Molly A. Erickson

Metacognition and social function in schizophrenia: Associations over a period of five months

Introduction. Deficits in the ability to think about thinking have been widely observed in persons with schizophrenia and linked with concurrent assessments of various forms of function. Less is known though about their links to outcome over time. To address this issue, the current study explores whether Mastery, a domain of metacognition that reflects the ability to use knowledge about ones own mental states and those of others to respond to psychological challenges, is related to the frequency of social contact and persons’ capacity for social relatedness. Methods. Participants were 72 adults with schizophrenia spectrum disorders enrolled in vocational rehabilitation; these patients completed a baseline assessment as well as a follow-up assessment 5 months later. Mastery was assessed using the Metacognitive Assessment Scale and social functioning by the Quality of Life Scale. Results. Using structural equation modelling, the proposed model demonstrated acceptable fit even when a range of possible confounding variables were entered as covariates. Conclusions. Results are consistent with the possibility that certain forms of metacognition affect social function among persons with schizophrenia, both concurrently and over time.

Synchronization dynamics and evidence for a repertoire of network states in resting EEG

Intrinsically driven neural activity generated at rest exhibits complex spatiotemporal dynamics characterized by patterns of synchronization across distant brain regions. Mounting evidence suggests that these patterns exhibit fluctuations and nonstationarity at multiple time scales. Resting-state electroencephalographic (EEG) recordings were examined in 12 young adults for changes in synchronization patterns on a fast time scale in the range of tens to hundreds of milliseconds. Results revealed that EEG dynamics continuously underwent rapid transitions between intermittently stable states. Numerous approximate recurrences of states were observed within single recording epochs, across different epochs separated by longer times, and between participants. For broadband (4–30 Hz) data, a majority of states could be grouped into three families, suggesting the existence of a limited repertoire of core states that is continually revisited and shared across participants. Our results document the existence of fast synchronization dynamics iterating amongst a small set of core networks in the resting brain, complementing earlier findings of nonstationary dynamics in electromagnetic recordings and transient EEG microstates.

Phenomenological Dimensions of Sensory Gating

Contemporary sensory gating definitions are generally tied to the perceptual and attentional phenomenology described by McGhie and Chapman, including abnormalities in the quality of sensory input, heightened awareness of background noises, and poor selective attention reported by individuals with schizophrenia. Despite these explicit phenomenological origins, little is known about the experiential phenomena underlying contemporary operationalizations of the sensory gating construct, such as whether the construct is restricted to experiences associated with the modulation of sensory percepts includes selective attention and distractibility or even whether the construct is accessible via self-report. Because clarification of these issues has important implications for the development and testing of psychological theories and the study of psychopathology, a series of studies was conducted to (a) empirically identify the major dimensions of sensory gating-like perceptual and attentional phenomenology in healthy young adults and (b) develop a psychometrically sound self-report rating scale to capture these dimensions, the Sensory Gating Inventory (SGI). Factor analyses of Likert items measuring a broad range of sensory gating-like subjective experiences revealed 1 primary factor that encompassed anomalies of perceptual modulation (eg, perceptions of heightened stimulus sensitivity and sensory inundation) and 3 other factors measuring disturbances in the processes of focal and radial attention as well as exacerbation of sensory gating-like anomalies by fatigue and stress. Psychometrically, the SGI demonstrated strong reliability and validity. An empirically based conceptual demarcation of the sensory gating construct is offered, and directions for future research are described.

Metacognition in schizophrenia spectrum disorders: Methods of assessment and associations with neurocognition and function

Background and Objectives: Research has confirmed that many with schizophrenia experience deficits in metacognitive capacity defined as impairments in the ability to think about thinking, both with regards to their own thinking and the thinking of others. These difficulties are related to, but not reducible to symptoms. One question posed here regards how these deficits are linked to other forms of cognitive deficits, including deficits in neurocognition, and how they and other forms of cognitive deficits are related to the ability to function. As neurocognition is degraded in schizophrenia, does the ability to think about ones own thinking diminish? Do deficits in metacognition affect function in a manner semi-independent of deficits in neurocognition? Methods: To explore these possibilities, this paper reviews recent studies of metacognition as assessed within personal narratives of self and illness spontaneously generated by adults with schizophrenia spectrum disorders. Results: Studies are reviewed which suggest that impairments in verbal memory and executive function may interfere with the ability to form and sustain representation of ones own internal state as well as the internal states of others. Additionally, results are de-tailed which suggest that metacognitive deficits directly affect function prospectively and may mediate the impact of neurocognitive deficits on functioning. Conclusions: Results are consistent with the possibility that a certain level of neurocognition is needed to think about thinking in a complex manner and that the ability to think about thinking is intimately related to the ability to work and relate to others among persons with schizophrenia.

