Metacognitive Training Research Articles

Executive function improvement in response to meta-cognitive training in chronic mTBI / PTSD.

We tested Goal Management Training (GMT), which has been recommended as an executive training protocol that may improve the deficits in the complex tasks inherent in life role participation experienced by those with chronic mild traumatic brain injury and post-traumatic stress disease (mTBI/PTSD). We assessed, not only cognitive function, but also life role participation (quality of life). We enrolled and treated 14 individuals and administered 10 GMT sessions in-person and provided the use of the Veterans Task Manager (VTM), a Smartphone App, which was designed to serve as a "practice-buddy" device to ensure translation of in-person learning to independent home and community practice of complex tasks. Pre-/post-treatment primary measure was the NIH Examiner, Unstructured Task. Secondary measures were as follows: Tower of London time to complete (cTOL), Community Reintegration of Service Members (CRIS) three subdomains [Extent of Participation; Limitations; Satisfaction of Life Role Participation (Satisfaction)]. We analyzed pre-post-treatment, t-test models to explore change, and generated descriptive statistics to inspect given individual patterns of change across measures. There was statistically significant improvement for the NIH EXAMINER Unstructured Task (p < .02; effect size = .67) and cTOL (p < .01; effect size = .52. There was a statistically significant improvement for two CRIS subdomains: Extent of Participation (p < .01; effect size = .75; Limitations (p < .05; effect size = .59). Individuals varied in their treatment response, across measures. In Veterans with mTBI/PTSD in response to GMT and the VTM learning support buddy, there was significant improvement in executive cognition processes, sufficiently robust to produce significant improvement in community life role participation. The individual variations support need for precision neurorehabilitation. The positive results occurred in response to treatment advantages afforded by the content of the combined GMT and the employment of the VTM learning support buddy, with advantages including the following: manualized content of the GMT; incremental complex task difficulty; GMT structure and flexibility to incorporate individualized functional goals; and the VTM capability of ensuring translation of in-person instruction to home and community practice, solidifying newly learned executive cognitive processes. Study results support future study, including a potential randomized controlled trial, the manualized GMT and availability of the VTM to ensure future clinical deployment of treatment, as warranted.

Metacognitive Awareness Perceptions of Students with High and Low Scores on TIMSS-Like Science Tests

The current study explores the differences in metacognitive awareness perceptions of students who had high and low scores on TIMSS-like science tests. The sample consisted of 937 Omani students, 478 in Grade Five and 459 in Grade Nine. TIMSS-like tests were specially designed for both grade levels, and students also completed a metacognitive awareness perceptions inventory which explored their use of four main skills: planning, information management strategies, debugging strategies and evaluation. MANOVA was used to analyze the data. The findings indicated that students with high scores in the TIMSS-like test out-performed students with low scores in the test on all four metacognitive skills surveyed. This was true for all three performance areas analysed: performance in the TIMSS-like test as a whole, performance in lower-level test questions and performance in higher-level test questions. These findings highlight the extent to which students’ metacognitive skills influence their performance in science tests. The study recommends that students be trained to improve their metacognitive skills, reviews several methods for doing this, and suggests that such training might better prepare them for taking science tests. However, it also notes that further research is needed to explore the impact of metacognitive training on student performance in specific science examinations such as TIMSS.

Metacognitive training for negative symptoms: Support for the cognitive model.

Developing effective treatment options for negative symptoms of psychotic disorders remains a major unmet treatment need and area for further research. In a recent uncontrolled study by the main author, Metacognition Training (MCT) for negative symptoms was found to lead to fewer negative symptoms, less stigma and increased self-rated reflective ability. As the analysis examined negative symptoms as a whole, we here performed an additional analysis on individual negative symptom items as recent research has suggested that negative symptoms are best conceptualized through a five-factor model. It was found that the intervention led to changes specifically on sociality and blunted affect (with large effect sizes), which might reflect changes in both intrapersonal and interpersonal (meta)cognitive processes.

