Editing Metacognition (section)

==Mental illness==

===Sparks of interest===
In the context of mental health, metacognition can be loosely defined as the process that "reinforces one's subjective sense of being a self and allows for becoming aware that some of one's thoughts and feelings are symptoms of an illness".<ref>{{cite journal|author1=Lysaker, P. H.|author2=Dimaggio, G.|author3=Buck, K. D.|author4=Callaway, S. S.|author5=Salvatore, G.|author6=Carcione, A.|author7=Stanghellini, G.|name-list-style=amp|year=2011|title=Poor insight in schizophrenia: Links between different forms of metacognition with awareness of symptoms, treatment needed, and consequences of illness|journal=Comprehensive Psychiatry|volume=52|issue=3|pages=253–60|pmid= 21497218|doi=10.1016/j.comppsych.2010.07.007}}</ref> The interest in metacognition emerged from a concern for an individual's ability to understand their own mental status compared to others as well as the ability to cope with the source of their distress.<ref>{{cite journal | last1 = Semerari | first1 = A. | last2 = Carcione | first2 = A. | last3 = Dimaggio | first3 = G. | last4 = Falcone | first4 = M. | last5 = Nicol | first5 = G. | last6 = Procacci | first6 = M. | last7 = Alleva | first7 = G. | year = 2003 | title = How to evaluate Metacognitive function in psychotherapy? The Metacognition Assessment Scale and its applications | journal = Clinical Psychology & Psychotherapy | volume = 10 | issue = 4| pages = 238–261 | doi=10.1002/cpp.362}}</ref> These [[insights]] into an individual's mental health status can have a profound effect on overall prognosis and recovery.
Metacognition brings many unique insights into the normal daily functioning of a human being. It also demonstrates that a lack of these insights compromises 'normal' functioning. This leads to less healthy functioning. In the [[autism]] spectrum, it is speculated that there is a profound deficit in [[theory of mind]].<ref>{{cite journal|author1=Lysaker, P. H.|author2= Dimaggio, G.|name-list-style=amp|year=2011|title=Metacognitive disturbances in people with severe mental illness: Theory, correlates with psychopathology and models of psychotherapy|journal=Psychology and Psychotherapy: Theory, Research and Practice|volume=84|issue=1|pages= 1–8|doi=10.1111/j.2044-8341.2010.02007.x|pmid=22903827}}</ref>
In people who identify as alcoholics, there is a belief that the need to control cognition is an independent predictor of alcohol use over anxiety. Alcohol may be used as a coping strategy for controlling unwanted thoughts and emotions formed by negative perceptions.<ref>{{cite journal | last1 = Spada | first1 = M. M. | last2 = Zandvoort | first2 = M. | last3 = Wells | first3 = A. | year = 2007 | title = Metacognitions in problem drinkers | journal = Cognitive Therapy and Research | volume = 31 | issue = 5| pages = 709–716 | doi = 10.1007/s10608-006-9066-1 | s2cid = 8935940 }}</ref> This is sometimes referred to as [[self medication]].

===Implications===

[[Adrian Wells]]' and Gerald Matthews' theory proposes that when faced with an undesired choice, an individual can operate in two distinct modes: "object" and "metacognitive".<ref>Wells, A. & Mathews, G. (1997). Attention and Emotion. A clinical perspective. Hove, UK: Erlbaum.</ref> Object mode interprets perceived stimuli as truth, where metacognitive mode understands thoughts as cues that have to be weighted and evaluated. They are not as easily trusted. There are targeted interventions unique of each patient, that gives rise to the belief that assistance in increasing metacognition in people diagnosed with schizophrenia is possible through tailored psychotherapy. With a customized therapy in place, clients then have the potential to develop greater ability to engage in complex self-reflection.<ref>{{cite journal | last1 = Lysaker | first1 = P. H. | last2 = Buck | first2 = K. D. | last3 = Carcione | first3 = A. | last4 = Procacci | first4 = M. | last5 = Salvatore | first5 = G. | last6 = Nicolò | first6 = G. | last7 = Dimaggio | first7 = G. | year = 2011 | title = Addressing metacognitive capacity for self-reflection in the psychotherapy for schizophrenia: A conceptual model of the key tasks and processes | journal = Psychology and Psychotherapy: Theory, Research and Practice | volume = 84 | issue = 1| pages = 58–69 | doi=10.1348/147608310X520436 | pmid=22903831 }}</ref> This can ultimately be pivotal in the patient's recovery process. In the [[obsessive–compulsive spectrum]], cognitive formulations have greater attention to [[intrusive thought]]s related to the disorder. "Cognitive self-consciousness" are the tendencies to focus attention on thought. Patients with OCD exemplify varying degrees of these "intrusive thoughts". Patients also with [[generalized anxiety disorder]] also show negative thought process in their cognition.<ref>{{cite journal | last1 = Jacobi | first1 = D. M. | last2 = Calamari | first2 = J. E. | last3 = Woodard | first3 = J. L. | year = 2006 | title = Obsessive-Compulsive Disorder Beliefs, Metacognitive Beliefs and Obsessional Symptoms: Relations between Parent Beliefs and Child Symptoms | journal = Clinical Psychology & Psychotherapy | volume = 13 | issue = 3| pages = 153–162 | doi = 10.1002/cpp.485 }}</ref>

