expert, thereby improving mutual understanding. METHOD: We developed a framework for making disciplinary perspectives of experts participating in an interdisciplinary research collaboration explicit. The applicability of the framework has been tested in an interdisciplinary medical research project aimed at the development and implementation of diffusion MRI for the diagnosis of kidney cancer, where the framework was applied to analyse and articulate the disciplinary perspectives of the experts involved. RESULTS: We propose a general framework, in the form of a series of questions, based on new insights from the philosophy of science into the epistemology of interdisciplinary research. We explain these philosophical underpinnings in order to clarify the cognitive and epistemological barriers of interdisciplinary research collaborations. In addition, we present a detailed example of the use of the framework in a concrete interdisciplinary research project aimed at developing a diagnostic technology. This case study demonstrates the applicability of the framework in interdisciplinary research projects. CONCLUSION: Interdisciplinary research collaborations can be facilitated by a better understanding of how an expert's disciplinary perspectives enables and guides their specific approach to a problem. Implicit disciplinary perspectives can and should be made explicit in a systematic manner, for which we propose a framework that can be used by disciplinary experts participating in interdisciplinary research project. Furthermore, we suggest that educators can explore how the framework and philosophical underpinning can be implemented in HPE to support the development of students' interdisciplinary expertise.

Metacognition of perceptual resolution across and around the visual field.

Do people have accurate metacognition of non-uniformities in perceptual resolution across (i.e., eccentricity) and around (i.e., polar angle) the visual field? Despite its theoretical and practical importance, this question has not yet been empirically tested. This study investigated metacognition of perceptual resolution by guessing patterns during a degradation (i.e., loss of high spatial frequencies) localization task. Participants localized the degraded face among the nine faces that simultaneously appeared throughout the visual field: fovea (fixation at the center of the screen), parafovea (left, right, above, and below fixation at 4° eccentricity), and periphery (left, right, above, and below fixation at 10° eccentricity). We presumed that if participants had accurate metacognition, in the absence of a degraded face, they would exhibit compensatory guessing patterns based on counterfactual reasoning ("The degraded face must have been presented at locations with lower perceptual resolution, because if it were presented at locations with higher perceptual resolution, I would have easily detected it."), meaning that we would expect more guess responses for locations with lower perceptual resolution. In two experiments, we observed guessing patterns that suggest that people can monitor non-uniformities in perceptual resolution across, but not around, the visual field during tasks, indicating partial in-the-moment metacognition. Additionally, we found that global explicit knowledge of perceptual resolution is not sufficient to guide in-the-moment metacognition during tasks, which suggests a dissociation between local and global metacognition.

An indicator of the view of time passing: the development and validation of the metacognitive knowledge of time passing scale (MKTPS) in Chinese college students.

How we view the passage of past time determines how we face time itself as well as our futures, which has a strong impact particularly during the highly creative and malleable college years. Chinese culture cherishes time deeply, and for centuries there has been a tradition of "educating children and youth to inspect the passage of time." However, in today's age of information and intelligence, time has shown a trend toward fragmentation. How do contemporary Chinese college students view the passage of time, and what structures or content does it contain? The answer to this question remains uncertain, necessitating further exploration. Following Flavell's theory of metacognitive knowledge (MK), we adopted a semi-structured interview method and used the results to first outline the basic structure of Chinese college students' view of time passing, identifying four major aspects: priming aftereffect, life touching, positive promotion, and negative inhibition. Then, using the initial four-dimensional structure as a starting point, we developed the Metacognitive Knowledge of Time Passing Scale (MKTPS), and carried out exploratory factor analysis and confirmatory factor analysis to test its fit. The results showed that the four-factor scale and its 22 items had a good fit to the data. Third, the reliability and validity of the self-developed scale were tested. The results show that the internal consistency, split-half, and retest reliability of the MKTPS are good (all rs > 0.60). The construct validity of the MKTPS is also good (r between subscales is 0.33-0.60, r between subscales and total scale is 0.64-0.87), the convergent validity with Zimbardo's negative past time perspective is high (r = 0.37), and the discriminant validity with Zimbardo's future time perspective is significant (r = 0.18). Regarding criterion correlation validity, the total scores of the MKTPS have a significantly higher positive correlation with those of the time management disposition (TMD) scale (r = 0.45). Future points for studying the view of time passing in adults of all ages and across cultures field and shortcomings of the current study are also discussed.

Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation.