Moderators of metacognitive strategy training for executive functioning in early schizophrenia and psychosis risk

Goal Management Training (GMT) improved self-reported executive functioning in a recent randomized, controlled trial in early intervention for psychosis participants. Little is known about the mechanism for this benefit, so this study investigates objectively measured executive function, the difference between subjective and objective executive function, independent living and employment status as potential moderators of efficacy of GMT.Baseline scores from 81 participants (GMT n = 39 vs Treatment-as-usual; TAU n = 42) were analyzed in a linear mixed model analysis for repeated measures as predictors of improvement on the self-reported Behavior Rating Inventory of Executive Function–Adult version (BRIEF-A) immediately and 30 weeks after GMT. Potential moderators were scores from objective measures of executive functioning, discrepancy between subjective and objective measures, independent living and employment status. Discrepancy was assessed by comparing four clusters of participants with differing patterns of scores.The effect of GMT remained significant regardless of initial objective executive functioning at baseline. Those with higher subjective complaints at baseline in two clusters with (i) both objective and subjective executive dysfunction, and (ii) mostly subjective executive dysfunction experienced greater change after treatment. Living arrangements or participation in education or work did not significantly moderate the effects of GMT.Poor performance on neuropsychological tasks is not an obstacle to making use of GMT, but further knowledge is needed about the benefits of strategy training for individuals with a combination of poor performance with few subjective complaints.

Is Metacognitive Training effective for improving neurocognitive function in patients with a recent onset of psychosis?

The aims are to assess improvements in memory, attention and executive function in first-episode psychosis after Metacognitive Training (MCT). A multicenter randomized clinical trial was performed with two arms: MCT and psychoeducational intervention. A total of 126 patients with a diagnosis of psychosis, less than 5 years from the onset of the disease, were included. Patients were assessed two or three moments (baseline, post-treatment, 6 months follow-up) depending on the test, with a battery of neurocognitive tests (TAVEC, TMTA-B, CPT, WCST, Stroop and premorbid IQ). General linear models for repeated measures were performed. A better improvement in the MCT was found by an interaction between group and time in CPT Hit index, TMTB, Stroop, recent memory and number of perseverations of the TAVEC. Considering three assessments, a better improvement was found in non-perseverative, perseverative and total errors of the WCST and TMTB. The MCT is an effective psychological intervention to improve several cognitive functions.

Heterogeneity in Response to MCT and Psychoeducation: A Feasibility Study Using Latent Class Mixed Models in First-Episode Psychosis.

Metacognitive training (MCT) is an effective treatment for psychosis. Longitudinal trajectories of treatment response are unknown but could point to strategies to maximize treatment efficacy during the first episodes. This work aims to explore the possible benefit of using latent class mixed models (LCMMs) to understand how treatment response differs between metacognitive training and psychoeducation. We conducted LCMMs in 28 patients that received MCT and 34 patients that received psychoeducation. We found that MCT is effective in improving cognitive insight in all patients but that these effects wane at follow-up. In contrast, psychoeducation does not improve cognitive insight, and may increase self-certainty in a group of patients. These results suggest that LCMMs are valuable tools that can aid in treatment prescription and in predicting response to specific treatments.

Transfer of metacognitive skills in self-regulated learning: effects on strategy application and content knowledge acquisition

