Metacognition, coping styles and social functioning in psychosis patients

Abstract

Despite pharmacological and psychological intervention for schizophrenic patients that had developed for a few decades, only 13.7% of the patients could attain functional remission. Current research urged to examine the determinant of functional outcome for schizophrenic patients. The linkage between cognitive deficit and functional impairment had been well supported. However, the effect of cognitive remediation on specific cognitive ability was far from satisfactory. Emerging evidence showed that metacognition was mediating the relationship between cognitive deficit and functional impairment. The current study aimed at investigating whether problem-focused coping served as a mediator between metacognitive deficit and functional impairment. Thirty-four patients with schizophrenia spectrum disorder from a local psychiatric outpatient clinic were recruited. They were asked to tell their personal narrative to assess their metacognitive ability in a more ecologically valid way when compared to previous studies. Semi-structured interviews were also conducted to assess their symptom severity, insight and social functioning. Self-rate questionnaires were distributed to assess their coping styles. Result suggested deficit in patients’ metacognitive ability. Patients with higher metacognitive mastery used problem-focused coping more frequently, while patients with higher relative use of problem-focused coping had better social functioning in immediate social network. Problem-focused coping was found to be a significant mediator of the relationship between metacognitive mastery and social functioning in immediate social network. Clinical implication on future treatment direction to improve patient’s functional outcome was discussed.