BACKGROUND: Childhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT). METHOD: CM was analyzed in a trial comparing a six months treatment program of either BA or MCT for 122 outpatients with major depressive disorder (MDD). Depression was assessed by the Hamilton Rating Scale for Depression (HRSD-24). CM was assessed using the Childhood Trauma Questionnaire (CTQ). RESULTS: Linear mixed models showed no predictor or moderator effects for the CTQ total score (all p > .58) but revealed a moderator effect for 'sexual abuse' on the reduction of depressive symptoms (ß = 10.98, SE = 4.48, p = .015) indicating that patients with experiences of childhood sexual abuse benefited more from BA. There also was a predictor effect for 'physical neglect' (ß = -3.35, SE = 1.70, p = .049): patients without the experience of physical neglect benefited more from treatment regardless of condition. Exploratory analyses indicated no predictor or moderator effects for the onset or persistence of depression, comorbid anxiety disorders or Cluster-C PDs (all p > .28). LIMITATIONS: Limitations include small sample sizes for some of the subsamples. CONCLUSION: Childhood sexual abuse seems to moderate treatment effectiveness in a sample of severely affected outpatients with MDD treated with MCT or BA. If confirmed in further trials, a history of sexual abuse might guide the choice between MCT and BA. TRIAL REGISTRATION: German Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered on February 13, 2017, without changes to the study protocol).

Group metacognitive therapy for children and adolescents with anxiety and depression: A preliminary trial and test of proposed mechanisms.

Preliminary research supports the feasibility of metacognitive therapy (MCT) in children with generalized anxiety, but the effectiveness of MCT in treating children with other anxiety and depressive disorders largely remains unknown. The purpose of this study was to investigate the effects associated with MCT in targeting symptoms of anxiety and depression in children and adolescents and to investigate mechanisms proposed by the metacognitive model. Ninety-seven participants aged 10-17 years (M = 12.9 ± 1.9, 82.5 % females) with anxiety and depressive disorders received eight sessions of group MCT. Participants were diagnostically assessed at pre- and post-treatment and completed symptom and process measures before, during, and after treatment, and again at three- and six-month follow-up. Multilevel models were conducted to investigate treatment-related and mediation effects. Results showed large reductions in total symptoms following treatment (d = 1.28). These reductions were associated with, and temporally preceded by changes in cognitive attentional syndrome (CAS), metacognitive beliefs, and self-reported attention control, but not objective attention control. Treatment gains were maintained at six-month follow-up (d = 1.18). Our results indicate that MCT may be a promising treatment for children and adolescents with anxiety and depression and provide preliminary evidence of changes in CAS, metacognition, and perceived attention control as potential drivers of treatment effects.

High Impostors Are More Hesitant to Ask for Help.

Help-seeking behavior requires both components of metacognition-monitoring (being aware of the need for help) and control (initiating the help-seeking action). Difficulties in initiating help-seeking, therefore, can be indicative of a metacognitive breakdown, for instance, when a student believes that a gap in knowledge is something to hide. To explore the relationship between knowing that one needs help and actually seeking it, we examined the potential influences of impostorism, which refers to the feeling of being a "fraud", despite one's objective accomplishments. Participants were asked to solve math reasoning and verbal reasoning insight problems, while also being given a "help" button that could be pressed at any time in order to get the solution. Results showed that, overall, students were more likely to ask for help with math than verbal reasoning problems-help also correlated with boosted performance. There was also a slight indication that individuals who scored relatively high on impostorism were numerically less likely to seek help and waited longer to do so for the math problems. Our findings suggest that a fear of being exposed as an impostor may hinder one's help-seeking behaviors, especially in more challenging subjects, such as math.

Effects of personality traits and mood induction on metamemory judgments and metacognitive beliefs.

Although the effects of mood and personality traits on memory performance have previously been studied, their relationship to the metamemory and metacognitive processes is still unknown. In this study, we investigated the effects of mood induction (positive and negative) and personality traits (extroverted and neurotics) on metacognitive beliefs, memory confidence, the judgment of learning (JOL) and feeling of knowing (FOK) judgments during face-name recognition tasks. One hundred twenty-seven participants who met the criteria based on their extraverted and neurotic personality scores on the Big Five Personality Inventory were randomly assigned to positive and negative mood induction conditions. We found that neurotics showed lower JOL judgments and accuracy than extroverts. The interaction effect between mood and personality significantly affected JOL and FOK accuracy, indicating that while extraverts were more accurate during positive induction, neurotics were more accurate during negative induction. In addition, neurotics were underconfident in their memory and reported more negative metacognitive beliefs than extroverts. We concluded that memory and metamemory processes are distinguishable in their relationships with mood states and personality traits. Our data also showed that JOL and FOK are distinct processes that support domain-specific metacognitive judgments.

