Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders
Résumé
Metacognitive deficits are well documented in schizophrenia spectrum disorders as a decreased capacity to adjust confidence to performance in a cognitive task. Because metacognitive ability directly depends on task performance, metacognitive deficits might be driven by lower task performance among patients. To test this hypothesis, we conducted a Bayesian meta-analysis of 42 studies comparing metacognitive abilities in 1425 individuals with schizophrenia compared to 1256 matched controls. We found a global metacognitive deficit in schizophrenia (g = −0.57, 95 % CrI [−0.72, −0.43]), which was driven by studies which did not control task performance (g = −0.63, 95 % CrI [−0.78, −0.49]), and inconclusive among controlled-studies (g = −0.23, 95 % CrI [−0.60, 0.16], BF01 = 2.2). No correlation was found between metacognitive deficit and clinical features. We provide evidence that the metacognitive deficit in schizophrenia is inflated due to non-equated task performance. Thus, efforts should be made to develop experimental protocols accounting for lower task performance in schizophrenia.
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