ArticleJournal of psychiatric research2020
A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances.
Article in Journal of psychiatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06127004 (Metacognitive Training for Negative Symptoms), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metacognitive Training for Negative Symptoms (MCT Minus)
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- From Memories of Past Experiences to Present Motivation? A Meta-analysis on the Association Between Episodic Memory and Negative Symptoms in People With Psychosis.Schizophrenia bulletin · 2022Pooled it
- Impact of the Unified Protocol on Attenuated Psychotic Symptoms, Cognitive Biases and Cognitive Insight in Patients at Ultra High Risk (UHR) for Psychosis: Secondary Results of a Pilot Randomized Controlled Trial.Journal of clinical psychology · 2026Trial
- Article
- Effectiveness of Psychological Intervention Methods for the Management of Positive and Negative Symptoms in Schizophrenia Patients: A Systematic Review and Network Meta-analysis.Indian journal of psychological medicine · 2025Review
- A primer on meta-awareness of mind wandering in schizotypy and schizophrenia.Psychological research · 2025Review
- Narrative-Derived Indices of Metacognition among People with Schizophrenia: Associations with Self-Reported and Performance-Based Social Functioning.Behavioral sciences (Basel, Switzerland) · 2024Article
- Lower cohesion and altered first-person pronoun usage in the spoken life narratives of individuals with schizophrenia.Schizophrenia research · 2023Article
- Linguistic findings in persons with schizophrenia-a review of the current literature.Frontiers in psychology · 2023Review
- Optimal cutoff scores of the Chinese version of 15-item negative symptom assessment that indicate prominent negative symptoms of schizophrenia.Frontiers in psychiatry · 2023Article
- Pleasant and unpleasant odor identification ability is associated with distinct dimensions of negative symptoms transdiagnostically in psychotic disorders.Schizophrenia research · 2022Article
- 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 · 2021Review
- Negative Symptom Domains Are Associated With Verbal Learning in Adolescents With Early Onset Psychosis.Frontiers in psychiatry · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
Abstract
The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive symptoms interact and thus interfere with persons' ability to understand and express emotions in ways others can recognize. Individuals with schizophrenia-spectrum disorders (N = 201) provided personal narratives detailing their life story and reflections about their mental illness. Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants' personal narratives via Coh-Metrix 3.0, an automated program that calculates language indices. Diminished expression and cognitive symptoms were measured with the Positive and Negative Syndrome Scale. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive symptoms and situation models on diminished expression. Results of the SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.073, p = .008, ±95% CI [-0.126, -0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (β = 0.099, p = .001, ±95% CI [0.038, 0.160]). In conclusion, results suggest that self-reflectivity, linguistic cohesion, and cognitive symptoms may be useful targets for intervention in efforts to treat diminished expression in psychosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.