The Efficacy of Prospective Memory and Metacognitive Skills Training in Improving the Cognitive Skills and the Quality of Life of Elderly Persons With Dementia.

Introduction Elderly people may experience a deterioration in cognitive function as part of natural aging, which impacts their ability to function independently. Dementia is often experienced by the elderly; their cognitive and memory deficits can limit independence and productivity. Metacognitive skills training can facilitate self-awareness and strategy use and may improve cognitive skills.  Aims and objectives  The article aimed to evaluate the effectiveness of prospective memory and metacognitive skills training in improving cognitive skills and quality of life for elderly persons with dementia.  Methods This was a quasi-experimental study that took place in Chennai city, India. Based on the criteria, a total of fifty (n = 50) elderly participants were selected and divided into control (n = 25) and experimental (n = 25) groups. The control group underwent conventional occupational therapy, whereas the experimental group underwent prospective memory and metacognitive skills training (PM and MST) over 36 sessions (three times/week, for 12 weeks). Outcome measures used were the mini mental status examination (MMSE) and quality of life - Alzheimer's disease (QOL-AD). Data were analyzed using the Mann-Whitney U test and Wilcoxon signed-rank test.  Results The results revealed that there were statistically significant (p-value < 0.05) differences between control and experimental groups. When compared to the control group, the experimental group had greater significant improvement in cognitive skills (MMSE, the control group's mean score was 20.94 and the experimental group's mean score was 30.94, p-value = 0.026), and quality of life (QOL-AD, the control group's mean score was 13.54 and the experimental group's mean score was 37.46, p-value = 0.000) after the implementation of a 12-week therapy program.  Conclusion This study concludes that PM and MST can be used as an effective intervention as it improves cognitive skills and quality of life among elderly persons with dementia.

Metacognitive Therapy for Body Dysmorphic Disorder: A Consecutive Case Series.

Background: Research suggests that metacognitions could be important in explaining symptoms of body dysmorphic disorder (BDD), but the effect of metacognitive therapy (MCT) on BDD is unknown. Method: The aim of this consecutive case series was to explore MCT for BDD, delivered individually within a public mental health setting. Treatment was based on MCT manuals for obsessive-compulsive disorder and generalized anxiety disorder. Of 11 eligible participants, 2 declined treatment, 8 completed treatment, and 1 dropped out. Results: MCT for BDD was associated with significant reductions in BDD symptoms, comorbid symptoms of depression and anxiety, and metacognitions. All treatment completers were characterized as treatment responders (i.e., >30% improvement), and improvements were maintained at 3-month follow-up. Conclusions: MCT could be a promising treatment for BDD. Future studies should explore MCT for BDD in controlled trials and explore how to motivate individuals with BDD for psychological treatment.

A within-person test of the metacognitive model: Daily dynamics between metacognitive beliefs, metacognitive strategies, and negative affect.

The metacognitive model of psychological disorders highlights that emotional distress is maintained by metacognitive strategies, which are related to underlying metacognitive beliefs. Considerable empirical evidence has supported the role of metacognitions in psychopathology, but few studies have examined the suggested links between metacognitive beliefs, metacognitive strategies, and symptoms within individuals. Within-person effects provide better empirical tests of theory-based hypotheses derived from clinical models as they relate to change at the individual level. Thus, the current study sought to test central predictions from the metacognitive model at the within-person level using Dynamic Structural Equation Modelling (DSEM). A sample of 222 participants gathered at convenience participated in a 26-day long assessment period where they reported daily measures of metacognitive beliefs, metacognitive strategies, and negative affect. Temporal precedence and bidirectional relations between the variables, and the possible day-to-day and within days mediation role of metacognitive strategies between metacognitive beliefs and negative affect, were tested. When controlling for previous days effects, metacognitions and negative affect (but not metacognitive strategies) predicted each other the next day, showing a reciprocal relationship. However, metacognitive strategies were significant mediators between metacognitions and negative affect within days and day-to-day. Implications and future directions based on these findings are discussed.

Role of Worry in Addiction: Implication of Metacognitive Beliefs and Type 2 Worry.

