Investigating the relationship between negative symptoms and metacognitive functioning in psychosis: An individual participant data meta-analysis (Trauelsen, 2023)

McGuire N., Gumley A., Hasson-Ohayon I., Allan S., Aunjitsakul W., Aydin O., Bo S., Bonfils K.A., Brocker A.-L., de Jong S., Dimaggio G., Inchausti F., Jansen J.E., Lecomte T., Luther L., MacBeth A., Montag C., Pedersen M.B., Pijnenborg G.H.M., Popolo R., Schwannauer M., Trauelsen A.-M., van Donkersgoed R., Wu W., Wang K., Lysaker P.H., McLeod H. 

Psychology and psychotherapy 2023;96(4): 918-933. 

Available online at this link 

PURPOSE: Negative symptoms are a persistent, yet under-explored problem in psychosis. Disturbances in metacognition are a potential causal factor in negative symptom development and maintenance. This meta-analysis uses individual participant data (IPD) from existing research to assess the relationship between negative symptoms and metacognition treated as summed scores and domains. 

METHOD(S): Data sets containing individuals with negative symptoms and metacognition data, aged 16+ with psychosis, were identified according to pre-specific parameters. IPD integrity and completeness were checked and data were synthesized in two-stage meta-analyses of each negative symptoms cluster compared with metacognition in seemingly unrelated regression using restricted maximum likelihood estimation. Planned and exploratory sensitivity analyses were also conducted. 

RESULT(S): Thirty-three eligible data sets were identified with 21 with sufficient similarity and availability to be included in meta-analyses, corresponding to 1301 participants. The strongest relationships observed were between summed scores of negative symptoms and metacognition. Metacognitive domains of self-reflectivity and understanding others' minds, and expressive negative symptoms emerged as significant in some meta-analyses. The uncertainty of several effect estimates increased significantly when controlling for covariates. 

CONCLUSION(S): This robust meta-analysis highlights the impact of using summed versus domain-specific scores of metacognition and negative symptoms, and relationships are not as clear-cut as once believed. Findings support arguments for further differentiation of negative symptom profiles and continued granular exploration of the relationship between metacognition and negative symptoms.Copyright © 2023 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.