Cognitive-attentional syndrome (CAS) characterizes a metacognitive model of emotion disorder (CAS is consistent with the attention strategy of excessively focusing on the source of a threat).<ref>{{Cite journal|date=2019-05-01|title=Cognitive-attentional syndrome – The psychometric properties of the CAS-1 and multi-measure CAS-based clinical diagnosis|journal=Comprehensive Psychiatry|language=en|volume=91|pages=13–21|doi=10.1016/j.comppsych.2019.02.007|issn=0010-440X|doi-access=free|last1=Kowalski|first1=Joachim|last2=Dragan|first2=Małgorzata|pmid=30884400}}</ref><ref>{{Cite journal|date=2020-11-01|title=Childhood adversities and psychopathology in participants with high and low severity of cognitive-attentional syndrome symptoms|url=https://www.sciencedirect.com/science/article/abs/pii/S2468749919300146|journal=European Journal of Trauma & Dissociation|language=en|volume=4|issue=4|pages=100112|doi=10.1016/j.ejtd.2019.05.005|issn=2468-7499|last1=Dragan|first1=Małgorzata|last2=Kowalski|first2=Joachim|s2cid=189978940|url-access=subscription}}</ref> This ultimately develops through the client's own beliefs. [[Metacognitive therapy]] attempts to correct this change in the CAS. One of the techniques in this model is called attention training (ATT).<ref>{{cite journal | last1 = Wells | first1 = A | year = 1990 | title = Panic disorder in association with relaxation-induced anxiety: An attentional training approach to treatment | journal = Behaviour Therapy | volume = 21 | issue = 3| pages = 273–280 | doi=10.1016/s0005-7894(05)80330-2| doi-access = free }}</ref><ref>{{Cite journal|date=2020-09-01|title=Effects of attention training technique on brain function in high- and low-cognitive-attentional syndrome individuals: Regional dynamics before, during, and after a single session of ATT|url=https://www.sciencedirect.com/science/article/abs/pii/S0005796720301479|journal=Behaviour Research and Therapy|language=en|volume=132|pages=103693|doi=10.1016/j.brat.2020.103693|issn=0005-7967|last1=Kowalski|first1=Joachim|last2=Wierzba|first2=Małgorzata|last3=Wypych|first3=Marek|last4=Marchewka|first4=Artur|last5=Dragan|first5=Małgorzata|pmid=32688045|s2cid=220669531|url-access=subscription}}</ref> It was designed to diminish the worry and anxiety by a sense of control and cognitive awareness. ATT also trains clients to detect threats and test how controllable reality appears to be.<ref>{{cite journal | last1 = Wells | first1 = A. | last2 = Fisher | first2 = P. | last3 = Myers | first3 = S. | last4 = Wheatley | first4 = J. | last5 = Patel | first5 = T. | last6 = Brewin | first6 = C. R. | year = 2009 | title = Metacognitive therapy in recurrent and persistent depression: A multiple-baseline study of a new treatment | journal = Cognitive Therapy and Research | volume = 33 | issue = 3| pages = 291–300 | doi = 10.1007/s10608-007-9178-2 | s2cid = 2504312 }}</ref>

Following the work of Asher Koriat,<ref>{{Cite journal |last=Koriat |first=Asher |date=2019 |title=Confidence judgments: The monitoring of object-level and same-level performance |url=http://link.springer.com/10.1007/s11409-019-09195-7 |journal=Metacognition and Learning |language= |volume=14 |issue=3 |pages=463–478 |doi=10.1007/s11409-019-09195-7|s2cid=201392935 |url-access=subscription }}</ref> who regards [[confidence]] as central aspect of metacognition, [[metacognitive training]] for psychosis aims at decreasing overconfidence in patients with [[schizophrenia]] and raising awareness of [[cognitive bias]]es. According to a [[meta-analysis]],<ref>{{Cite journal |last1=Penney |first1=Danielle |last2=Sauvé |first2=Geneviève |last3=Mendelson |first3=Daniel |last4=Thibaudeau |first4=Élisabeth |last5=Moritz |first5=Steffen |last6=Lepage |first6=Martin |date=2022-03-23 |title=Immediate and Sustained Outcomes and Moderators Associated With Metacognitive Training for Psychosis: A Systematic Review and Meta-analysis |url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2790555 |journal=JAMA Psychiatry |volume=79 |issue=5 |pages=417–429 |language=en |doi=10.1001/jamapsychiatry.2022.0277 |issn=2168-622X |pmc=8943641 |pmid=35320347}}</ref> this type of intervention improves [[delusion]]s and [[hallucination]]s.