INTRODUCTION: According to the self-medication hypothesis, worriers use substances to cope with their symptoms; however, some published results have challenged this hypothesis. The aim of this study is to show if worry increases the risk of SUD when it is negatively appraised by negative metacognitive beliefs. METHOD: We recruited three samples: 68 patients with a severe AUD, 27 patients dependent on eating and 42 control participants. We used the Yale Food Addiction Scale-2, the Metacognitions Questionnaire-65, the UPPS-P Impulsive Behaviour Scale and the Anxiety Thoughts Inventory. RESULTS: We confirmed a direct effect of worries and metaworry on alcohol (AUD) and eating addiction (EA), but our multivariate analyses revealed that metacognitive beliefs and metaworry are the most robust predictors of alcohol and eating addiction. DISCUSSION: We reported substance-related differences in the relationship between worry and addiction. AUD is related to the metacognitive activity set in motion by worries while EA is associated with a maladaptive form of worry (meta-worry) where worries are negatively interpreted.

Worry Postponement From the Metacognitive Perspective: A Randomized Waitlist-Controlled Trial.

Background: Pathological worry is associated with appraisals of worrying as uncontrollable. Worry postponement (WP) with a stimulus control rationale appears to be effective in non-clinical samples. However, preliminary research in participants with generalized anxiety disorder (GAD) does not support its efficacy in reducing negative metacognitions or worry. The aim of this study was to investigate the efficacy of WP with a metacognitive rationale. Method: Participants with GAD (n = 47) or hypochondriasis (HYP; n = 35) were randomly assigned to either an intervention group (IG) or waitlist (WL). The IG received a two-session long WP intervention aiming at mainly reducing negative metacognitions concerning uncontrollability of worrying. Participants were instructed to postpone their worry process to a predetermined later time during the six days between the two sessions. Participants completed questionnaires of negative metacognitions and worry at pre-assessment, post-assessment, and follow-up. Results: We observed a significant Time*Group interaction for negative metacognitions and worry. Post-hoc analyses on the total sample and separately for GAD and HYP revealed significantly lower worry scores in the treated GAD sample compared to the WL, representing the only significant effect. In the GAD group, pre-post-effect sizes were small for negative metacognitions and large for worry. Effects persisted to a four-week follow-up. Conclusion: WP with a metacognitive rationale seems to be effective in reducing worry in participants with GAD. The effectiveness for HYP seems limited, possibly due to the small sample size.

Metacognitive knowledge about self-control.

Good self-control is highly valuable, but the processes that promote it are not fully understood. This review emphasizes that self-control is "inherently metacognitive" (p. 204, Duckworth et al., 2014) and describes the potential benefits of metacognitive knowledge for self-control. In line with research on metacognition in academic goal pursuit, we elaborate how three distinct types of metacognitive knowledge may aid self-control: strategy knowledge (for example, a repertoire of self-regulatory strategies), task knowledge (for example, understanding self-control demands), and person knowledge (for example, awareness of one's self-control strengths and weaknesses). Additionally, we identify research gaps and suggest that future studies should investigate the development and updating of metacognitive knowledge about self-control and how metacognitive knowledge can prevent individuals from justifying indulgence.

Why fall for misinformation? Role of information processing strategies, health consciousness, and overconfidence in health literacy.

Health misinformation, defined as false or misleading claims lacking scientific evidence, poses a significant threat to public health. This paper investigates factors associated with the failure to discern misinformation, including health consciousness, information processing strategies, and inaccurate self-assessments of health literacy. Through an online experiment involving 707 English-speaking U.S. participants (mean age = 43 years, 56.2% female), we found that misinformation beliefs about nutrition, vaccination, vaping, and cancer were significantly correlated, implying susceptibility across health topics. Greater susceptibility was associated with higher health consciousness, lower objective health literacy, more elaboration, and more selective scanning. Results provided evidence for the Dunning-Kruger effect and metacognitive monitoring errors, whereby confident individuals were unaware of inadequate health literacy and showed poor misinformation identification. Findings suggest that promoting both health literacy education and cognitive reflection skills among the general adult population could empower them to more critically evaluate online health information.

Predicting Learning: Understanding the Role of Executive Functions in Children's Belief Revision Using Bayesian Models.

