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ABSTRACT: Introduction:Reasoning biases such as jumping to conclusions (JTC) and overconfidence in errors have been well replicated in patients with delusions. However, their relation to dopaminergic activity, central to pathophysiologic models of psychosis, has not yet been investigated. This study aimed to examine the effects of a dopaminergic agonist (l-dopa) and a dopaminergic antagonist (haloperidol) on the JTC bias and overconfidence in errors after single-dose administration in healthy individuals.Methods:The study used a randomized, double-blind, placebo-controlled, 3-way crossover design. Participants were 36 healthy individuals aged 18-36 years. The variables of interest were draws to decision and probability threshold to decision on a computerized variant of the beads task and the number of high-confident incorrect responses on a visual memory task.Results:There were no significant effects of substance on draws to decision and probability threshold to decision. A significant effect emerged for high-confident incorrect responses in the memory task; pairwise comparisons indicated a significant reduction of the number of high-confident incorrect responses after administration of haloperidol vs l-dopa and placebo.Conclusions:This is the first study to investigate the direct effects of dopaminergic drugs on reasoning biases. The JTC bias and overconfidence in errors showed a differential pattern of dopaminergic modulation, suggesting that they represent different facets of reasoning abnormalities that interact with each other to produce delusions in susceptible individuals.
Schizophrenia Bulletin 05/2013; · 8.80 Impact Factor
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ABSTRACT: Antipsychotic medication represents the first-line treatment of schizophrenia. While it is undisputed that antipsychotics ameliorate positive symptoms, the exact cognitive and emotional pathways through which its effect is exerted has remained unclear. The present study investigated the subjective effects of antipsychotics across various domains of cognition and emotion in both patients with psychotic symptoms and patients with other psychiatric diagnoses. A total of 69 patients with a probable history of psychosis or psychotic symptoms and 26 patients with psychiatric diagnoses other than psychosis participated in a survey conducted over the Internet. Multiple control measures aimed to secure response validity. All patients were currently or had previously been treated with antipsychotic agents. A questionnaire comprising 49 items and measuring possible effects of antipsychotics on cognition and emotion was administered. For 30 out of 49 items a clear response pattern emerged, which was similar for patients with psychotic disorders and patients with other diagnoses. Factor analysis of these items revealed three main effects of antipsychotic medication related to doubt and self-doubt, cognitive and emotional numbing, and social withdrawal. Antipsychotic treatment appears to be connected to a number of negative subjective effects on cognition and emotion. Further studies are warranted to assess how these effects impact on the patients' subjective well-being and quality of life, as well as their association with antipsychotic efficacy on the one hand, and adherence rates on the other. The induction of doubt and the dampening of emotion may be one reason why antipsychotics work and at the same time offer an explanation why they are experienced as rather unpleasant and are eventually discontinued by many patients.
Neuropharmacology 05/2013; · 4.81 Impact Factor
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ABSTRACT: Background: Metacognitive Group Training for Schizophrenia Patients (MCTg) focuses on dysfunctional thinking styles (e.g. cognitive biases) putatively involved in the formation and maintenance of delusions. Recently, the Individualized Metacognitive Therapy Program for Patients with Psychosis (MCT+), an extension of the group training, was released. MCT+ sessions aim to correct false metacognitive beliefs, which in turn should challenge a patient's personal delusional convictions. Aims: The present study demonstrates how MCT and MCT+ can be combined and how the contents are conveyed to the patient. Method: We present a single case study of a patient undergoing a combined treatment of MCT and MCT+. Before intervention and 4 weeks later the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scales (PSYRATS) were administered. Results: The patient showed a substantial symptom reduction after 4 weeks of combined therapy of MCTg and MCT+ as measured with PANSS and PSYRATS. Conclusions: The present case history lends preliminary evidence for the feasibility of this new treatment approach in psychosis.
