Effect of Metacognitive Training for Patients with Schizophrenia on their Delusions and Cognitive Insight.

Document Type : Research articles

Authors

1 Assistant lecturer Psychiatric Nursing and Mental Health, Faculty of Nursing, Damanhour University

2 Professor Psychiatric Nursing and Mental health, Faculty of Nursing, Alexandria University

3 Assistant Professor Psychiatric Nursing and Mental health, Faculty of Nursing, Alexandria University

Abstract

Background: Delusions are key symptoms of schizophrenia that are often accompanied by
distress, and may result in hazardous decisions including assaulting others or suicide.
Impaired cognitive insight is also prevalent in schizophrenia and is thought to perpetuate
the development and maintenance of delusions and hallucinations. The implementation of
metacognitive training (MCT) for patients with schizophrenia in rehabilitation programs
may help them to become aware of their cognitive biases and begin to train the mind in an
attempt to slow the progression of delusions. Aim of study: Determine the effect of
metacognitive training on delusions and cognitive insight among patients with
schizophrenia. Research hypothesis: Patients with schizophrenia who participate in the
MCT exhibit significant lower levels of delusions` severity and higher level of cognitive
insight than before participation in the MCT. Setting: The study was conducted in the
inpatient wards of EL-Maamoura Hospital for Psychiatric Medicine. Sampling: A sample
of 25 randomly selected male and/or female patients with schizophrenia out of a population
size of 164. The sample was subdivided into 5 groups; 5 patients each. Results: the
patients' total score of delusions’ severity significantly decreased after MCT from 14.32 ±
1.68 in pre-test to 8.20 ± 2.43 in post- test by the end of MCT, (t=15.249, P<0.001). As
well, the total mean score of cognitive insight increased significantly throughout the study
phases, from -0.04±5.87 at the pre-test to 9.56±4.91 at the post-test, (t=13.954, p< 0.001).
Conclusion: The results revealed the efficacy of MCT for patients with schizophrenia; it
significantly improves the lives of individuals living with this challenging mental illness.
The MCT reduces delusions by training patients to be less confident in their judgments and
to seek more evidence, modify the “cognitive infrastructure” of delusional ideation, and to
prompt participants to critically reflect on, complement, or change their level of insight.
Recommendations: The MCT has to be included in the plan of patients` care to translate
the effects of MCT into meaningful changes in everyday life and outcomes that improve
patients’ lives.

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