Recent studies suggest that learners who are asked to predict the outcome of an event learn more than learners who are asked to evaluate it retrospectively or not at all. One possible explanation for this "prediction boost" is that it helps learners engage metacognitive reasoning skills that may not be spontaneously leveraged, especially for individuals with still-developing executive functions. In this paper, we combined multiple analytic approaches to investigate the potential role of executive functions in elementary school-aged children's science learning. We performed an experiment that investigates children's science learning during a water displacement task where a "prediction boost" had previously been observed-children either made an explicit prediction or evaluated an event post hoc (i.e., postdiction). We then considered the relation of executive function measures and learning, which were collected following the main experiment. Via mixed effects regression models, we found that stronger executive function skills (i.e., stronger inhibition and switching scores) were associated with higher accuracy in Postdiction but not in the Prediction Condition. Using a theory-based Bayesian model, we simulated children's individual performance on the learning task (capturing "belief flexibility"), and compared this "flexibility" to the other measures to understand the relationship between belief revision, executive function, and prediction. Children in the Prediction Condition showed near-ceiling "belief flexibility" scores, which were significantly higher than among children in the Postdiction Condition. We also found a significant correlation between children's executive function measures to our "belief flexibility" parameter, but only for children in the Postdiction Condition. These results indicate that when children provided responses post hoc, they may have required stronger executive function capacities to navigate the learning task. Additionally, these results suggest that the "prediction boost" in children's science learning could be explained by increased metacognitive flexibility in the belief revision process.

I didn't know I had executive dysfunction, now I can do something about it: perspectives about CO-OP from people with Parkinson's disease.

PURPOSES: People with Parkinson's disease (PD) experience increasing disability across their lifespan. Holistic rehabilitation approaches are needed to maximize their daily functioning and quality of life (QoL). The Cognitive Orientation to daily Occupational Performance (CO-OP) approach targets daily functioning, with established efficacy in other neurological populations. This study is part of a larger trial of CO-OP with people with PD, describing the perspectives of people with PD who received CO-OP about its effect on their lives. METHODS: People with PD participating in a randomized controlled trial (RCT) were interviewed following the CO-OP programme. Views about the feasibility, acceptability, and experiences of CO-OP were explored. Inductive thematic analysis was used to interpret the findings. RESULTS: Analysis of interviews (n = 20) identified that CO-OP drove positive change in participants' daily lives. Participants reported transfer and generalization of learned strategies, suggesting effective use of skills learned in CO-OP. CONCLUSIONS: Addressing a critical gap in PD management, findings suggest that CO-OP was perceived as effective in addressing a broad scope of PD-related issues. Findings hold particular significance for individuals experiencing long-term PD consequences, potentially offering a viable option to enhance participation and QoL. Findings support CO-OP as an implementable, acceptable, and potentially beneficial intervention in PD. Further research is warranted to establish efficacy.

People with Parkinson's disease (PD) experience increasing disability across their lifespan because of motor and "hidden" psychological difficulties.Holistic rehabilitation approaches are needed to comprehensively address heterogeneous PD-related consequences to maximize daily functioning and quality of life (QoL) for people with PD.People with PD perceived that the CO-OP approach was as a positive experience that improved their management of daily life, self-awareness, and self-efficacy.Findings support CO-OP as an implementable, acceptable, and potentially beneficial intervention for people with PD.

Metacognitive Interpersonal Therapy for Misophonia: A Single-Case Study.

BACKGROUND: Misophonia is a chronic condition in which the exposure to specific sounds increases the arousal and recurrence of specific intense negative emotions. We hypothesized that misophonia may be strongly related to maladaptive interpersonal schemas that create difficulties in interpersonal relationships. Subjects with maladaptive interpersonal schemas think that other people try to subjugate, criticize, dominate, exploit, deceive, disregard, and humiliate them. Furthermore, these patients typically endorse a representation of self as mistreated, constricted, harmed, damaged, humiliated, impotent, inadequate, or fragile. METHODS: We describe the course of a treatment of Metacognitive Interpersonal Therapy (MIT) in a young man presenting misophonia and co-occurrent obsessive-compulsive personality disorder (OCPD) and avoidant personality disorder (AvPD), with narcissistic traits and normal hearing. We collected qualitative and quantitative data at the beginning of the intervention and at 2 years follow-up. RESULTS: The therapy aimed at increasing awareness of maladaptive interpersonal schemas and promoting a healthy self. The results reported a significant decrease in misophonia; behavioural experiments were used to increase the quality of social relationships and tolerance to the trigger sounds. CONCLUSIONS: MIT can be an effective therapy for the treatment of misophonia.