Behavioural and Cognitive Psychotherapy 05/2013; · 1.69 Impact Factor
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ABSTRACT: OBJECTIVE: To assess the association of subjective quality of life as measured by the Subjective Well-being under Neuroleptic Treatment questionnaire (SWN-K) with neuropsychological functioning; to address interactions with the SWN-K domain mental functioning as a measure of subjective cognitive dysfunction; and to examine the interaction of subjective well-being and psychopathology ratings. METHODS: Forty-five patients diagnosed with schizophrenia spectrum disorder (SSD) were assessed regarding subjective well-being (SWN-K), neuropsychological impairment, and psychopathology (Brief Psychiatric Rating Scale; BPRS). RESULTS: After controlling for multiple comparisons, SWN-K total score showed significant positive correlations with concentration/attention (r=.498), working memory (r=.537), verbal memory (r=.522), and global cognition (r=.459). No correlations of SWN mental functioning and neuropsychological impairment remained significant after Bonferroni correction. Correlations between SWN-K subscales and neuropsychological functioning were generally positive, indicating higher subjective well-being in patients with better neurocognition. In multivariate analyses, global cognition was a significant predictor (p=.011), accounting for 19.7% of SWN total score variance. Adding BPRS total score as predictor (p=.054) explained an additional 6.9% of SWN-K variance. Linear regression analyses with SWN-K mental functioning as dependent variable did not yield statistically significant models. CONCLUSION: Subjective well-being and objective neuropsychological functioning show only moderate associations and can be seen as largely independent parameters. In particular, subjective mental functioning cannot serve as a proxy for objective neuropsychological testing.
Comprehensive psychiatry 04/2013; · 2.08 Impact Factor
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ABSTRACT: BACKGROUND: Testosterone binds to androgen receptors, which can be found abundantly in the hippocampus. Associations between testosterone levels and visuospatial memory have been reported, albeit with inconsistent results. Previous studies have used point sampling of testosterone levels (blood, saliva) rather than long-term secretion measures. Hair analysis for steroids allows for retrospective ascertainment of cumulative steroid measures over several months. We examined hair testosterone and its association with verbal and visuospatial memory in middle-aged men and women with and without major depression. METHODS: We examined a total of 73 middle-aged individuals (35 depressed patients, and 38 age-, sex- and education-matched healthy subjects). We tested verbal (Auditory Verbal Learning Task) and visuospatial (Rey figure) memory and measured testosterone in the hair by liquid chromatography tandem mass spectrometry. RESULTS: Hair testosterone levels did not differ between patients and controls (mean 1.35pg/mg vs. 1.40pg/mg, SD 0.61 and 0.80, respectively). In men (n=24) but not women (n=49), hair testosterone was associated with visuospatial memory in a multiple regression analysis after controlling for age, education, body mass index, and depression (adjusted R(2)=0.56). CONCLUSIONS: With the new method of testosterone measurement in hair allowing for long-term cumulative ascertainment of testosterone secretion, we extend recent results of a male-specific role for testosterone in visuospatial memory.
Psychoneuroendocrinology 04/2013; · 5.81 Impact Factor
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ABSTRACT: BACKGROUND AND OBJECTIVES: Mixed results have been obtained regarding memory in patients with borderline personality disorder (BPD). Prior reports and anecdotal evidence suggests that patients with BPD are prone to false memories but this assumption has to been put to firm empirical test, yet. METHODS: Memory accuracy and confidence was assessed in 20 BPD patients and 22 healthy controls using a visual variant of the false memory (Deese-Roediger-McDermott) paradigm which involved a negative and a positive-valenced picture. RESULTS: Groups did not differ regarding veridical item recognition. Importantly, patients did not display more false memories than controls. At trend level, borderline patients rated more items as new with high confidence compared to healthy controls. CONCLUSIONS: The results tentatively suggest that borderline patients show uncompromised visual memory functions and display no increased susceptibility for distorted memories.
Journal of behavior therapy and experimental psychiatry 04/2013; 44(4):376-380. · 2.48 Impact Factor
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ABSTRACT: Introduction. The aim of the present study was to investigate (meta)cognitive beliefs related to posttraumatic stress disorder (PTSD) in a sample of individuals displaced as children at the end of the Second World War as well as transgenerational effects of trauma and PTSD on the offspring. Methods. Displaced individuals with (n=20) and without PTSD (n=24) and nondisplaced healthy controls (n=11), as well as one of their adult offspring, were assessed with the Metacognitions Questionnaire (MCQ-30). Older adults, formerly displaced in childhood, were additionally assessed with the Posttraumatic Cognitions Inventory (PTCI). Results. Dysfunctional beliefs (MCQ-30, PTCI) were particularly pronounced in formerly displaced individuals with PTSD, but not in the offspring generation. Conclusions. The findings suggest that in an aging group of displaced individuals with PTSD dysfunctional beliefs are associated with the disorder. Bias modification may help to attenuate symptomatology. No evidence was found for a transgenerational effect.