Metacognitive skills are often considered domain-general, therefore they have the potential to transfer across domains, subjects, and tasks. However, transfer of metacognitive skills seldomly occurs spontaneously. Schuster et al., (2020) showed that training can have beneficial effects on spontaneous near and far transfer of metacognitive skills. However, evidence of metacognitive skill transfer resulting in superior acquisition of content knowledge is pending. In the present study we set out to extend prior findings by investigating whether students benefit from training metacognitive skills not only regarding metacognitive skill application but also regarding content knowledge acquisition in learning tasks of different transfer distances. 243 fifth-grade students were randomly assigned to three different conditions for the first 15 weeks of a school year: two hybrid metacognitive skill training conditions (metacognitive skills and one out of two cognitive strategies) and one non-hybrid training condition (cognitive strategies or motivation regulation only). For the second 15 weeks of the school year, all students received non-hybrid training involving a new cognitive strategy. Spontaneous metacognitive skill transfer of different transfer distances (near and far) was tested after the first and after the second 15 weeks of training. The effect of hybrid metacognitive skill training on the acquisition of content knowledge was measured once directly after the first 15 weeks. Results show that hybrid metacognitive skill training supported spontaneous transfer of metacognitive skills to learning scenarios of both near and far transfer distance. However, hybrid metacognitive skill training only had a positive effect on content knowledge acquisition if metacognitive skill transfer was near.

Metacognitive Strategies in Undergraduate College Students’ English Writing Based on Optimization Theory

In the existing research, scholars have different views on the concept and structure of metacognition. Based on different theories, they produce different training methods of metacognition strategies. However, because the training design and training process in the experiment are too complicated and the time is difficult to control, it remains difficult to effectively extend this kind of training to more educational fields. This paper deeply integrates the optimization theory with the case teaching of college students’ English writing in undergraduate colleges and proposes the optimal design of the case teaching process. The optimal design is mainly carried out according to four processes: English writing education consultation, English writing teaching case compilation, English writing case teaching implementation, and English writing case teaching evaluation. In ordinary English writing, students focus on four aspects: preplanning, selective attention, self-monitoring, self-evaluation, and adjusting, controlling, and managing one's own cognitive activities according to self-monitoring metacognitive strategies, mastering the optimization theory, and adjusting the writing speed are self-adjustment and self-evaluation according to one's own situation. In the selected dimensions of English writing, the mean of the postwriting test was higher than that of the prewriting test. The mean of the “average sentence length” increased from 8.6 to 19.1. Integrating metacognitive strategy training into English writing teaching can improve students’ English writing ability.

Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia

IntroductionMoritz et al.’s metacognitive training (MCT), a new development of cognitive therapy, is a manualised group training programme, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia. Methods50 outpatients from the Hospital Del Salvador in Valparaíso, Chile, were randomly assigned to the intervention group that received MCT or the control group that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS). ResultsGreater statistically significant improvements were recorded in the MCT group, both in symptoms and cognitive biases and in cognitive insight, than in the control group. When comparing both groups, significant results in favor of MCT were only observed in positive symptoms. ConclusionsThe results of this study suggest MCT is superior to TAU in treating positive symptoms. It was not possible to demonstrate its superiority in improving cognitive biases and cognitive insight.

Effect of Online Metacognitive Training on Health Anxiety and Mental Health of Medical Students During the COVID-19 Pandemic: A Randomized Clinical Trial

Objectives Students are the spiritual assets of each country. Anxiety and mental health problems negatively affect their performance. This study aims to assess the effect of online group metacognitive training on the medical students’ health anxiety and general health during the COVID-19 pandemic. Methods This a randomized clinical trial. Participants were 56 students of Mashhad University of Medical Sciences aged 18-30 years who were selected by a convenience sampling method and were randomly divided into two groups of intervention and control. The intervention group received online metacognitive training at 8 sessions, each for one hour, while the control group did not receive any intervention. At three stages of pre-test, post-test, and one-month follow-up, they completed Salkovskis and Warwick’s short health anxiety inventory and the 28-item general health questionnaire. Data were analyzed in SPSS software, version 23. Using the repeated measures analysis of variance (ANOVA) test. Results Metacognitive training was effective in reducing health anxiety and improving general health of students (P&lt;0.05). The results remained significant one month after the intervention. Conclusion Metacognitive training online can reduce health anxiety and improve general health of medical students during the COVID-19 pandemic.

Metacognitive strategy training versus psychoeducation for improving fatigue in children and adolescents with acquired brain injuries: A randomized controlled trial.

