Metacognitive mastery moderates the relationship between positive symptoms and distress in adults with serious mental illness

Abstract

Background Research supports the possibility that a person’s metacognitive ability may influence the impact of positive symptoms. This connection is important because understanding how metacognitive capacity relates to positive symptoms and distress can guide treatment and bolster recovery. Aims To explore this, we assessed the moderating role of Metacognitive Mastery on the relationship of positive symptoms to affective symptoms, or markers of distress, measured both concurrently and at a later time point (to assess durability of metacognition) with persons with serious mental illness. To rule out the possibility that any findings were the result of cognitive impairments or general psychopathology we included measures of neurocognition and symptoms as potential covariates. Methods Participants were 67 individuals with the majority diagnosed with either schizophrenia spectrum disorder, major depressive disorder, or bipolar disorder. Metacognition was measured with the Metacognitive Assessment Scale–Abbreviated, symptoms were measured using the Brief Psychiatric Rating Scale and verbal memory was measured using the California Verbal Learning Test. Results Metacognitive Mastery moderated the relationship between positive symptoms and affective symptoms at both time points with differential patterns at each point. Conclusions Metacognitive Mastery may exert a complex influence upon the effects of positive symptoms on distress.