Cognitive Neuropsychiatry 02/2013;
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ABSTRACT: An attentional bias for trauma-related verbal cues was frequently demonstrated in posttraumatic stress disorder (PTSD) using variants of the emotional Stroop task (EST). However, the mechanisms underlying the Stroop-effect are ill-defined and it is yet unclear how the findings apply to different paradigms and stimulus modalities. To address these open questions, for the first time a spatial-cuing task with pictorial cues of different emotional valence was administered to trauma-exposed individuals with and without PTSD, and non-trauma-exposed controls. Groups did not show different response profiles across affective conditions. However, a group effect was evident when comparing depressed with non-depressed individuals: Those with depression showed delayed attending towards trauma-related cues and faster attending away from negative cues. In correlational analyses, attentional avoidance was associated with both depression and PTSD symptom severity. These findings highlight the need for research on trauma populations and anxiety in general to pay closer attention to depression as an important confound in the study of emotional information processing.
Psychiatry research. 01/2013;
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ABSTRACT: The relation between religiosity/spirituality (R/S), personal beliefs, and mental health has been extensively studied. However, concerning anxiety disorders (ADs), empirical evidence is scarce. This study investigated the differences in R/S and magical/paranormal ideation among obsessive-compulsive disorder patients (OCD; n = 49), patients with other ADs (n = 36), and healthy controls (HCs; n = 35). Our results suggest negative religious coping as being the only parameter showing significantly higher scores in OCD and AD participants in comparison with HCs. Negative religious coping reflects negative functional expressions of R/S in stressful situations. Logistic regression also suggested negative religious coping as the strongest predictor of group affiliation to the nonhealthy group. Further results show no significant differences between other R/S, magical, and paranormal ideation traits among groups. This study underlines an important role of negative religious coping in ADs yet does not clearly indicate a specific causality. Religious-sensitive treatment targeting cognitive aspects of negative religious coping are discussed.
The Journal of nervous and mental disease 09/2012; 200(10):876-84. · 1.77 Impact Factor
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ABSTRACT: Background: The social attitudes and interpersonal relationships of patients with obsessive-compulsive disorder (OCD) are subject to a longstanding controversy. Whereas cognitive-behavioural researchers emphasize exaggerated pro-social attitudes in OCD like inflated responsibility and worry for other people (especially significant others), dynamic theories traditionally focus on anti-social attitudes such as latent aggression and hostility. In two recent studies, we gathered support not only for a co-existence of these seemingly opposing attitudes in OCD, but also for a functional connection: inflated responsibility in part appears to serve as a coping strategy (or "defense") against negative interpersonal feelings. Aims: In the present study, we tested a shortened version of the Responsibility and Interpersonal Behaviours and Attitudes Questionnaire (RIBAQ-R). Method: The scale was administered to 34 participants with OCD and 34 healthy controls. The questionnaire concurrently measures pro-social and anti-social interpersonal attitudes across three subscales. Results: In line with our prior studies, patients displayed higher scores on both exaggerated pro-social attitudes (e.g. "I suffer from a strict conscience concerning my relatives") as well as latent aggression (e.g. "Sometimes I would like to harm strangers on the street") and suspiciousness/distrust (e.g. "I cannot even trust my own family"). A total of 59% of the patients but only 12% of the healthy controls showed marked interpersonal ambivalence (defined as scores higher than one standard deviation from the mean of the nonclinical controls on both the pro-social and at least one of the two anti-social subscales). Conclusions: The study asserts high interpersonal ambivalence in OCD. Further research is required to pinpoint both the dynamic and causal links between opposing interpersonal styles. Normalization and social competence training may prove beneficial to resolve the apparent problems of patients with OCD regarding anger expression and social conflict management.
