Metacognition, social cognition, and mentalizing in psychosis: are these distinct constructs when it comes to subjective experience or are we just splitting hairs?
BMC Psychiatry July 2, 2021 P. Lysaker, S. Cheli, G. Dimaggio et al.
A review compares three research fields—metacognition, social cognition, and mentalizing—to determine whether metacognitive research offers unique insight into psychosis. The authors argue that metacognition, as defined by the integrated model, can quantify activities whose impairment may cause subjective disturbances in psychosis. They distinguish metacognition from the other fields in experimental procedures, theoretical advances, and clinical applications. Metacognitive research uniquely describes an architecture that, when compromised in psychosis, leads to loss of purpose, possibilities, place in the world, and self-coherence. Repairing this architecture may promote recovery of a coherent sense of self and others, with implications for recovery-oriented treatment.