The present study aims to explore the relative effectiveness of two group-based cognitive rehabilitation programs for reducing fatigue in pediatric acquired brain injury (pABI). This is an exploratory study of secondary endpoints in a blinded, parallel-randomized controlled trial with children and adolescents (ages 10-17 years) with pABI and reported executive dysfunction. It investigates the effectiveness of a metacognitive program (pediatric goal management training, n = 36) compared to a psychoeducational program (pediatric brain health workshop, n = 37) for reducing fatigue (Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale), 8 weeks and 6 months postintervention. Seventy-three participants completed the allocated interventions, and 71 attended the 6-month follow-up. The results showed a significant decrease in parent-reported fatigue for both interventions from baseline to the 6-month follow-up. Forty percent of the total sample had a reliable change. There was no significant difference between the intervention groups, but a tendency in favor of the psychoeducational approach. Only subscales cognitive and sleep/rest fatigue showed significant reductions. In regression analyses, several factors predicted fatigue at 6 months follow-up, but only better global outcome and executive attention predicted a decrease in fatigue symptoms after 6 months. Group-based cognitive rehabilitation in the chronic phase of pABI, including education of parents and teachers, may be helpful in reducing fatigue. Global outcome and executive attention at baseline predicted fatigue improvement. Developmental factors are important to consider when tailoring pediatric interventions, as well as modifiable factors associated with fatigue. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Metacognitive Skills Training: Exploring the Role in Pupil Teachers' Academic Performance

The current study was conducted to explore the role of Metacognitive skills in prospective teachers' academic performance. Qualitative research was conducted. The Interpretivist paradigm has been followed for this study. This study was a follow-up of a quantitative experiment The sample of four male and four female prospective teachers enrolled in the B.Ed Honors in a public university has been selected with the help of a purposive sampling technique. A semi-structured interview protocol consisting of 10 items was used for the data collection. The data was analyzed with the help of Thematic analysis. According to the research participants' views, they not only learnt Metacognitive skills but also used them during their studies and task performance. They found these skills helpful in conducting the tasks successfully and effectively. So, it is recommended that teacher educators should use Metacognitive development strategies to develop these skills in prospective teachers.

Mindfulness for Anxiety Management and Happiness: The Role of VR, Metacognition, and Hormones

Chronic stress, even at a young age, has become a major health concern with the harmful effects on cognition, mood, and well-being largely underestimated. Mindfulness interventions are well-recognized as effective strategies in stress management. However, we know less about the impact of mindfulness on physiological indicators such as hormones/neurotransmitters. This review study aims to provide representative studies regarding the impact of mindfulness practices on hormones and neurotransmitters, which are responsible for stress regulation, positivity, and wellness. Taking into consideration the difficulties that many people have to follow a conventional mindfulness program, we also investigated the effectiveness of virtual reality as an assistive tool for mindfulness training. The results confirmed our initial hypothesis, according to which mindfulness training reduces stress hormones while increasing hormones/neurotransmitters which induce relaxation along with positivity and self-satisfaction. Virtual reality provides several advantages facilitating training conditions, optimizing the experience, and increasing the effectiveness of interventions. In addition, it strengthens self-control skills. These results indicate also that those physiological parameters, which are considered to be out of human control, can be modified with self-control practices. We conclude that mindfulness practices constitute a form of metacognitive training by which individuals can take control and balance the physiological processes that determine cognition, mood, and well-being. Virtual reality maximizes therapeutic outcomes, especially for people with disabilities or difficulties with conventional interventions.

He Study of Meta-cognitive Strategy Training Based on Higher Vocational English Newspaper Learning under the Digital Context

This paper explores students’ attitudes towards meta-cognitive strategy and its teaching effectiveness through training of meta-cognitive strategy for freshmen in higher vocational English course. The study shows that it is feasible to incorporate meta-cognitive strategy training into English newspaper teaching in current digital context, which can help improve students' awareness of self-study.