Behavioural and Cognitive Psychotherapy 09/2012; · 1.69 Impact Factor
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ABSTRACT: Many individuals suffering from depression do not actively seek treatment. Self-help strategies represent low-threshold treatment options that are particularly relevant for milder cases. The present study addressed two important issues: (1) we examined depressed individuals' motives and attitudes that may represent barriers to face-to-face treatment; (2) we examined if the participation in an online treatment program facilitates or compromises their willingness to undergo face-to-face treatment. We recruited 210 participants with depression for a trial on the efficacy of an online treatment program for depression. Participants were randomly allocated either to a self-help treatment (Deprexis) or to a wait-list control group. All participants filled out a newly developed 42-item questionnaire called Psychotherapy Expectations, Concerns, and Hopes Inventory (PECHI). The scale measures attitudes toward face-to-face treatment and was administered at baseline and 8 weeks later. Principal component analysis of the PECHI revealed five dimensions: hope for symptomatic improvement, fear of poor alliance with the therapist, skill acquisition, skepticism and resentment of psychotherapy, and self-stigma. Attitudes toward treatment were stable over time and neither modulated by group status nor by self-reported or objective symptom decline. Correlation analyses revealed that current levels of depression and well-being were potent predictors of attitudes toward treatment, suggesting that when the patient feels more depressed, doubts about the effectiveness of therapy emerge more strongly. To conclude, results suggest that Deprexis neither promotes nor reduces negative attitudes toward psychotherapy, nor does it increase barriers to enter face-to-face treatments. An alarming paradox emerged: when a depressed person is in greatest need of help, motivation to seek face-to-face treatment is lowest. Depression and Anxiety 00:1-11, 2012. © 2012 Wiley Periodicals, Inc.
Depression and Anxiety 08/2012; · 4.18 Impact Factor
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ABSTRACT: Deficits in emotion perception and overconfidence in errors are well-documented in schizophrenia but have not been examined concurrently. The present study aimed to fill this gap. Twenty-three schizophrenia patients and twenty-nine healthy subjects underwent a Continuous Facial Sequence Task (CFST). The CFST comprised two blocks: a female (1st block) and a male protagonist (2nd block) displayed the six basic emotions postulated by Ekman as well as two more complex mental states and a neutral expression. Participants were first asked to identify the affect displayed by the performer and then to judge their response confidence. No group differences emerged regarding overall emotion perception. Follow-up analyses showed that patients were less correct in detecting some negative emotions but performed better for neutral or positive emotions. Regarding confidence, incorrect decisions in patients were associated with higher confidence than in controls (statistical trend level, moderate effect size). Patients displayed significant overconfidence in errors for negative emotions. In addition, patients were more prone to high-confident errors for emotions that were displayed in weak emotional intensity. While the study supports the view that the examination of confidence adds unique information to our understanding of social cognition, several methodological limitations render its findings preliminary.
Psychiatry research. 08/2012;
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ABSTRACT: BACKGROUND AND OBJECTIVES: A vast amount of memory and meta-memory research in schizophrenia shows that these patients perform worse on memory accuracy and hold false information with strong conviction compared to healthy controls. So far, studies investigating these effects mainly used traditional static stimulus material like word lists or pictures. The question remains whether these memory and meta-memory effects are also present in (1) more near-life dynamic situations (i.e., using standardized videos) and (2) whether emotionality has an influence on memory and meta-memory deficits (i.e., response confidence) in schizophrenia compared to healthy controls. METHOD: Twenty-seven schizophrenia patients and 24 healthy controls were administered a newly developed emotional video paradigm with five videos differing in emotionality (positive, two negative, neutral, and delusional related). After each video, a recognition task required participants to make old-new discriminations along with confidence ratings, investigating memory accuracy and meta-memory deficits in more dynamic settings. RESULTS: For all but the positively valenced video, patients recognized fewer correct items compared to healthy controls, and did not differ with regard to the number of false memories for related items. In line with prior findings, schizophrenia patients showed more high-confident responses for misses and false memories for related items but displayed underconfidence for hits when compared to healthy controls, independent of emotionality. LIMITATIONS: Limited sample size and control group; combined valence and arousal indicator for emotionality; general psychopathology indicator. CONCLUSIONS: Emotionality differentially moderated memory accuracy, biases in schizophrenia patients compared to controls. Moreover, the meta-memory deficits identified in static paradigms also manifest in more dynamic settings near-life settings and seem to be independent of emotionality.
