Relationship between self-reflectivity, Theory of Mind, neurocognition, and global functioning: An investigation of schizophrenic disorder

Background: People with schizophrenia show impairments in metacognitive. function, including awareness and monitoring of one’s mental processes (Self-Reflectivity (SR)), recognition of the fallibility of one’s thoughts, and the. ability to infer others’ emotions and intentions (Theory of Mind (ToM)). The. aim of the present study was to explore whether SR and ToM play a key role. in influencing the global functioning of persons affected by schizophrenia.. Methods: Twenty persons with schizophrenia were recruited before hospital. discharge and compared with 17 controls. Clinical, neurocognitive, and global. functioning assessments were performed. The Beck Cognitive Insight Scale. was used to assess: (1) Self-Reflectiveness, which allows subjects with psychosis. to objectively observe their cognitive distortions, and (2) Self-Certainty,. which reflects rigid confidence in their own beliefs (over-confidence). ToM. assessment included verbal and non-verbal measures.. Results: Our study confirms the semi-independent nature of the metacognitive. functions of ToM abilities and the cognitive insight domain. In fact, by. multiple regression model analyses, only the Self-Reflectiveness deficit was. found to be the best predictor of low global functioning in schizophrenia and. represents a target for rehabilitation interventions to remediate the processes. that cause fallible interpretations of daily events.. Conclusions: Our results encourage a new trend in the cognitive-behaviour. therapy of schizophrenia to be complemented with metacognitive approaches.