Examining the effects of former cannabis use on cerebellum-dependent eyeblink conditioning in humans

RationalePrevious work in humans has shown that chronic cannabis users exhibit disruptions in classical eyeblink conditioning (EBC), a form of associative learning that is known to be dependent on the cerebellum. Based upon previous work in animals, it was hypothesized that these learning deficits were related to cannabinoid receptor (CB1R) downregulation. However, it remains unclear whether there is a recovery of cerebellum-dependent learning after the cessation of cannabis use.MethodsTherefore, former cannabis users (n=10), current cannabis users (n=10), and cannabis-naïve controls (n=10), all free of DSM-IV Axis-I or -II disorders, were evaluated. A standard delay EBC procedure was utilized in which paired presentations of a conditioned stimulus (CS; e.g., tone) and a co-terminating unconditioned stimulus (US; e.g., ocular airpuff) were administered, thus eliciting a conditioned eyeblink response (CR). The primary dependent measures were percentage of CRs and CR latency across conditioning blocks.ResultsSimilar to prior studies, current cannabis users exhibited marked impairments in both the acquisition and timing of CRs compared to controls. Although former cannabis users showed intact CR acquisition compared to controls, they exhibited significantly impaired (shorter) CR latencies. In both cannabis groups, UR amplitude did not differ from controls, indicating normal US processing.ConclusionsThese data suggest that a recovery of function has occurred for the learning of the CS–US association, while the accurate timing of the CR shows lasting impairments. Taken together, these results suggest that heavy cannabis use can disrupt timing-related synaptic plasticity within the cerebellum, even after the cessation of cannabis use.

The Association of Metacognition with Neurocognition and Function in Schizophrenia: Advances from the Study of Personal Narratives

Research has confirmed that many with schizophrenia experience deficits in metacognitive capacity defined as impairments in the ability to think about thinking, both with regards to their own thinking and the thinking of others. These difficulties are related to but not reducible to symptoms. One question posed here for contemporary research regards how these deficits are linked to other forms of cognitive deficits, including deficits in neurocognition, and how they and other forms of cognitive deficits are related to the ability to function. As neurocognition is degraded during the early course of schizophrenia, does the ability to think about one’s own thinking diminish? Furthermore, even if related to deficits in neurocognition, do deficits in metacognition affect function in a manner independent of deficits in neurocognition? Does metacognitive function mediate the impact of neurocognitive deficits on daily functioning? To explore these possibilities, this chapter reviews recent studies which have advanced our understanding of these issues by studying metacognition as it occurs spontaneously within personal narratives of self and illness by adults with schizophrenia spectrum disorders. Results are presented which suggest that impairments in verbal memory and executive function may interfere with the ability to form and sustain representation of one’s own internal state as well as the internal states of others. Additionally, results are detailed which suggest that metacognitive deficits directly affect function prospectively and may mediate the impact of neurocognitive deficits on functioning.

Individual Psychotherapy for Schizophrenia: An Overview of Its History, Recent Developments and New Directions

Empirical study of long term outcomes for persons with schizophrenia suggests that recovery is often possible. This literature also emphasizes that recovery may involve different kinds of experiences for different people with the same psychiatric condition. For some, recovery may mean symptom remission while for others it may be reflected by the achievement of psychosocial milestones. For yet others, however, to recover can involve subjective changes in how those persons experience themselves as meaningful agents in the world. For some, to recover could be to reclaim a full sense of self, a sense of self that can meaningfully engage others and the rigors of daily life. In this chapter we review the potential of individual psychotherapy to address the more subjective aspects of recovery related to sense of self. We first review literature on the effectiveness of psychotherapy for persons with schizophrenia. We then discuss literature on the larger issue of how decrements in personal narrative and metacognition may underpin some of the disturbance in sense of self observed in schizophrenia. Finally, we focus on how psychotherapy could be conceptualized and adapted to help enrich self-experience by addressing narrative and metacognition. Directions for future research are discussed.