Auditory perceptual biases, such as a tendency to hear things differently, are linked to anomalous self-experiences, especially feeling alienated from one's surroundings and emotional numbing, in people with first episode psychosis and healthy controls. No link was found between metacognitive efficiency and anomalous experiences. The findings support the minimal self-disturbance model of schizophrenia spectrum vulnerability, particularly the idea of hyperreflexivity.
In non-clinical groups, unusual sensory experiences like those in Tulpamancy and ASMR communities are not linked to stronger metacognitive beliefs, but having multiple such experiences is associated with higher hallucination-proneness. Tulpamancers who also experience ASMR scored higher on hallucination-proneness than controls, while Tulpamancers reported lower endorsement of metacognitive beliefs. No differences emerged in delusion-proneness, self-reflection, or self-schemas across groups. Metacognition influences unusual experiences in non-clinical populations, and the relationship varies by group. Improving metacognition in clinical populations may help reduce distress tied to unusual sensory experiences.