He Study of Meta-cognitive Strategy Training Based on Higher Vocational English Newspaper Learning under the Digital Context

This paper explores students’ attitudes towards meta-cognitive strategy and its teaching effectiveness through training of meta-cognitive strategy for freshmen in higher vocational English course. The study shows that it is feasible to incorporate meta-cognitive strategy training into English newspaper teaching in current digital context, which can help improve students' awareness of self-study.

Mindfulness Strategies for Metacognitive Skills Training in Special Education: The Role of Virtual Reality

The purpose of the current review study is to provide representative evidence regarding the effectiveness of mindfulness training strategies on the development of metacognitive skills for people with special education needs. In addition, we explore the role of virtual reality in the efficacy of mindfulness interventions among people with learning disabilities, neurodevelopmental disorders, intellectual disabilities, and behavioral disorders. In addition, we present innovative mindfulness training strategies, appropriate for metacognitive skills training in special education. Finally, we seek the features that possibly make virtual reality a fertile ground for the implementation of mindfulness training. The results showed that mindfulness training improves the metacognitive skills needed for the inclusion of people with disabilities. Virtual reality constitutes an effective assistive technology that can facilitate mindfulness training in various contexts, accelerating positive outcomes in mental and physical health, academic performance, and well-being.

Metacognitive Therapy in Patients with Obsessive-Compulsive Disorder: A review.

Metacognitive therapy is a relatively novel and growing psychotherapeutic approach. Within the last 20 years, several metacognitive-oriented therapy methods have been developed. They are metacognitive therapy which was developed by Wells, metacognitive training which was produced by Moritz et al. especially for patients with psychotic disorder, and metacognitive reflection and insight therapy for psychotic patients. Among them, the most structured one seems the metacognitive therapy. The main notion of metacognitive therapy is to alter the dysfunctional metacognitive interpretations and strategies underlying psychopathology. However, it should be emphasized that it has some fundamental differences from cognitive behavioral therapy because metacognitive therapy is a relatively new school of cognitive therapy, its effectiveness in the treatment of many psychiatric disorders continues to be evaluated intensively. Obsessive-compulsive disorder is one of these disorders. As obsessive-compulsive disorder is a lifelong disorder that causes significant loss of workforce and pharmacotherapy is sometimes insufficient, psychotherapeutic approaches are of great importance. In this context, exposure and response prevention still seems to be an important treatment option in terms of psychotherapeutic approaches. However, it is clear that a new approach is required in psychiatry practice in cases where exposure and response prevention and classical cognitive behavioral therapy are not sufficient and remain with residual symptoms. In this respect, metacognitive therapy can be an important alternative to fill this gap. However, more evidence needs to be created with studies with much larger samples.

P09.02.B Engaging Parents in Neuropsychological Rehabilitation for Childhood Cancer Survivors: The I’M aware: Patients And Carers Together (ImPACT) Program

Abstract Background Cognitive impairment is the most common late effect in childhood cancer survivors (CCS). A third are likely to experience impairments in skills such as attention, processing speed, memory, and executive function. Neurobehavioral impairments are also observed in CCS (e.g., apathy) and may underlie cognitive impairment. Although these problems can impair quality of life, scholastic achievement and long-term socioeconomic outcomes, there is a dearth of research on interventions to treat cognitive impairment in CCS. Cognitive rehabilitation studies in CCS have focused primarily on computerized cognitive training and meta-cognitive strategy training, but with limited effects and poor study designs. They have lacked four key elements: 1) transfer of learning to real-world functional outcomes; 2) awareness training to enhance compensatory strategy use, particularly since CCS may experience neurological unawareness preventing the optimal application of strategies; 3) inclusion of parents that could enhance transfer of learning to the home; and 4) recognition of the inter-related nature of cognitive, neurobehavioral, and psychological functions. A novel, context-sensitive neuropsychological rehabilitation program has been developed for CSS to address these missing elements - the “I’M aware: Patients and Carers Together (ImPACT)” program - based on an evidenced-based approach pioneered at NYU Hospital in the US. In this protocol, the feasibility, acceptability, and preliminary efficacy of the ImPACT program (8 x 1 hour sessions) will be evaluated. Material and Methods Phase One will consist of semi-structured interviews with 5 to 10 CCS and their parents in order to review and refine procedures for the ImPACT program. In Phase Two, twenty participants will be randomized to a wait-list control (WLC) or intervention group. WLCs will not receive the intervention immediately, but will serve as the control comparison group. Measures of self- and parent-reported cognition, neurobehavioral function, and global function will be administered pre- and post- intervention, and 9 weeks later (or equivalent time points for WLCs). Results Results of this project will provide vital data in support of a future large-scale trial. Conclusion Findings could have implications for the management of cognitive and neurobehavioral impairment in CCS that could transform the nature of services provided to CCS. The program can be delivered remotely or in-person and harnesses existing supports in the child’s life to promote real-world functioning.

