What if metacognition is not enough? Its association with delusion may be moderated by self-criticism

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Simone Cheli, Veronica Cavalletti, Francesco Mancini, Gil Goldzweig (2021): What if metacognition is not enough? Its association with delusion may be moderated by self-criticism. In: Current Psychology, 2021.

Abstract

Metacognition among those reporting psychotic symptoms is associated with a distortion in the way they understand their own
and others’ mental states. Recent advances suggest that distortion in the form of self-criticism may activate a threat response
and fuel symptom expression. At high level of self-criticism metacognition may reduce its protective role towards psychosis.
Here, we explored whether the associations between impaired self-reflectivity and delusional ideation would decrease in
the presence of self-criticism. A moderated regression model confirmed our hypothesis in a large sample of healthy young
adults (N = 2065) even when controlled for sex, education, and family income. Our findings suggest how interventions aimed
at reducing symptoms and promoting metacognition should always be interconnected with those targeting self-criticism.

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