Journal of behavior therapy and experimental psychiatry 07/2012; 44(1):77-83. · 2.48 Impact Factor
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ABSTRACT: Research looking at specific memory aberrations in the schizophrenia has primarily focused on their phenomenology using standardized semantic laboratory tasks. However, no study has investigated to what extent such aberrations have consequences for everyday episodic memories using more realistic false memory paradigms. Using a false memory paradigm where participants are presented with misleading suggestive information (Gudjonsson Suggestibility Scale), we investigated the susceptibility of patients with schizophrenia (n = 21) and healthy controls (n = 18) to post hoc misleading information acceptance and compliance. Patients with schizophrenia exhibited an increased susceptibility to go along with misleading suggestive items. Furthermore, they showed an increased tendency to change answers under conditions of social pressure. Underscoring previous findings on memory aberrations in schizophrenia, patients with schizophrenia had reduced levels of correct recognition (ie, true memory) relative to healthy controls. The effects remained stable when controlling for specific mediating variables such as symptom severity and intelligence in patients with schizophrenia. These findings are a first indication that social pressure and misleading information may impair source memory for everyday episodic memories in schizophrenia, and such impairment has clear consequences for treatment issues and forensic practice.
Comprehensive psychiatry 06/2012; · 2.08 Impact Factor
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ABSTRACT: Borderline personality disorder (BPD) is characterized by a pattern of instability in interpersonal relationships. Therefore, the investigation of social cognition is of compelling interest for the understanding of BPD. One important aspect of social cognition is theory of mind (ToM), which describes the ability to understand others' mental states, such as beliefs, desires and intentions. The aim of the present study was to further investigate ToM in BPD patients.
The Reading the Mind in the Eyes Test was assessed in 31 BPD patients and 27 healthy controls. In addition, the test was complemented by a response confidence rating.
BPD patients and healthy controls did not differ in their mind-reading ability with respect to accuracy, but patients were significantly more often highly confident in their decisions than controls.
Overconfidence might contribute to the severe difficulties in interpersonal relationships often observed in BPD patients.
Psychiatry and Clinical Neurosciences 06/2012; 66(4):322-7. · 2.13 Impact Factor
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ABSTRACT: The investigation of cognitive biases has considerably broadened our understanding of the cognitive underpinnings of schizophrenia. This is the first study to investigate the illusory truth or validity effect in schizophrenia, which denotes the phenomenon that the renewed exposure to difficult knowledge questions shifts responses toward affirmation. We hypothesized an excess of the truth effect in schizophrenia, which may play a role in the maintenance of the disorder, particularly relating to positive symptoms.
The study was set up over the Internet. The final analyses considered 36 patients with a probable diagnosis of schizophrenia, and a sample of 40 healthy subjects. Both groups took part on two occasions. In the baseline survey, difficult knowledge questions on neutral (e.g., "On each continent there is a town called Rome." (true)) or emotional (delusion-relevant; e.g., "The German federal police uses approximately 3000 cameras for the purpose of video-based face-detection." (not true)) topics were presented as statements, which were either correct or incorrect. After one week, subjects were requested to take part in the second and final survey. Here, previously presented as well as novel statements had to be appraised according to their truth.
As expected, an overall truth effect was found: statements that were repeated achieved higher subjective truth ratings than novel statements. Patients high on positive symptoms showed an excessive truth effect for emotional (delusion-relevant) items. The positive syndrome was correlated with the emotional truth effect in both healthy and schizophrenia participants.
The sample was recruited via online forums and had probable but not externally validated diagnoses of schizophrenia. No psychiatric control group was tested.
The truth effect for emotional items appears to be exaggerated in patients high on positive symptoms, which may play a role in delusion formation and maintenance. Several limitations of the study however render our conclusions preliminary. As patients with schizophrenia often dwell on and ruminate over selective and distorted pieces of information (e.g., conspiracy theories), the subjective authenticity of this information may be further elevated by means of the truth effect.
Journal of behavior therapy and experimental psychiatry 05/2012; 43(4):1058-63. · 2.48 Impact Factor
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ABSTRACT: Depression is among the most prevalent disorders worldwide. In view of numerous treatment barriers, internet-based interventions are increasingly adopted to "treat the untreated". The present trial (registered as NCT01401296) was conducted over the internet and aimed to assess the efficacy of an online self-help program for depression (Deprexis). In random order, participants with elevated depression symptoms received program access or were allocated to a wait-list control condition. After eight weeks, participants were invited to take part in an online re-assessment. To compensate for common problems of online studies, such as low completion rates and unclear diagnostic status, reminders and incentives were used, and clinical diagnoses were externally confirmed in a subgroup of 29% of participants. Relative to the wait-list group, program users experienced significant symptom decline on the Beck Depression Inventory (BDI; primary outcome), the Dysfunctional Attitudes Scale (DAS), the Quality of Life scale (WHOQOL-BREF) and the Rosenberg Self-Esteem Scale (RSE). Compared to wait-list participants, symptom decline was especially pronounced among those with moderate symptoms at baseline as well as those not currently consulting a therapist. Completion (82%) and re-test reliability of the instruments (r = .72-.87) were good. The results of this trial suggest that online treatment can be beneficial for people with depression, particularly for those with moderate symptoms.