Efficacy of metacognitive strategy training on reducing disability of post-stroke survivor: A pilot study

Background: Post-stroke survivors experience significant challenges with their functional health. Despite advances in neuro-rehabilitation, they cannot participate in meaningful daily life activities, leading to disability. Many intervention approaches are applied in stroke rehabilitation to make them independent and lead a quality life. Objectives: The objective of this pilot study was to investigate the effect of the Metacognitive Strategy Training (MCST) on Conventional Occupational Rehabilitation Therapy on improving independence and reducing the disability of post-stroke survivors. Materials and methods: Thirty subjects with post-stroke syndrome participated in an exploratory, double-blind, randomized controlled trial with pre-post and follow-up studies. Subjects were randomized over two intervention groups. Group-1 received MCST with conventional therapy (n=15), and Group-2 conventional therapy only (n=15). The Functional Independence Measure (FIM) measures independence at baseline (Time1), post-intervention (Time2), and after six months (Time3). Results: Changes in Functional Independence Measure scores for the two groups over six months showed significant effects of group (F(1,24)=9.422, p&lt;0.005), time (F(1.160, 27.848)=21.449, p&lt;0.0001) but time and group interaction was not significantly affected (F(1.160, 27.848)=0.172, p=0.719). Post hoc analysis with a Bonferroni adjustment revealed that FIM was statistically significantly increased from pre-intervention to post-intervention (22.597 (95% CI, 34.511 to 10.683), p&lt;0.0001), and from pre-intervention to six month follow up. (24.203 (95% CI,37.554 to 10.853), p=0.0001), but not from post-intervention to six months (1.606 (95% CI, -5.988 to 2.776), p=1.000). Conclusion: MCST has better efficiency in reducing disability and improving the independence of post-stroke survivors in the long term.

Metacognitive improvement: Disentangling adaptive training from experimental confounds.

Metacognition is defined as the capacity to monitor and control one's own cognitive processes. Recently, Carpenter and colleagues (2019) reported that metacognitive performance can be improved through adaptive training: healthy participants performed a perceptual discrimination task, and subsequently indicated confidence in their response. Metacognitive performance, defined as how much information these confidence judgments contain about the accuracy of perceptual decisions, was found to increase in a group of participants receiving monetary reward based on their confidence judgments over hundreds of trials and multiple sessions. By contrast, in a control group where only perceptual performance was incentivized, metacognitive performance remained constant across experimental sessions. We identified two possible confounds that may have led to an artificial increase in metacognitive performance, namely the absence of reward in the initial session and an inconsistency between the reward scheme and the instructions about the confidence scale. We thus conducted a preregistered conceptual replication where all sessions were rewarded and where instructions were consistent with the reward scheme. Critically, once these two confounds were corrected we found moderate evidence for an absence of metacognitive training. Our data thus suggest that previous claims about metacognitive training are premature, and calls for more research on how to train individuals to monitor their own performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).