Behaviour research and therapy 05/2012; 50(7-8):513-21. · 3.00 Impact Factor
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ABSTRACT: The attention training technique (ATT) is a cognitive treatment method that is aimed at ameliorating intrusive thoughts in
anxiety disorders. To the best of our knowledge, no randomized controlled study has yet been conducted on individuals with
obsessive–compulsive disorder (OCD). For the present study, we recruited 80 participants with OCD over the internet and allocated
them to an experimental (ATT implemented as bibliotherapy) or a wait-list condition. Assessments were made at baseline and
four weeks later. Groups performed similar at both time points on the self-report version of the Yale-Brown Obsessive Compulsive
Scale (Y-BOCS) and the Obsessive Compulsive Inventory-revised (OCI-R). The present study speaks against the effectiveness
of ATT as a stand-alone bibliotherapeutical approach for OCD. From our data and increasing evidence that OCD patients do not
suffer from severe attention or executive deficits we consider an approach targeting attentional biases for certain OCD-related
events more useful than a generic (i.e., OCD-unspecific) cognitive remediation approach.
KeywordsObsessive–compulsive disorder–Attention training–Cognition–Controlled trial
Journal of Contemporary Psychotherapy 04/2012; 41(3):135-143.
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ABSTRACT: It has been suggested that an exaggerated self-serving bias may underlie the formation of paranoia. One goal of the present
study was to explore whether an abnormality of attributional style is confined to patients with persecutory delusions or extends
to currently non-deluded patients. A second goal was to test whether paranoid patients show an external-personal rather than
an external-situational attributional style for blame. An attributional styles questionnaire was administered to psychiatric
patients diagnosed with schizophrenia (n=35), depression (n=18), and anxiety disorders (n=34), as well as a healthy control group (n=28). For each event (positive or negative outcome) participants were asked to write down what may have led to this event,
and then to endorse the degree to which this event was caused by others/circumstances or themselves. Assessment of the Likert
scale ratings demonstrated that while healthy subjects displayed a significant self-serving bias, currently paranoid and non-paranoid
schizophrenia patients performed intermediately between healthy participants and depressed patients. Analysis of coded verbal
statements indicated that irrespective of event type (positive, negative) patients with persecutory delusions had an even-handed
attribution bias, whereas all other groups predominantly regarded themselves as causal. The latter finding indicates that
acute paranoia may be associated with a decreased locus of internal control, which may promote the occurrence of certain paranoid
beliefs (e.g., feelings of alien control and passivity experiences, respectively).
Cognitive Therapy and Research 04/2012; 31(3):371-383. · 1.33 Impact Factor
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ABSTRACT: Dysfunctions in social cognition are implicated in the pathogenesis of schizophrenia and have been extensively replicated over the years. For memory research, the administration of cognitive tasks with metacognitive aspects like confidence ratings has deepened our insight into how impairments contribute to symptoms of the disorder. A total of 76 patients with schizophrenia or schizoaffective disorder and a sample of 30 healthy participants were tested with the Reading the Mind in the Eyes test (Eyes-test). The Eyes-test was complemented with a rating scale requesting response confidence and was administered along with paradigms tapping neuropsychological parameters and cognitive insight. Schizophrenia patients showed impaired abilities on mental state perception. In addition, they committed more high-confidence errors and at the same time made fewer high-confidence correct responses. Impairments were most pronounced in patients with formal thought disorder. The patients displayed a decreased metacognitive awareness for their deficits. The results suggest that adding confidence ratings to the investigation of social cognition promises to advance our understanding of social cognition in schizophrenia. Patients not only show severe impairments in social cognition, but are overconfident in their judgments and lack cognitive insight into their deficits. The results highlight the need for metacognitive therapeutic approaches for the treatment of this population.
Psychiatry Research 04/2012; 196(1):1-8. · 2.52 Impact Factor
